Department of Sport and Exercise Sciences, Sport, Exercise and Wellbeing Research Centre, Faculty of Health and Life Sciences, Northumbria University, Northumberland Road, Newcastle upon Tyne, NE1 8ST, UK.
Sports Med. 2013 Jun;43(6):413-24. doi: 10.1007/s40279-013-0044-y.
Effective regulation of pace enables the majority of runners to complete competitive endurance events without mishap. However, some runners do experience exercise-induced collapse associated with postural hypotension, which in rare cases results from life-threatening conditions such as cardiac disorders, cerebral events, heat stroke and hyponatraemia. Despite the experience of either catastrophic system failure or extreme peripheral muscle fatigue, some runners persist in attempting to reach the finish line, and this often results in a sequence of dynamic changes in posture and gait that we have termed the 'Foster collapse positions'. The initial stage involves an unstable gait and the runner assumes the 'Early Foster' collapse position with hips slightly flexed and their head lowered. This unstable gait further degrades into a shuffle referred to as the 'Half Foster' collapse position characterized by hip flexion of approximately 90° with the trunk and head parallel to the ground. At this point, the muscles of postural support and the co-ordination of propulsion begin to be compromised. If the condition worsens, the runner will fall to the ground and assume the 'Full Foster' collapse position, which involves crawling forwards on knees and elbows towards the finish line, with their trunk angled such that the head is at a lower angle than the hips. Upon reaching the finish line, or sometimes before that, the runner may collapse and remain prone until recovering either with or without assistance or medical treatment. The Foster collapse positions are indicative of a final, likely primordial, protective mechanism designed to attenuate postural hypotension, cardiac 'pump' insufficiency or cerebral blood flow deficiency. Continuing to attempt to reach the finish line in this impaired state is also perhaps indicative of a high psychological drive or a variety of neurological and psychological pathologies such as diminished sensitivity to interoceptive feedback, unrealistic situational appraisal or extreme motivational drives. A better understanding of the physiological, neurological and psychological antecedents of the Foster collapse sequence remains an important issue with practical implications for runner safety and theoretical understanding of collapses during exercise.
有效的步伐调节可使大多数跑步者顺利完成竞技耐力赛事。然而，有些跑步者确实会经历与体位性低血压相关的运动性崩溃，在极少数情况下，这种情况是由危及生命的疾病引起的，如心脏疾病、脑部事件、中暑和低钠血症。尽管跑步者经历了灾难性的系统故障或极端外周肌肉疲劳，但有些人仍坚持试图到达终点线，这通常会导致姿势和步态的一系列动态变化，我们称之为“福斯特崩溃姿势”。初始阶段涉及不稳定的步态，跑步者采取“早期福斯特”崩溃姿势，臀部略微弯曲，头部低垂。这种不稳定的步态进一步恶化，变成一种被称为“半福斯特”崩溃姿势的拖曳步态，其特点是髋关节弯曲约 90°，躯干和头部与地面平行。此时，姿势支撑肌肉和推进协调开始受到影响。如果情况恶化，跑步者将摔倒在地，并采取“完全福斯特”崩溃姿势，即膝盖和肘部着地向前爬行靠近终点线，躯干倾斜，使头部低于臀部。到达终点线后，跑步者可能会摔倒并保持俯卧姿势，直到在有或没有帮助或医疗治疗的情况下恢复。福斯特崩溃姿势是一种最终的、可能是原始的保护机制，旨在减轻体位性低血压、心脏“泵”功能不足或大脑血流不足。在这种受损状态下继续试图到达终点线，也可能表明存在高度的心理驱动力，或者存在各种神经和心理病理，如对内脏反馈的敏感性降低、对情境的不切实际评估或极端的动机驱动。更好地理解福斯特崩溃序列的生理、神经和心理前提，对于跑步者的安全和对运动中崩溃的理论理解具有重要的实际意义。
