Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.
Am J Sports Med. 2020 Oct;48(12):3072-3080. doi: 10.1177/0363546520950731. Epub 2020 Sep 11.
Inconsistent associations have been reported for impact-related ground reaction force variables and running injuries when grouping all injuries together. However, previous work has shown more consistent associations when focusing on specific injuries.
To compare ground reaction force variables between healthy and injured runners as a group and within specific common injuries.
Controlled laboratory study.
A total of 125 runners presenting with patellofemoral pain, tibial bone stress injury, plantar fasciitis, Achilles tendinopathy, or iliotibial band syndrome and 65 healthy controls completed an instrumented treadmill assessment at a self-selected speed. Impact-related ground reaction force variables included vertical average (VALR) and instantaneous (VILR) load rates, posterior and medial/lateral instantaneous load rates, and vertical stiffness at initial loading (VSIL). Mean comparisons were made between the general and specific injury and control groups (α = .05). Cutoff thresholds were established and evaluated using several criteria.
VALR (+17.5%; < .01), VILR (+15.8%; < .01), and VSIL (+19.7%; < .01) were significantly higher in the overall injured versus control groups. For individual injuries, VALR, VILR, and VSIL were significantly higher for patellofemoral pain (+23.4%-26.4%; < .01) and plantar fasciitis (+17.5%-29.0%; < .01), as well as VSIL for Achilles tendinopathy (+29.4%; < .01). Cutoff thresholds showed better diagnostic criteria for individual versus grouped injuries.
Impact variables (VALR, VILR, and VSIL) were significantly higher when assessing the injured group as a whole. However, these findings were driven by specific injury groups, highlighting the importance of taking an injury-specific approach to biomechanical risk factors for running injury.
These results suggest that practitioners may want to address impact loading in their treatment of injured runners, especially in those with patellofemoral pain and plantar fasciitis.
当将所有损伤归为一组时，与撞击相关的地面反作用力变量与跑步损伤之间的关联并不一致。然而，当聚焦于特定损伤时，之前的研究显示出更一致的关联。
比较健康跑步者和受伤跑步者作为一个整体以及特定常见损伤之间的地面反作用力变量。
对照实验室研究。
共有 125 名患有髌股疼痛综合征、胫骨骨应力性损伤、足底筋膜炎、跟腱炎或髂胫束综合征的跑步者和 65 名健康对照者在自我选择的速度下完成了仪器化跑步机评估。与撞击相关的地面反作用力变量包括垂直平均（VALR）和瞬时（VILR）加载率、后向和内侧/外侧瞬时加载率以及初始加载时的垂直刚度（VSIL）。在一般和特定损伤与对照组之间进行均值比较（α=0.05）。使用几种标准建立和评估了临界值。
与对照组相比，整体损伤组的 VALR（+17.5%；<0.01）、VILR（+15.8%；<0.01）和 VSIL（+19.7%；<0.01）显著更高。对于个别损伤，髌股疼痛（+23.4%-26.4%；<0.01）和足底筋膜炎（+17.5%-29.0%；<0.01）的 VALR、VILR 和 VSIL 以及跟腱炎的 VSIL（+29.4%；<0.01）均显著更高。临界值显示出针对个体与分组损伤的更好的诊断标准。
当整体评估损伤组时，撞击变量（VALR、VILR 和 VSIL）显著更高。然而，这些发现是由特定的损伤组驱动的，突出了对跑步损伤的生物力学危险因素采取特定损伤方法的重要性。
这些结果表明，从业者可能希望在治疗受伤的跑步者时解决撞击负荷问题，特别是在那些患有髌股疼痛综合征和足底筋膜炎的患者中。
