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COMPARISON OF CLINICAL AND BIOMECHANICAL METRICS FOLLOWING GAIT RETRAINING FOR RUNNING-RELATED INJURY IN MILITARY PERSONNEL

Abstract

BACKGROUND: All Military Service Members (MSMs) are required to run in accordance with their work; addressing running mechanics (i.e., gait retraining) could provide a means to reduce running-related injury rates and/or improve clinical outcomes post-injury. Prior research has identified biomechanical patterns during running associated with increased injury risk. Troublingly, MSMs need access to laboratory-grade running evaluations. However, the advent of telehealth in health care offers a potential means to incorporate gait retraining to address running-related injury risk within the MSM population. METHODS: After a physical therapy referral for running-related knee pain, 25 MSMs were recruited to participate. Participants received standard physical therapy (Control, n=13) or supplemental telehealth gait retraining consisting of video feedback regarding running form over a cloud-based coaching platform (Telehealth, n=12) for 8 weeks. Kinetic (peak ground reaction force (GRF), AVLR) and spatiotemporal (contact time, cadence) variables were collected while running on a treadmill at baseline and following the conclusion of the intervention. Participants also provided reports of their pain ranging from 0 (absent) to 100 (severe). Biomechanical variables were assessed using 2x2 mixed-design ANOVAs, whereas changes in pain scores between groups were assessed via independent t-test. RESULTS: There were no between-group differences in participant demographics, pain, or running parameters at baseline (p<.05). There was an observed main effect for time for all participants for pain during running (p<0.001), but no interaction effect between groups. Despite not reaching statistical significance, moderate to large effect sizes were observed as the Telehealth group displayed greater magnitude improvements in cadence (mean difference= 18.78 steps/min, d=0.553), AVLR (mean difference=10.75 body weights/s, d=0.902), and contact time (mean difference=18.55 ms, d=0.578) compared to the Control group. No significant differences or effect sizes were observed for changes in reported pain (mean difference= 4.18, d=0.152) CONCLUSIONS: Telehealth gait retraining influenced gait parameters conducive to running-related injury in MSMs similar to standard care. Potentially clinically meaningful cadence, AVLR, and contact time improvements were observed in the Telehealth group; further research with larger samples is indicated.

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