Differences in kinetic asymmetry between injured and noninjured novice runners

NewsBot · May 14, 2013

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Differences in kinetic asymmetry between injured and noninjured novice runners: A prospective cohort study
S.W. Bredeweg, I. Buist, B. Kluitenberg
Gait & Posture (In Press)

Purpose
The purpose of this prospective study was to describe natural levels of asymmetry in running, compare levels of asymmetry between injured and noninjured novice runners and compare kinetic variables between the injured and noninjured lower limb within the novice runners with an injury.

Methods
At baseline vertical ground reaction forces and symmetry angles (SA) were assessed with an instrumented treadmill equipped with three force measuring transducers. Female participants ran at 8 and 9 km h−1 and male runners ran at 9 and 10 km h−1. Participants were novice female and male recreational runners and were followed during a 9-week running program.

Results
Two hundred and ten novice runners enrolled this study, 133 (63.3%) female and 77 (36.7%) male runners. Thirty-four runners reported an RRI. At baseline SA values varied widely for all spatio-temporal and kinetic variables. The inter-individual differences in SA were also high. No significant differences in SA were found between female and male runners running at 9 km h−1. In injured runners the SA of the impact peak was significantly lower compared to noninjured runners.

Conclusions
Natural levels of asymmetry in running were high. The SA of impact peak in injured runners was lower compared to noninjured runners and no differences were seen between the injured and noninjured lower limbs.
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Highlights
• Natural levels of asymmetry of kinetic factors in running were high.
• Differences in asymmetry of impact peak and contact time were significant, but these variables did not remain significant in multifactorial analysis.
• There were no differences in asymmetry of kinetic and spatio-temporal variables between injured and noninjured runners in this prospective study.
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NewsBot · Oct 14, 2017

Asymmetry in Clinical and Running Gait Measures in Injured and Healthy Runners
Brar, Varneet Kaur
Thesis, University of Oregon 2017

This study assessed kinematic asymmetry clinically and during running gait for both injured and healthy runners at the hip, knee, and ankle. This study consists of two parts: 1) a primary evaluation of correlations between extent of range of motion (ROM) asymmetry measured clinically and during running in a healthy population and 2) an assessment of differences between asymmetry in injured runners with Achilles tendinopathy (AT) and medial tibial stress syndrome (MTSS), and their matched controls. Asymmetry during running gait was collected while subjects ran continuous loops in the laboratory. A trained clinician assessed for measures of clinical asymmetry using a goniometer. The extent of asymmetry at each joint was quantified through the symmetry index (SI). A significant moderate correlation was noted in the internal hip rotations between clinical asymmetry and during running gait (r = 0.443; p = 0.01). While these results do show potential correlations between clinical and running joint kinematic asymmetries, further investigation is required to determine any causal conclusions as to whether or not modifications in static asymmetry may translate to better symmetry in running. No other significant correlations were noted. A significant difference between the SIs of injured runners and matched controls was detected in the ankle dorsiflexion (p=0.037) ROM of clinical assessment. During running gait, significant differences in SIs between groups were detected in the peak ankle dorsiflexion (p = 0.012) and dorsiflexion ROM (p = 0.004). These results indicate that lower extremity injuries, such as AT and MTSS, present with significantly increased amounts of asymmetry with ankle dorsiflexion and ROM during running. Clinically, similar differences are observed with the peak dorsiflexion with the knee extended. Given healthy runners were noted to have a correlation between the asymmetry present clinically and during running gait, these results may have relevant implications clinically.
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NewsBot · Mar 18, 2020

Bilateral asymmetry of running gait in competitive, recreational and novice runners at different speeds
ShiweiMo et al
Human Movement Science; Volume 71, June 2020, 102600

Highlights
•Competitive runners reduce asymmetry with speed increasing from 8 to 12 km/h
•Recreational runners gain the most symmetric gait at around their preferred speeds
•Novice runners hardly maintain consistent asymmetric pattern with speed increasing
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The mechanisms and underlying causes of bilateral asymmetry among healthy runners of different levels remain unclear. This cross-sectional laboratory study aimed to investigate the effects of running speed and running experience or competitive level on bilateral symmetry during running. Eleven competitive runners, 9 recreational runners and 11 novice runners were recruited in this study. They ran on an instrumented treadmill for 3 min at each of 5 fixed speeds (8, 9, 10, 11 and 12 km/h) in a randomized order. Bilateral asymmetry was evaluated and quantified using symmetry index (SI) of temporal and kinetic parameters. Overall, SI ranged between 0.8% for stride time and 21.4% for vertical average loading rate. Significant speed effects were observed on SI of flight time (p = .012), which was significantly higher at 8 km/h than that of the other 4 speeds (p = .023, 0.005, 0.023 and 0.028, respectively). Group-by-speed interactions were detected on SI in time to peak vertical ground reaction force (p = .032) and vertical average loading rate (p = .002). The competitive runners presented linear reduction in the SI with increasing speed from 8 to 12 km/h (R2 > 0.94); for the recreational runners, SI changed nonlinearly and presented a roughly U-shaped trend across speeds (R2 > 0.88); and for the novice runners, changes of SI across speed were inconsistent and dependent on parameters of interest (R2 > 0.64). Bilateral asymmetry was affected by both running speed and runners' running experience or competitive level. The competitive runners were found to run with a more symmetrical manner with a greater running speed, the recreational runners demonstrated the most symmetrical pattern at the critical speed, whereas the novice runners showed inconsistent trends.
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NewsBot · Oct 21, 2020

Inter-limb strength asymmetry in adolescent distance runners: Test-retest reliability and relationships with performance and running economy
Richard C. Blagrove, Chris Bishop , Glyn Howatson & Philip R. Hayes
Journal of Sports Sciences: 13 Sep 2020

The purpose of this investigation was, firstly, to quantify the test-retest reliability of strength measures in adolescent distance runners; and secondly, to explore the relationships between inter-limb strength asymmetry and performance and running economy (RE) in a similar cohort of young runners. For the reliability study, twelve (n = 6 female) post-pubertal adolescent distance runners performed an isometric quarter-squat on a dual force plate and unilateral isometric hip extension and hip abduction tests on two occasions. For the correlation study, participants (n = 31) performed the strength tests plus a submaximal incremental running assessment and a maximal running test. Running economy was expressed as the average energy cost of running for all speeds below lactate turnpoint and was scaled for body mass using a previously calculated power exponent. Allometrically scaled peak force during the quarter-squat and peak torque in the hip strength tasks showed acceptable levels of reproducibility (typical error ≤6.3%). Relationships between strength asymmetry and performance and RE were low or negligible (r < 0.47, p > 0.05), except for hip abduction strength asymmetry and RE in the female participants (r = 0.85, p < 0.001, n = 16). Practitioners should consider inter-limb hip abduction strength asymmetry on an individual level, and attempting to reduce this asymmetry in females may positively impact RE.
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NewsBot · Nov 11, 2020

Lower Extremity Kinematic and Kinetic Asymmetries during Running
Stiffler-Joachim, Mikel R et al
Medicine & Science in Sports & Exercise: November 3, 2020

Between-limb asymmetries during running are often evaluated to assess injury risk or recovery. Asymmetries less than 10% are generally considered normal, but it is unknown if asymmetries vary depending on the metric of interest, the athlete’s sex, or running speed.

PURPOSE
The primary aim of this investigation was to describe the magnitude of asymmetries of common variables during running among healthy athletes and to determine if sex and speed influence magnitudes of asymmetry.

METHODS
This study analyzed routinely collected running gait data on healthy Division I collegiate athletes. All athletes had no history of lower-extremity (LE) surgery, no LE injuries for 3 months before testing, and had running data available at 2.68, 2.95, 3.35, 3.80, and 4.47m·s-1. Asymmetries were calculated for ground reaction forces, spatiotemporal metrics, joint kinematics, and joint kinetics. Separate linear mixed effects models assessed the influence of sex, speed, and the interaction on asymmetries of interest. Z-scores were calculated for significant effects to further assess magnitude of differences.

RESULTS
Results from 204 athletes were included. The magnitude of asymmetry varied depending on the variable of interest, with asymmetries ≤ 3o observed for joint kinematics and greater asymmetries observed among joint work asymmetries ranged from 10-40%. No significant interactions between sex and speed were observed. Differences in sex and speed were noted; however, the effect sizes were very small based on z-score comparison (-0.17 ≤ z ≤ 0.36) and were unlikely to be meaningful.

CONCLUSIONS
The magnitude of asymmetry varies considerably depending on the running gait variable. Interpretation of between-limb asymmetry in running mechanics needs to be specific to the variable of interest, while sex or running speed appear to be minor factors.
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NewsBot · Feb 22, 2021

Evaluation of selected indices of gait asymmetry for the assessment of running asymmetry
PiotrTabor et al
Gait & Posture; 20 February 2021

Highlights
•The indices of symmetry used in gait analysis can be used in running evaluation.
•More useful are the so-called continuous indices based on continuous.
•The phenomenon of asymmetry should be described in at least three aspects.
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Background
The methods of running asymmetry evaluation are not as highly developed as the methods of gait evaluation.

Research question
Which asymmetry indices used in the gait analysis best characterize the asymmetry of the running movement?

Methods
The kinematics of the sprint in a straight run over a distance of 50 m was evaluated using the X-sens system. Three indices (Ia, IS, SA) were based on discrete values from the first point of contact of the foot with the ground (1% of the running cycle phase) and were called discrete coefficients. Furthermore, two indices (SI, RAI) were used to evaluate asymmetry over the entire running cycle and were termed continuous coefficients. The study examined 21 elite and non-professional middle-distance runners of both sexes. The evaluation of the usefulness of individual indices for the evaluation of gait asymmetry was performed by means of the analysis of ROC curves and evaluation of data scatter on Bland-Altman charts.

Results
The values of discrete and continuous asymmetry coefficients were different to each other. In Bland-Altman plots there was a meaningful variety of discrete coefficients and a small variety of continuous coefficients. The analysis of ROC curves proves this assumption. Including the real curve course of angular placement in particular joints it is observed that continuous coefficients describe asymmetry of movement more precisely.

Significance
It was found that the so-called continuous indices SI and RAI ensure the best identification of the phenomenon of movement asymmetry.
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NewsBot · Nov 5, 2022

Gait asymmetry and running-related injury in female collegiate cross-country runners
Robert A.Wayner et al
Physical Therapy in Sport; 5 November 2022

Highlights
•Female collegiate runners present with symmetrical running kinematic and kinetics.
•Velocity had no effect on degree of kinematic and kinetic asymmetry.
•Magnitude of pre-season asymmetry was not associated with running-related injury.
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Background
Running biomechanics are commonly linked to injury. There is limited evidence on the effects of running speed on asymmetry and the prospective association of asymmetry and injury. The purposes of this study were to describe the degree in asymmetry in biomechanical variables commonly associated with injury, examine the effect of speed on asymmetry, and determine if there were any significant differences in pre-season measures of asymmetry between runners who went on to sustain an injury during the competitive season compared to those who remained healthy.

Methods
Three-dimensional running biomechanics were obtained from twenty-two female collegiate cross-country runners at four different running speeds prior to their season. Asymmetry was quantified using the Symmetry Angle. Participants were followed over the twelve-week season and all time-loss injuries were identified.

Findings
There was no significant effect of velocity on asymmetry. Additionally, there were no significant differences in symmetry between runners who sustained an injury (n = 7) and those that remained injury-free (n = 15) during the cross-country season.

Interpretation
Clinicians working with runners should expect a high degree of symmetry in running biomechanics when performing gait analyses across running speeds. In regards to injury, caution should be used when linking injury to asymmetry.
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NewsBot · Jan 24, 2023

Gait asymmetry and running-related injury in female collegiate cross-country runners
Robert A.Wayner et al
Physical Therapy in Sport; Volume 59, January 2023, Pages 1-6

Background
Running biomechanics are commonly linked to injury. There is limited evidence on the effects of running speed on asymmetry and the prospective association of asymmetry and injury. The purposes of this study were to describe the degree in asymmetry in biomechanical variables commonly associated with injury, examine the effect of speed on asymmetry, and determine if there were any significant differences in pre-season measures of asymmetry between runners who went on to sustain an injury during the competitive season compared to those who remained healthy.

Methods
Three-dimensional running biomechanics were obtained from twenty-two female collegiate cross-country runners at four different running speeds prior to their season. Asymmetry was quantified using the Symmetry Angle. Participants were followed over the twelve-week season and all time-loss injuries were identified.

Findings
There was no significant effect of velocity on asymmetry. Additionally, there were no significant differences in symmetry between runners who sustained an injury (n = 7) and those that remained injury-free (n = 15) during the cross-country season.

Interpretation
Clinicians working with runners should expect a high degree of symmetry in running biomechanics when performing gait analyses across running speeds. In regards to injury, caution should be used when linking injury to asymmetry.
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NewsBot · Feb 7, 2023

Foot Morphology and Running Gait Pattern between the Left and Right Limbs in Recreational Runners
Jing Wen Pan, Mei Yee Mavis Ho, Ray Ban Chuan Loh, Muhammad Nur Shahril Iskandar, Pui Wah Kong
Source

Previous studies generally selected one foot to classify participants into groups with different foot types and then analyzed the running or walking biomechanics for one limb. Such approach may have neglected the possible differences in foot morphology and gait between two limbs. This study aimed to compare the foot morphological characteristics and running kinematics of the lower extremities between the left and right limbs among a group of healthy, asymptomatic runners. Forty-four participants [20 females, 24 males; age 25.1 (6.5) years old; height 167.2 (7.0) cm; body mass 62.8 (8.1) kg] were recruited. Foot morphological characteristics were measured for both feet, and bilateral running kinematics were analyzed with 2D video analysis. No significant between-limb differences were found in the foot dimensions, hallux valgus (bunion) angle, or navicular drop (all p > 0.05). On the other hand, several kinematic variables were significantly different between the left and right limbs during running, including the peak foot eversion (p = 0.014), peak knee flexion (p = 0.002), and peak hip adduction (p < 0.001). The results indicate that runners with similar morphological characteristics between the left and right feet can display between-limb gait asymmetry during running. Researchers and practitioners should be aware of the potential between-limb asymmetry in running kinematics and foot morphology. Future studies should avoid arbitrarily analyzing one limb to represent a runner’s gait or foot morphology.
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NewsBot · Nov 30, 2023

Lower-limb dominance does not explain subject-specific foot kinematic asymmetries observed during walking and running
Stephanie L. Molitor et al
Journal of BiomechanicsVolume 162, January 2024, 111877

Studies of human locomotion have observed asymmetries in lower-limb kinematics, especially at the more distal joints. However, it is unclear whether these asymmetries are related to functional differences between the dominant and non-dominant limb. This study aimed to determine the effect of lower-limb dominance on foot kinematics during human locomotion. Range of motion for the metatarsophalangeal joint (MPJ) and medial longitudinal arch (MLA), as well as time duration of windlass mechanism engagement, were recorded from healthy young adults (N = 12) across a range of treadmill walking and running speeds. On the group level, there were no differences in MPJ or MLA range of motion, or windlass engagement timing, between the dominant and non-dominant limb (p > 0.05). While not explained by limb dominance, between-limb differences in MPJ and MLA ranges of motion were observed for individual participants on the order of ∼2–6°, which could be clinically relevant or impact interpretation of research data.
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