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Sensor-based gait training to reduce contact time for runners with exercise-related lower leg pain: a randomised controlled trial [with consumer summary]
Lempke AFDJ, Stephens SL, Fish PN, Thompson XD, Hart JM, Hryvniak DJ, Rodu JS, Hertel J
BMJ Open Sport & Exercise Medicine 2022;8(4):e001293
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: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To assess the effects of a 4-week randomised controlled trial comparing an outdoor gait-training programme to reduce contact time in conjunction with home exercises (contact time gait-training feedback with home exercises (FBHE)) to home exercises (HEs) alone for runners with exercise-related lower leg pain on sensor-derived biomechanics and patient-reported outcomes. DESIGN: Randomised controlled trial. SETTING: Laboratory and field-based study. PARTICIPANTS: 20 runners with exercise-related lower leg pain were randomly allocated into FBHE (4 male (M), 6 female (F), 23 +/- 4 years, 22.0 +/- 4.3 kg/m2) or HE groups (3 M, 7 F, 25 +/- 5 years, 23.6 +/- 3.9 kg/m2). INTERVENTIONS: Both groups completed eight sessions of HEs over 4 weeks. The FBHE group received vibrotactile feedback through wearable sensors to reduce contact time during outdoor running. PRIMARY AND SECONDARY OUTCOME MEASURES: Patient-reported outcome measures (PROMs) and outdoor gait assessments were conducted for both groups at baseline and 4 weeks. PROMs were repeated at 6 weeks, and feedback retention was assessed at 6 weeks for the FBHE group. Repeated measures analyses of variance were used to assess the influence of group and timepoint on primary outcomes. RESULTS: The FBHE group reported increased function and recovery on PROMs beyond the HE group at 6 weeks (p < 0.001). There was a significant group by time interaction for Global Rating of Change (p = 0.004) and contact time (p = 0.002); the FBHE group reported greater subjective improvement and reduced contact time at 4 and 6 weeks compared with the HE group and compared with baseline. The FBHE group had increased cadence (mean difference: 7 steps/min, p = 0.01) at 4 weeks during outdoor running compared with baseline. CONCLUSION: FBHE was more effective than HE alone for runners with exercise-related lower leg pain, manifested with improved PROMs, reduced contact time and increased cadence.

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