A Prospective Cohort Study to Predict Running-Related Lower Limb Sports Injuries Using Gait Kinematic Parameters
The study purpose was to follow a prospective cohort study design to use gait kinematic parameters to identify the risk factors and to develop a statistical model to predict running-related lower limb injuries of sportspersons.
Materials and methods. BTS G-WALK® gait analysis system was used to collect gait kinematic data of 87 subjects from an institute of physical education and sports science.
The subjects were followed for a full academic season after which the researcher inquired about their injury occurrences. Binary logistic regression was used to develop a prediction model to predict lower limb injuries of sportspersons.
Results. The result of the study revealed that increasing Range of Obliquity, Range of Tilt and Range of Rotation were associated with increased likelihood of future running-related lower limb injury. However, the lower Symmetry Index was associated with increase in the likelihood of future running-related lower limb injury.
Conclusions. The study confirmed that it is possible to predict injury, but for practical implication further research is essential with a bigger sample size.
Bahr, R., & Krosshaug, T. (2005). Understanding injury mechanisms: A key component of preventing injuries in sport. British Journal of Sports Medicine, 39(6), 324-329. https://doi.org/10.1136/bjsm.2005.018341
McCrory, P. (2006). What is sports and exercise medicine? British Journal of Sports Medicine, 40(12), 955-957.
Verhagen, E., & Mechelen, W. V. (2010). Sports Injury Research. OXFORD University Press.
Bahr, Roald, McCrory, P., LaPrade, R. F., Meeuwisse, W., & Engebretsen, L. (2012). The IOC Manual of Sports Injuries: An Illustrated Guide to the Management of Injuries in Physical Activity. International Olympic Committee.
Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery From Injury in Sport: Considerations in the Transition From Medical Care to Performance Care. Sports Health, 1(5), 392-395. https://doi.org/10.1177/1941738109343156
Saragiotto, B. T., Pierro, C. D., & Lopes, A. D. (2014). Risk factors and injury prevention in elite athletes: A descriptive study of the opinions of physical therapists, doctors and trainers. Brazilian Journal of Physical Therapy, 18(2), 137-143. http://dx.doi.org/10.1590/S1413-35552012005000147
Knight, K. L. (2008). More precise classification of orthopaedic injury types and treatment will improve patient care. Journal of Athletic Training, 43(2), 117-118. https://doi.org/10.4085/1062-6050-43.2.117
Slobounov, S. (2008). Injuries In Athletics: Causes and Consequences. Springer.
Harris-Hayes, M., Czuppon, S., Dillen, L. R. V., Steger-May, K., Sahrmann, S., Schootman, M., Salsich, G. B., Clohisy, J. C., & Mueller, M. J. (2016). Movement-Pattern Training to Improve Function in People With Chronic Hip Joint Pain: A Feasibility Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 46(6), 452-461. https://www.jospt.org/doi/10.2519/jospt.2016.6279
Zhang, X., Aeles, J., & Vanwanseele, B. (2017). Comparison of foot muscle morphology and foot kinematics between recreational runners with normal feet and with asymptomatic over-pronated feet. Gait & Posture, 54, 290-294. https://doi.org/10.1016/j.gaitpost.2017.03.030
Powell, J. W., & Barber-Foss, K. D. (1999). Injury Patterns in Selected High School Sports: A Review of the 1995-1997 Seasons. Journal of Athletic Training, 34(3), 277-284.
Sorenson, E. A. (2009). Functional movement screen as a predictor of injury in high school basketball athletes [Doctoral Dissertation, University of Oregon Graduate School]. https://core.ac.uk/download/pdf/36685232.pdf
Kruse, D., & Lemmen, B. (2009). Spine Injuries in the Sport of Gymnastics. Current Sports Medicine Reports, 8(1), 20-28. https://doi.org/10.1249/JSR.0b013e3181967ca6
Mokha, M., Sprague, P. A., & Gatens, D. R. (2016). Predicting Musculoskeletal Injury in National Collegiate Athletic Association Division II Athletes From Asymmetries and Individual-Test Versus Composite Functional Movement Screen Scores. Journal of Athletic Training, 51(4), 276-282. https://doi.org/10.4085/1062-6050-51.2.07
Springer, S., Gottlieb, U., & Lozin, M. (2016). Spatiotemporal Gait Parameters as Predictors of Lower-Limb Overuse Injuries in Military Training. The Scientific World Journal, 1–5. https://doi.org/10.1155/2016/5939164
Azzam, M., Throckmorton, T. W., Smith, R. A., Graham, D., Scholler, J., & Azar, F. M. (2015). The Functional Movement Screen as a predictor of injury in professional basketball players. Current Orthopaedic Practice, 26(6), 619-623. https://doi.org/10.1097/BCO.0000000000000296
Whittaker, J. L., Booysen, N., Motte, S. de la, Dennett, L., Lewis, C. L., Wilson, D., McKay, C., Warner, M., Padua, D., Emery, C. A., & Stokes, M. (2017). Predicting Sport and Occupational Lower Extremity Injury Risk through Movement Quality Screening: A Systematic Review. British Journal of Sports Medicine, 51(7), 580-585.
Johnson, L. L., Borkowf, C. B., & Shaw, P. A. (2012). Hypothesis Testing. In Principles and Practice of Clinical Research (3rd ed., pp. 255–270). Elsevier. https://doi.org/10.1016/B978-0-12-382167-6.00021-7
Verma, J. P. (2013). Data Analysis in Management with SPSS Software. Springer.
Steyerberg, E. W. (2009). Clinical Prediction Models: A Practical Approach to Development, Validation, and Updating. Springer.
Mann, C. J. (2012). Observational research methods—Cohort studies, cross sectional studies, and case–control studies. African Journal of Emergency Medicine, 2(1), 38-46. https://doi.org/10.1016/j.afjem.2011.12.004
Rango, P. De. (2016). Prospective Cohort Studies. European Journal of Vascular and Endovascular Surgery, 51(151), 1. http://doi.org/10.1016/j.ejvs.2015.09.021
MacGill, M. (2018). What is a cohort study in medical research? [Commercial]. Medical News Today. https://www.medicalnewstoday.com/articles/281703
Setia, M. S. (2016). Methodology Series Module 1: Cohort Studies. Indian Journal of Dermatology, 61(1), 21-25. https://doi.org/10.4103/0019-5154.174011
Song, J. W., & Chung, K. C. (2010). Observational Studies: Cohort and Case-Control Studies. Plastic and Reconstructive Surgery, 126(6), 2234-2242. https://doi.org/10.1097%2FPRS.0b013e3181f44abc
Verma, J. P. (2016). Repeated Measures Design for Empirical Researchers. Wiley.
Callahan, L. R. (2020). Overview of running injuries of the lower extremity [Commercial]. UpToDate. https://www.uptodate.com/contents/overview-of-running-injuries-of-the-lower-extremity
Aicale, R., Tarantino, D., & Maffulli, N. (2018). Overuse injuries in sport: A comprehensive overview. Journal of Orthopaedic Surgery and Research, 13, 1-11. https://doi.org/10.1186/s13018-018-1017-5
Hreljac, A. (2004). Impact and Overuse Injuries in Runners. Medicine & Science in Sports & Exercise, 36(5), 845-849. https://doi.org/10.1249/01.MSS.0000126803.66636.DD
Thijs, Y., Tiggelen, D. V., Roosen, P., Clercq, D. D., & Witvrouw, E. (2007). A prospective study on gait-related intrinsic risk factors for patellofemoral pain. Clinical Journal of Sport Medicine, 17(6), 437-445. https://doi.org/10.1097/JSM.0b013e31815ac44f
Willems, T. M., Clercq, D. D., Delbaere, K., Vanderstraeten, G., Cock, A. D., & Witvrouw, E. (2006). A prospective study of gait related risk factors for exercise-related lower leg pain. Gait Posture, 23(1), 91-98. https://doi.org/10.1016/j.gaitpost.2004.12.004
Hamill, J., Palmer, C., & Emmerik, R. E. A. V. (2012). Coordinative variability and overuse injury. Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology, 4:45, 1–9. https://doi.org/10.1186%2F1758-2555-4-45
Ferber, R., Hreljac, A., & Kendall, K. D. (2009). Suspected Mechanisms in the Cause of Overuse Running Injuries A Clinical Review. Sports Health, 1(3), 242-246. https://doi.org/10.1177/1941738109334272
Baker, R. W. (2013). Measuring Walking: A Handbook of Clinical Gait Analysis. Mac Keith Pres.
Kirtley, C. (2006). Clinical Gait Analysis Theory and Practice. Elsevier.
Levine, D., Richards, J., & Whittle, M. W. (2012). Whittle’s Gait Analysis. Elsevier.
Richards, J., Chohan, A., & Erande, R. (2013). Biomechanics. In Tidy’s Physiotherapy (5th ed., pp. 331-368). Churchill Livingstone. https://doi.org/10.1016/B978-0-7020-4344-4.00015-8
Whittle, M. (1991). Gait Analysis: An Introduction. Butterworth-Heinemann.
Messier, S. P., Mihalko, S. L., Ip, E., DeVita, P., Cannon, D. W., Love, M., Beringer, D., Saldana, S., Fellin, R. E., & Seay, J. F. (2018). A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS). The American Journal of Sports Medicine, 46(9), 2211-2221.
Armonk, N. Y. (2017). IBM SPSS (Version 25) [Computer software]. IBM Corporation.
Gogoi, H., Rajpoot, Y. S., & Sajwan, A.S. (2020). Sports Specific Injury Pattern of Sportspersons. International Journal of Human Movement and Sports Sciences, 8(5), 199-210. https://doi.org/10.13189/saj.2020.080507
Bourdon, P. C., Cardinale, M., Murray, A., Gastin, P., Kellmann, M., Varley, M. C., Gabbett, T. J., Coutts, A. J., Burgess, D. J., Gregson, W., & Cable, N. T. (2017). Monitoring Athlete Training Loads: Consensus Statement. International Journal of Sports Physiology and Performance, 12(Suppl 2), S2161-S2170. https://doi.org/10.1123/IJSPP.2017-0208
Burns, G. T., Zendler, J. M., & Zernicke, R. F. (2019). Step frequency patterns of elite ultramarathon runners during a 100-km road race. Journal of Applied Physiology, 126, 462-468. https://doi.org/10.1152/japplphysiol.00374.2018
Kessler, D. F. (2020). Running FASTER: Changing Running Technique to Reduce Stress Injuries. International Journal of Athletic Therapy and Training, 25, 49-53. https://doi.org/10.1123/ijatt.2020-0011
Schubert, A. G., Kempf, J., & Heiderscheit, B. C. (2014). Influence of Stride Frequency and Length on Running Mechanics A Systematic Review. Sports Health, 6(3), 210-217. https://doi.org/10.1177/1941738113508544
Wellenkotter, J., Kernozek, T. W., Meardon, S. A., & Suchomel, T. J. (2014). The Effects of Running Cadence Manipulation on Plantar Loading in Healthy Runners. International Journal of Sports Medicine, 35(9), 1-6. https://doi.org/10.1055/s-0033-1363236
Chumanov, E. S., Heiderscheit, B. C., & Thelen, D. G. (2011). Hamstring Musculotendon Dynamics during Stance and Swing Phases of High Speed Running. Medicine & Science in Sports & Exercise, 43(3), 525-532. https://doi.org/10.1249/MSS.0b013e3181f23fe8
Simonsen, E. B. (2013). Contributions to the understanding of gait control [Thesis, University of Copenhagen].
Benca, E., Listabarth, S., Flock, F. K. J., Pablik, E., Fischer, C., Walzer, S. M., Dorotka, R., Windhager, R., & Ziai, P. (2020). Analysis of Running-Related Injuries: The Vienna Study. Journal of Clinical Medicine, 9, 1-17. http://doi.org/10.3390/jcm9020438
Alizadeh, S., & Mattes, K. (2019). How anterior pelvic tilt affects the lower extremity kinematics during the late swing phase in soccer players while running: A time series analysis. Human Movement Science, 66, 459-466. https://doi.org/10.1016/j.humov.2019.06.001
Mokha, M., & Gatens, D. (2018). Hip and Pelvis Biomechanics during Running as Risk Factors for Injury in Collegiate Runners: A Prospective Study. Journal of Exercise and Nutrition, 1(4), 1-6.
Hughes, T., Sergeant, J. C., Windt, D. A. van der, Riley, R., & Callaghan, M. J. (2018). Periodic Health Examination and Injury Prediction in Professional Football (Soccer): Theoretically, the Prognosis is Good. Sports Medicine, 48, 2443-2448. https://doi.org/10.1007/s40279-018-0928-y
Wilkerson, G. B., Giles, J. L., & Seibel, D. K. (2012). Prediction of Core and Lower Extremity Strains and Sprains in Collegiate Football Players: A Preliminary Study. Journal of Athletic Training, 47(3), 264-272. https://doi.org/10.4085/1062-6050-47.3.17
This work is licensed under a Creative Commons Attribution 4.0 International License.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).