Can plantar pressure patterns predict running injury?

NewsBot · Mar 31, 2016

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Can RSScan footscan software predict injury in a military population following plantar pressure assessment? A prospective cohort study
Andrew Franklyn-Miller, James Bilzon, Cassie Wilson, Paul McCrory
The Foot; Available online 11 November 2013

Background
Injury in initial military training is common with incidences from 25-65% of recruits sustaining musculoskeletal injury. Risk factors for injury include extrinsic factors such as rapid onset of high volume training, but intrinsic factors such as lower limb biomechanics and foot type. Prediction of injury would allow more effective training delivery, reduce manpower wastage and improve duty of care to individuals by addressing potential interventions. Plantar pressure interpretation of footfall has been shown to reflect biomechanical intrinsic abnormality although no quantifiable method of risk stratification exists.

Objective
To identify if pressure plate assessment of walking gait is predictive of injury in a military population.

Method
200 male subjects commencing Naval Officer training were assessed by plantar pressure plate recording, of foot contact pressures. A software interpretation, D3D?„?, stratified the interpretation to measure 4 specific areas of potential correction. Participants were graded as to High, Medium and low risk of injury and subsequently followed up for injury through their basic training.

Results
Seventy two percent of all injuries were attributed to subjects in the High and Medium risk of injury as defined by the risk categorization. 47% of all injuries were sustained in the high-risk group. Participants categorized in the high-risk group for injury were significantly more likely to sustain injury than in medium or low groups (p < 0.001, OR 5.28 with 95% CI 2.88, 9.70).

Conclusions
Plantar pressure assessment of risk for overuse lower limb injury can be predictive of sustaining an overuse injury in a controlled training environment.
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Admin2 · Nov 19, 2013

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NewsBot · Mar 31, 2016

Plantar Pressure Measurements and Running-related Injury: A Systematic Review of Methods and Possible Associations
Robert Mann, Laurent Malisoux, Axel Urhausen, Kenneth Meijer, Daniel Theisen
Gait and Posture; Article in Press

Highlights
•No standardisation of pressure data analysis exists within RRI research.
•No clear pattern relating plantar pressure data and running injury was identified.
•Pressure insole devices offer the advantage of continuous measurement with shoes.
•Prospective and RCT study designs on RRI in the running environment are warranted.
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Pressure-sensitive measuring devices have been identified as appropriate tools for measuring an array of parameters during running. It is unclear which biomechanical characteristics relate to running-related injury (RRI) and which data-processing techniques are most promising to detect this relationship. This systematic review aims to identify pertinent methodologies and characteristics measured using plantar pressure devices, and to summarise their associations with RRI. PubMed, Embase, CINAHL, ScienceDirect and Scopus were searched up until March 2015. Retrospective and prospective, biomechanical studies on running using any kind of pressure-sensitive device with RRI as an outcome were included. All studies involving regular or recreational runners were considered. The study quality was assessed and the measured parameters were summarised. One low quality, two moderate quality and five high quality studies were included. Five different subdivisions of plantar area were identified, as well as five instants and four phases of measurement during foot-ground contact. Overall many parameters were collated and subdivided as plantar pressure and force, plantar pressure and force location, contact area, timing and stride parameters. Differences between the injured and control group were found for mediolateral and anteroposterior displacement of force, contact area, velocity of force displacement, relative force-time integral, mediolateral force ratio, time to peak force and inter-stride correlative patterns. However, no consistent results were found between studies and no biomechanical risk patterns were apparent. Additionally, conflicting findings were reported for peak force in three studies. Based on these observations, we provide suggestions for improved methodology measurement of pertinent parameters for future studies.
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NewsBot · Apr 19, 2017

Medial shoe-ground pressure and specific running injuries: A 1-year prospective cohort study
René B. Korsgaard Brund et al
JSMS; Article in Press

Objectives
Achilles tendinitis, plantar fasciopathy and medial tibial stress syndrome injuries (APM-injuries) account for approximately 25% of the total number of running injuries amongst recreational runners. Reports on the association between static foot pronation and APM-injuries are contradictory. Possibly, dynamic measures of pronation may display a stronger relationship with the risk of APM-injuries. Therefore, the purpose of the present study was to investigate if running distance until the first APM-injury was dependent on the foot balance during stance phase in recreational male runners.

Design
Prospective cohort study.

Methods
Foot balance for both feet was measured during treadmill running at the fastest possible 5000-m running pace in 79 healthy recreational male runners. Foot balance was calculated by dividing the average of medial pressure with the average of lateral pressure. Foot balance was categorized into those which presented a higher lateral shod pressure (LP) than medial pressure, and those which presented a higher medial shod pressure (MP) than lateral pressure during the stance phase. A time-to-event model was used to compare differences in incidence between foot balance groups.

Results
Compared with the LP-group (n = 59), the proportion of APM-injuries was greater in the MP-group (n = 99) after 1500 km of running, resulting in a cumulative risk difference of 16%-points (95% CI = 3%-point; 28%-point, p = 0.011).

Conclusions
Runners displaying a more medial pressure during stance phase at baseline sustained a greater amount of APM-injuries compared to those displaying a lateral shod pressure during stance phase. Prospective studies including a greater amount of runners are needed to confirm this relationship.
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