University of Groningen, University Medical Center Groningen, Center for Human Movement Science, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran.
University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.
Gait Posture. 2021 Jan;83:201-209. doi: 10.1016/j.gaitpost.2020.10.032. Epub 2020 Nov 3.
Atypical rearfoot eversion is an important kinematic risk factor in running-related injuries. Prominent interventions for atypical rearfoot eversion include foot orthoses, footwear, and taping, yet a running gait retraining is lacking. Therefore, the aim was to investigate the effects of changing mediolateral center of pressure (COP) on rearfoot eversion, subtalar pronation, medial longitudinal arch angle (MLAA), hip kinematics and vertical ground reaction force (vGRF).
Fifteen healthy female runners underwent gait retraining under three conditions. Participants were instructed to run normally, on the lateral (COP lateral) and medial (COP medial) side of the foot. Foot progression angle (FPA) was controlled using real-time visual feedback. 3D measurements of rearfoot eversion, subtalar pronation, MLAA, FPA, hip kinematics, vGRF and COP were analyzed. A repeated-measures ANOVA followed by pairwise comparisons was used to analyze changes in outcome between three conditions. Data were also analyzed using statistic parameter mapping.
Running on the lateral side of the foot compared to normal running and running on the medial side of the foot reduced peak rearfoot eversion (mean difference (MD) with normal 3.3°, p < 0.001, MD with COP medial 6°, p < 0.001), peak pronation (MD with normal 5°, p < 0.001, MD with COP medial 9.6°, p=<0.001), peak MLAA (MD with normal 2.3°, p < 0.001, MD with COP medial 4.1°, p < 0.001), peak hip internal rotation (MD with normal 1.8°, p < 0.001), and peak hip adduction (MD with normal running 1°, p = 0.011). Running on the medial side of the foot significantly increased peak rearfoot eversion, pronation and MLAA compared to normal running.
This study demonstrated that COP translation along the mediolateral foot axis significantly influences rearfoot eversion, MLAA, and subtalar pronation during running. Running with either more lateral or medial COP reduced or increased peak rearfoot eversion, peak subtalar pronation, and peak MLAA, respectively, compared to normal running. These results might use as a basis to help clinicians and researchers prescribe running gait retraining by changing mediolateral COP for runners with atypical rearfoot eversion or MLAA.
非典型的后足外翻是与跑步相关损伤的一个重要运动学风险因素。针对非典型后足外翻的主要干预措施包括足矫形器、鞋类和贴扎，但缺乏跑步步态再训练。因此，本研究旨在探讨改变中心脚压（COP）的侧向位置对后足外翻、距下关节内翻、内侧纵弓角度（MLAA）、髋关节运动学和垂直地面反作用力（vGRF）的影响。
15 名健康女性跑步者在三种情况下接受了步态再训练。参与者被指示正常跑步、在脚的外侧（COP 外侧）和内侧（COP 内侧）跑步。使用实时视觉反馈控制足前进步角（FPA）。分析后足外翻、距下关节内翻、MLAA、FPA、髋关节运动学、vGRF 和 COP 的三维测量值。采用重复测量方差分析（ANOVA），然后进行两两比较，分析三种情况下结果的变化。还使用统计参数映射（statistic parameter mapping）对数据进行分析。
与正常跑步和在脚的内侧跑步相比，脚的外侧跑步可显著降低峰值后足外翻（与正常跑步相比的平均差异（MD）为 3.3°，p<0.001，与 COP 内侧跑步相比的 MD 为 6°，p<0.001）、峰值距下关节内翻（与正常跑步相比的 MD 为 5°，p<0.001，与 COP 内侧跑步相比的 MD 为 9.6°，p<0.001）、峰值 MLAA（与正常跑步相比的 MD 为 2.3°，p<0.001，与 COP 内侧跑步相比的 MD 为 4.1°，p<0.001）、峰值髋关节内旋（与正常跑步相比的 MD 为 1.8°，p<0.001）和峰值髋关节内收（与正常跑步相比的 MD 为 1°，p=0.011）。脚的内侧跑步与正常跑步相比，显著增加了峰值后足外翻、距下关节内翻和 MLAA。
本研究表明，COP 在足的内外侧沿额状面轴的平移显著影响跑步时的后足外翻、MLAA 和距下关节内翻。与正常跑步相比，用更外侧或更内侧的 COP 跑步时，后足外翻、距下关节内翻和 MLAA 的峰值分别降低或增加。这些结果可能有助于临床医生和研究人员通过改变有非典型后足外翻或 MLAA 的跑步者的内外侧 COP 来制定跑步步态再训练方案。
