The Effects of Gait Retraining In Runners With Patellofemoral Pain: A randomized trial

• Published in: Clinical biomechanics (Bristol) 2016-06, Vol.35, p.14-22
• Main Authors: Roper, Jenevieve L, Harding, Elizabeth M, Doerfler, Deborah, Dexter, James G, Kravitz, Len, Dufek, Janet S, Mermier, Christine M
• Format: Article
• Language: English
• Subjects: Adult; Ankle Joint - physiology; Biomechanical Phenomena; Biomechanics; Female; Foot - physiology; Gait; Gait - physiology; Humans; Injuries; Injury; Knee; Knee Joint - physiology; Knees; Lower extremity; Male; Pain; Patellofemoral Pain Syndrome - physiopathology; Patellofemoral Pain Syndrome - rehabilitation; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Range of Motion, Articular - physiology; Retraining; Running; Running - injuries; Running - physiology; Strikes; Weight-Bearing - physiology; Young Adult
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2016.03.010

Abstract Background Running popularity has increased resulting in a concomitant increase in running-related injuries. Of these injuries, patellofemoral pain was most commonly reported. The purpose of this study was to determine whether gait retraining by modifying footstrike patterns from rearfoot strike to forefoot strike reduces patellofemoral pain and improves associated biomechanical measures, and whether the modification influences risk of ankle injuries. Methods Sixteen subjects (n = 16) were randomly placed in the control (n = 8) or experimental (n = 8) group. Subsequently, the experimental group performed eight gait retraining running sessions over two weeks where footstrike pattern was switched from rearfoot strike to forefoot strike, while the control group performed eight running sessions with no intervention. Selected kinetic and kinematic variables were recorded pre-, post-, and one-month post-running trials. Findings Knee pain was significantly reduced post-retraining (p < 0.05; effect size = 0.294) and at one-month follow-up (p < 0.05; effect size = 0.294). Knee range of motion was significantly increased post-retraining (p < 0.05; effect size = 0.202). Knee abduction was significantly improved post-retraining (p < 0.05; effect size = 0.291) at one-month follow-up (p < 0.05; effect size = 0.291). Ankle flexion at initial contact was significantly different post-retraining (p < 0.05; effect size = 0.547), as well as ankle range of motion post-retraining (p < 0.05; effect size = 0.425) and one-month follow-up (p < 0.05; effect size = 0.425). Interpretation These findings suggest that running with a forefoot strike pattern leads to reduced knee pain, and should be considered as a possible strategy for management of patellofemoral pain in recreational runners. This trial is registered at the US National Institutes of Health ( clinicaltrials.gov ) #NCT02567123.