ORCID Profile
0000-0003-0633-2113
Current Organisations
Curtin University
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Curtin University School of Allied Health
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Publications
Immediate effects of modified landing pattern on a probabilistic tibial stress fracture model in runners
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.CLINBIOMECH.2016.02.013
Abstract: Tibial stress fracture is a common injury in runners. This condition has been associated with increased impact loading. Since vertical loading rates are related to the landing pattern, many heelstrike runners attempt to modify their footfalls for a lower risk of tibial stress fracture. Such effect of modified landing pattern remains unknown. This study examined the immediate effects of landing pattern modification on the probability of tibial stress fracture. Fourteen experienced heelstrike runners ran on an instrumented treadmill and they were given augmented feedback for landing pattern switch. We measured their running kinematics and kinetics during different landing patterns. Ankle joint contact force and peak tibial strains were estimated using computational models. We used an established mathematical model to determine the effect of landing pattern on stress fracture probability. Heelstrike runners experienced greater impact loading immediately after landing pattern switch (P 0.986). Immediate transitioning of the landing pattern in heelstrike runners may not offer timely protection against tibial stress fracture, despite a reduction of impact loading. Long-term effects of landing pattern switch remains unknown.
Type effect of inhibitory KT tape on measured vs. perceived maximal grip strength
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JBMT.2017.10.011
Abstract: This study examined the effects of KT tape (KT) applied in an inhibitory manner on muscle activity, measured maximal grip strength, and perceived maximal grip strength in regular KT-users and non-users. This study was a single-blinded crossover study with sixty participants including 27 kT-users and 33 non-users. Participants underwent maximal grip strength tests with and without inhibitory KT applied across the wrist extensors. Muscle activity and maximal grip strength were measured, while perceived maximal grip strength was rated using a visual analogue scale. No significant interaction effect was found between taping conditions and participant KT-experience for muscle activity (F = 0.825, p = 0.367), measured grip strength (F = 1.018, p = 0.317) or perceived grip strength (F = 0.122, p = 0.728). No significant differences were observed in the EMG activity between taping conditions for either KT-users (p = 0.367) or non-users (p = 0.215). A similar trend was found in the measured grip strength (KT-users: p = 0.317 non-users: p = 0.294) and perceived grip strength (KT-users: p = 0.728 non-users: p = 0.063). KT applied in an inhibitory manner does not impede EMG activity, measured maximal grip strength, or perceived maximal grip strength in adults, regardless of their preconceived notions of KT.
Immediate and short-term biomechanical adaptation of habitual barefoot runners who start shod running
Publisher: Informa UK Limited
Date: 18-04-2018
DOI: 10.1080/02640414.2017.1313997
Abstract: This study investigated the immediate and short-term effects of minimalist shoes (MS) and traditional running shoes (TRS) on vertical loading rates, foot strike pattern and lower limb kinematics in a group of habitual barefoot runners. Twelve habitual barefoot runners were randomly given a pair of MS or TRS and were asked to run with the prescribed shoes for 1 month. Outcome variables were obtained before, immediate after and 1 month after shoe prescription. Average and instantaneous vertical loading rates at the 1-month follow-up were significantly higher than that at the pre-shod session (P < 0.034, η
Comparison of the correlations between impact loading rates and peak accelerations measured at two different body sites: Intra- and inter-subject analysis
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.GAITPOST.2016.02.002
Abstract: High average (VALR) and instantaneous vertical loading rates (VILR) during impact have been associated with many running-related injuries. Peak acceleration (PA), measured with an accelerometer, has provided an alternative method to estimate impact loading during outdoor running. This study sought to compare both intra- and inter-subject correlations between vertical loading rates and PA measured at two body sites during running. Ground reaction force data were collected from 10 healthy adults (age=23.6±3.8 years) during treadmill running at different speeds and inclination surfaces. Concurrently, PAs at the lateral malleoli and the distal tibia were measured using synchronized accelerometers. We found significant positive intra-subject correlation between loading rates and PA at the lateral malleoli (r=0.561-0.950, p<0.001) and the distal tibia (r=0.486-0.913, p<0.001). PA measured at the lateral malleoli showed stronger correlation with loading rates (p=0.004) than the measurement at the distal tibia. On the other hand, inter-subject variances were observed in the association between PA and vertical loading rates. The inter-subject variances at the distal tibia were 3.88±3.09BW/s and 5.69±3.05BW/s in VALR and VLIR respectively. Similarly, the inter-subject variances in the measurement at lateral malleoli were 5.24±2.85BW/s and 6.67±2.83BW/s in VALR and VLIR respectively. PA measured at lateral malleoli has stronger correlation with VALR or VILR than the measurement at distal tibia. Caution is advised when using PA to conduct inter-subject comparisons of vertical loading rates during running.
Can runners maintain a newly learned gait pattern outside a laboratory environment following gait retraining?
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.GAITPOST.2019.01.014
Abstract: Previous peak tibial shock gait retraining programs, which were usually conducted on a treadmill, were reported to be effective on impact loading reduction in runners. However, whether the trained runners can translate the training effect at different running modes (treadmill/overground), or running slopes (uphill/downhill), remains unknown. Is the training effect from a treadmill-based gait retraining translatable to unconstrained running conditions, including overground and uphill/downhill running? The peak tibial shock was measured during treadmill/overground running, as well as level/uphill/downhill running before and after a course of treadmill-based gait retraining. The 8-session training aimed to soften footfalls using real-time biofeedback of tibial shock data. Repeated measures ANOVA was used to examine the effect of training, running mode, and running slope, on a group level. Reliable change index of each participant was used to assess the in idual response to the training protocol used in this study. Eighty percent of the participants were responsive to the gait retraining and managed to reduce their peak tibial shock following training. They managed to translate the training effect to treadmill slope running (Level: p < 0.05, Cohen's d = 1.65 Uphill: p = 0.001, Cohen's d = 0.91 Downhill: p < 0.05 Cohen's d = 1.29) and overground level running (p = 0.014, Cohen's d = 0.85). However, their peak tibial shock were not reduced during overground slope running (Uphill: p = 0.054 Cohen's d = 0.62 Downhill p = 0.12 Cohen's d = 0.48). Our findings indicated that a newly learned gait pattern may not fully translate to running outside of the laboratory environment.
Immediate and short-term effects of gait retraining on the knee joint moments and symptoms in patients with early tibiofemoral joint osteoarthritis: a randomized controlled trial
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.JOCA.2018.07.011
Abstract: To evaluate the effectiveness of a knee adduction moment (KAM) gait retraining in patients with early knee osteoarthritis up to 6 months post-training. We conducted a single blinded randomized controlled trial on a total of 23 patients with early knee osteoarthritis who were randomly allocated to the gait retraining group and walking exercise group. Twenty of them completed the corresponding training and the 6-month evaluation. We measured KAM, knee flexion moment (KFM) and western ontario and McMaster universities osteoarthritis index (WOMAC) osteoarthritis index before, immediate after, and 6 months after training. A repeated measures analysis of covariance (ANCOVA) was used to compare KAM, KFM and WOMAC osteoarthritis index scores across the three time points i.e., pre-training, post-training, and 6-month follow-up with gender, knee osteoarthritis severity, and pre-training KAM, KFM and WOMAC scores set as covariates. Post-hoc analyses were conducted when indicated. Significant time × group interactions were found for both KAM and WOMAC osteoarthritis index scores (P < 0.002). No interaction was found for KFM (P = 0.123). KAM after gait retraining was significantly lower than the pre-training value (P 0.208). WOMAC osteoarthritis index score after training and score at the 6-month follow-up were significantly improved in the gait retraining group (P = 0.001), while the WOMAC osteoarthritis index score remained similar. Gait retraining is an effective intervention to reduce KAM during walking and to improve the symptoms of patients with early knee osteoarthritis in short term.
Biomechanical effects following footstrike pattern modification using wearable sensors
Publisher: Elsevier BV
Date: 2021
Biomechanical outcomes due to impact loading in runners while looking sideways
Publisher: Human Kinetics
Date: 12-2018
Abstract: A stable gaze is necessary to optimize visual conditions during running. Head accelerations generally remain stable when looking in front however, it is unclear if this response is similar when the head is turned sideways, and whether other adaptive strategies are present to maintain this stability. The purpose of this study, therefore, was to examine whether runners maintained stable head accelerations while gazing at fixed targets in front and to their sides. The authors collected biomechanical data from 13 runners as they directed their gaze to visual targets located in front, 45°, and 90° to the sides at a random sequence. Vertical head and tibial accelerations were the primary outcome measures, while vertical loading rate, footstrike angle, contact time, stride length, and stride rate were the secondary measures. A reduction in vertical head accelerations was found in the rightmost direction ( P = .04), while an increase in vertical tibial accelerations was found on the same direction ( P = .02). No other significant differences were observed for the other variables. The results of this study suggest that the tibia accommodated the increased shock to maintain head stability.
Walking with head-mounted virtual and augmented reality devices: Effects on position control and gait biomechanics
Publisher: Public Library of Science (PLoS)
Date: 04-12-2019
Does maximalist footwear lower impact loading during level ground and downhill running?
Publisher: Informa UK Limited
Date: 24-05-2018
DOI: 10.1080/17461391.2018.1472298
Abstract: A new model of running shoes which features an extreme cushioning and an oversized midsole, known as the maximalist (MAX) was launched. This design claims to provide excellent shock absorption, particularly during downhill running. This study sought to assess the effects of MAX on the external impact loading, footstrike pattern, and stride length during level ground and downhill running on an instrumented treadmill. Twenty-seven distance runners completed four 5-minute running trials in the two footwear conditions (MAX and traditional running shoes (TRS)) on a level surface (0%) and downhill (10%-declination). Average and instantaneous loading rates (ILRs), footstrike pattern and stride length were measured during the last minute of each running trial. A 12% greater ILR was observed in downhill running with MAX (p = .045 Cohen's d = 0.44) as compared to TRS. No significant difference was found in the loading rates (p > .589) and stride length (p = .924) when running on a level surface. Majority of runners maintained the same footstrike pattern in both footwear conditions. Findings of this study suggested that MAX might not reduce the external impact loading in runners during level and downhill treadmill running. Instead, this type of footwear may conceivably increase the external impact loading during downhill treadmill running.
Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial
Publisher: SAGE Publications
Date: 24-10-2018
Abstract: The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury. To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period. Randomized controlled trial Level of evidence, 1. A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants’ running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform. A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group ( P .001, Cohen’s d 0.99), whereas the loading rates were either similar or slightly increased in the control group after training ( P = .001 to 0.461, Cohen’s d = 0.03 to −0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls. A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification. HKUCTR-1996 (University of Hong Kong Clinical Trials Registry).
How do training experience and geographical origin of a runner affect running biomechanics?
Publisher: Elsevier BV
Date: 02-2021
Neurophysiological Correlates of Gait Retraining With Real-Time Visual and Auditory Feedback
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2019
Transfer Learning Effects of Biofeedback Running Retraining in Untrained Conditions
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-04-2019
DOI: 10.1249/MSS.0000000000002007
Abstract: Running gait retraining via peak tibial shock biofeedback has been previously shown to reduce impact loading and mitigate running-related symptoms. In previous research, peak tibial shock is typically measured and trained for one limb at a single constant training speed during all training sessions. The goal of this study was to determine how runners transfer learning in the trained limb to the untrained limb at different unconstrained speeds. Thirteen runners (3 females, age = 41.1 ± 6.9 yr, running experience = 6.8 ± 4.4 yr, weekly running distance = 30.7 ± 22.2 km) underwent running gait biofeedback retraining via continuous tibial acceleration measured at the right distal tibia. Before and after the training, participants were asked to run at their self-selected constrained training speeds (2.8 ± 0.2 m·s −1 ) and at 110% and 90% of the training speed. Pretraining and posttraining peak tibial shock values for each limb were compared. Participants reduced peak tibial shock in the trained limb by 35% to 37% ( P 0.05, Cohen’s d = 0.78–0.85), and in the untrained limb by 20% to 23% ( P 0.05, Cohen’s d = 0.51–0.71) across the three testing speeds. The reduction was not significantly different between the trained and untrained limbs ( P = 0.31–0.79, Cohen’s d = 0.18–0.45). Similarly, there was no difference in peak tibial shock reduction among the three running speeds ( P = 0.48–0.61, Cohen’s d = 0.06–0.45). Participants demonstrated transfer learning effects evidenced by concomitant reduced peak tibial shock in the untrained limb, and the learning effects were retrained when running at a 10% variance of the training speed.
Effects of deceptive footwear condition on subjective comfort and running biomechanics
Publisher: Hindawi Limited
Date: 23-01-2020
DOI: 10.1002/TSM2.135
Measurement agreement between a newly developed sensing insole and traditional laboratory-based method for footstrike pattern detection in runners
Publisher: Public Library of Science (PLoS)
Date: 09-06-2017
A new footwear technology to promote non-heelstrike landing and enhance running performance: Fact or fad?
Publisher: Informa UK Limited
Date: 08-09-2017
DOI: 10.1080/02640414.2016.1224915
Abstract: This study sought to compare the kinetics and kinematics data in a group of habitual shod runners when running in traditional running shoes and newly designed minimalist shoes with lug platform. This novel footwear design claims to simulate barefoot running and reduce energy loss during impact. We compared footstrike angle (FSA), vertical average (VALR) and instantaneous (VILR) loading rates, energy loss and initial vertical stiffness between two shoe conditions. Runners demonstrated a decreased FSA while running in minimalist shoes with lug platform than traditional shoes (P = 0.003 Cohen's d = 0.918). However, we did not observe a landing pattern transition. VALR and VILR between two footwear conditions showed no significant difference (P = 0.191-0.258 Cohen's d = 0.304-0.460). Initial vertical stiffness (P = 0.032 Cohen's d = 0.671) and energy loss (P = 0.044 Cohen's d = 0.578) were greater when running in minimalist shoes with lug platform. The results show that minimalist shoes with lug platform reduce the FSA but may not lead to a landing pattern switch or lower vertical loading rates. Interestingly, the new shoe design leads to a greater energy loss than traditional running shoes, which could be explained by a higher initial vertical stiffness.
Shoe‐mounted accelerometers should be used with caution in gait retraining
Publisher: Wiley
Date: 15-02-2019
DOI: 10.1111/SMS.13396
Abstract: Real-time biofeedback gait retraining has been reported to be an effective intervention to lower the impact loading during gait. While many of the previous gait retraining studies have utilized a laboratory-based setup, some studies used accelerometers affixed at the distal tibia to allow training outside the laboratory environment. However, many commercial sensors for gait modification are shoe-mounted. Hence, this study sought to compare impact loading parameters measured by shoe-mounted and tibia sensors in participants before and after a course of walking or running retraining using signal source from the shoe-mounted sensors. We also compared the correlations between peak positive acceleration measured at shoe (PPA
Impact Loading during Distracted Running before and after Auditory Gait Retraining
Publisher: Georg Thieme Verlag KG
Date: 12-11-2018
DOI: 10.1055/A-0667-9875
Abstract: Visual feedback gait retraining has been reported to successfully reduce impact loading in runners, even when the runners were distracted. However, auditory feedback is more feasible in real life application. Hence, this study compared the peak positive acceleration (PPA), vertical average (VALR) and instantaneous (VILR) loading rate during distracted running before and after a course of auditory feedback gait retraining in 16 runners. The runners were asked to land with softer footfalls with and without auditory feedback. Low or high sound pitch was generated according to the impact of particular footfall, when compared with the preset target. Runners then received a course of auditory gait retraining, and after the gait retraining, runners completed a reassessment. Runners before gait retraining exhibited lower PPA, VALR and VILR with augmented auditory feedback (p .049). We found a reduction in PPA, VALR and VILR after gait retraining, regardless of the presence of feedback (p .018). However, runners after gait retraining did not demonstrate further reduction in PPA and VALR with auditory feedback (p .104). A small effect of auditory feedback on VILR in runners after gait retraining was observed (p=0.032). Real time auditory feedback gait retraining is effective in impact loading reduction, even when the runners were distracted.
Running biomechanics before and after Pose® method gait retraining in distance runners.
Publisher: Informa UK Limited
Date: 31-07-2021
DOI: 10.1080/14763141.2019.1624812
Abstract: Pose® Method gait retraining has been claimed to modify running form and prevent injury. This study examined the running biomechanics before and after Pose® Method gait retraining. Fourteen runners underwent a 4-week Pose® Method gait retraining program delivered by a certified coach. Paired t-tests were employed to compare vertical average (VALR) and instantaneous loading rates (VILR), lower limb kinematics, footstrike angle and trunk flexion in the sagittal plane before and after the training. Kinetically, there were no significant differences in the VALR (
Effects of Kinesio tape in individuals with lateral epicondylitis: A deceptive crossover trial
Publisher: Informa UK Limited
Date: 12-09-2017
DOI: 10.1080/09593985.2017.1359871
Abstract: To determine the true and immediate effect of applying Kinesio tape (KT) on the pain intensity, pain-free grip strength, maximal grip strength, and electromyographic activity with facilitatory KT, inhibitory KT, sham KT, and untaped condition in patients with lateral epicondylitis (LE) who were ignorant about KT. Deceptive crossover trial. Thirty-three patients with unilateral chronic LE who were ignorant about KT, 30 of them were successfully deceived in this study. Patients were randomly allocated into different sequences of four taping conditions: facilitatory KT, inhibitory KT, sham KT, and untaped condition. Pain intensity, pain-free grip strength, maximal grip strength, and electromyographic activity of wrist extensor muscles were assessed immediately after each tape application. No significant differences in the pain intensity (p = 0.321, η Neither facilitatory nor inhibitory effects were observed between different application techniques of KT in patients with LE. Hence, alternative intervention should be used to manage LE.
Facilitatory and inhibitory effects of Kinesio tape: Fact or fad?
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.JSAMS.2015.01.010
Abstract: Kinesio tape (KT) is a commonly used intervention in sports. It claims to be able to alter the muscle activity, in terms of both facilitation and inhibition, by certain application methods. This study compared the neuromuscular activity of the wrist extensor muscles and maximal grip strength with facilitatory, inhibitory KT, and tapeless condition in healthy adults who were ignorant about KT. Potential placebo effects were eliminated by deception. Randomized deceptive trial. 33 participants performed maximal grip assessment in a randomly assigned order of three taping conditions: true facilitatory KT, inhibitory KT, and no tape. The participants were blindfolded during the evaluation. Under the pretense of applying a series of adhesive muscle sensors, KT was applied to their wrist extensor muscles of the dominant forearm in the first two conditions. Within-subject comparisons of normalized root mean square of the wrist extensors electromyographic activity and maximal grip strength were conducted across three taping conditions. 31 out of 33 enlisted participants were confirmed to be ignorant about KT. No significant differences were found in the maximum grip strength (p=0.394), electromyographic activity (p=0.276), and self-perceived performance (p=0.825) between facilitatory KT, inhibitory KT, and tapeless conditions. Neither facilitatory nor inhibitory effects were observed between different application techniques of KT in healthy participants. Clinically, alternative method should be used for muscle activity modulation.
Placebo effect of facilitatory Kinesio tape on muscle activity and muscle strength
Publisher: Informa UK Limited
Date: 20-02-2019
DOI: 10.1080/09593985.2018.1441936
Abstract: Kinesio tape (KT) is claimed to be able to facilitate muscle activation and promote muscle strength. Previous studies have proposed that placebo effect could be a major attributing factor. This study sought to compare the effects of facilitatory KT on muscle activity and performance between regular KT-users and non-users. Sixty participants, including 27 regular KT-users and 33 non-users, performed maximal grip assessment with and without facilitatory KT, which was applied to their wrist extensor muscles of the dominant forearm from the direction of origin to insertion at 75% of its maximal tension. Within-subject comparisons of normalized root mean square of the wrist extensors electromyographic activity, maximal grip strength, and perceived performance were conducted. KT-users showed an increase in grip strength with application of facilitatory KT, when compared to tapeless condition (p = 0.030, Cohen's d = 0.16). Non-users demonstrated similar grip strength with and with KT application (p = 0.232). No significant differences were found in the muscle activity (p > 0.198) and perceived performance (p > 0.400) in both groups. Facilitatory KT promotes maximal grip strength only among regular KT users, but its effect is trivial. Interestingly, such effect is not related to any electrophysiological change in the KT applying muscle, which may indicate an indirect working mechanism leading to the increased grip strength.
Control of impact loading during distracted running before and after gait retraining in runners
Publisher: Informa UK Limited
Date: 03-11-2018
DOI: 10.1080/02640414.2017.1398886
Abstract: Gait retraining using visual biofeedback has been reported to reduce impact loading in runners. However, most of the previous studies did not adequately examine the level of motor learning after training, as the modified gait pattern was not tested in a dual-task condition. Hence, this study sought to compare the landing peak positive acceleration (PPA) and vertical loading rates during distracted running before and after gait retraining. Sixteen recreational runners underwent a two-week visual biofeedback gait retraining program for impact loading reduction, with feedback on the PPA measured at heel. In the evaluation of PPA and vertical loading rates before and after the retraining, the participants performed a cognitive and verbal counting task while running. Repeated measures ANOVA indicated a significant interaction between feedback and training on PPA (F = 4.642 P = 0.048) but not vertical loading rates (F > 1.953 P > 0.067). Pairwise comparisons indicated a significantly lower PPA and vertical loading rates after gait retraining (P 0.68). Visual feedback after gait retraining reduced PPA and vertical loading rates during distracted running (P 0.36). Gait retraining is effective in lowering impact loading even when the runners are distracted. In dual-task situation, visual biofeedback provided beneficial influence on kinetics control after gait retraining.
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