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| Progression in running intensity or running volume and the development of specific injuries in recreational runners: Run Clever, a randomized trial using competing risks [with consumer summary] |
| Ramskov D, Rasmussen S, Sorensen H, Parner ET, Lind M, Nielsen R |
| The Journal of Orthopaedic and Sports Physical Therapy 2018 Oct;48(10):740-748 |
| clinical trial |
| 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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STUDY DESIGN: Randomized clinical trial, etiology. BACKGROUND: Training intensity and volume have been proposed to be associated with specific running-related injuries. If such an association exists, secondary preventive measures could be initiated by clinicians based on symptoms of a specific injury diagnosis. OBJECTIVES: To test the following hypotheses: (i) a running schedule focusing on intensity will increase the risk of sustaining Achilles tendinopathy, gastrocnemius injuries and plantar fasciitis compared with hypothesized volume-related injuries. (ii) A running schedule focusing on running volume will increase the risk of sustaining patellofemoral pain syndrome, iliotibial band syndrome and patellar tendinopathy compared with hypothesized intensity-related injuries. METHODS: Healthy recreational runners were included in a 24-week follow-up, divided into 8-week preconditioning and 16-week specific focus-training. Participants were randomized to one of two running schedules: schedule intensity (Sch-I) or schedule volume (Sch-V). Sch-I progressed the amount of high intensity running (>= 88% VO2max) each week. Sch-V progressed total weekly running volume. Global positioning system watch or smartphone collected data on running. Running-related injuries were diagnosed based on a clinical examination. Estimates were risk difference (RD) and 95%CI. RESULTS: Of 447 runners, a total of 80 sustained an injury (Sch-I n = 36; Sch-V n = 44). Risk of intensity injuries in Sch-I were: RD2-weeks -0.8% (-5.0 to 3.4); RD4-weeks -0.8% (-6.7 to 5.1); RD8-weeks -2.0% (-9.2 to 5.1); RD16-weeks -5.1% (-16.5 to 6.3). Risk of volume injuries in Sch-V were: RD2-weeks -0.9% (-5.0 to 3.2); RD4-weeks -2.0% (-7.5 to 3.5); RD8-weeks -3.2% (-9.1 to 2.7); RD16-weeks -3.4% (-13.2 to 6.2). CONCLUSION: No difference in risk of hypothesized intensity and volume specific running-related injuries exist between running schedules focused on progression in either running intensity or volume. LEVEL OF EVIDENCE: Etiology, level 1b.
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