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Title: Influence of fatigue and real-time feedback gait retraining on tibial stress fracture risk in male runners
Author: Clansey, Adam Charles
Awarding Body: University of Ulster
Current Institution: Ulster University
Date of Award: 2013
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Tibial stress fractures (TSF) are a serious and common injury among running populations, with incidence rates of up to 20% (Bennell et al. 1996). It has been recognised that there are many risk factors relating to its development including running mechanics. Although researchers have examined the influence of fatigue and real-time feedback (RTF) training on these risk factors, there still remains ambiguity within the literature. The main aims of this thesis were to examine the effects of fatigue on mechanical risk factors associated with TSF in runners during overground and treadmill running, and to determine the short and medium-term effects of RTF gait retraining on impact loading and running economy (RE). Oxygen consumption , kinematic and kinetic data were collected using a gas analyzer, 12- camera motion capture system, force platform and accelerometers attached to the head and lower limb. In study one, 21 runners performed three overground gait analyses (Pre, Mid, and Post). Between tests, each runner ran on a treadmill for 20 min at 3.5 Mm lactate threshold (LT) speed. Results showed significant increases in peak rearfoot eversion, peak head acceleration (PHA), peak free moment and loading rates during the progression from Pre to Post tests. In study two, twelve runners from study one were analyzed during the first and last min of each L T run. Both PHA and peak tibial accelerations (PTA) significantly increased at the end of each 20 min L T run, while stride characteristics were maintained throughout. Study three involved two randomly assigned groups; RTF group (12 males) and control (CON) group (10 males). The RTF group ran on a treadmill while receiving visual and auditory feedback based on their PTA values. The CON group performed the same training but without any RTF. The training consisted of six 20 min runs over three weeks. After the intervention, as expected the CON group remained consistent while PTA, loading rates were significantly reduced in the RTF group. Although, loading rates were below the pre-screening values, only PTA remained significant at the 1-month follow-up test. There was a significant increase in plantarflexion at initial contact (IC) in the RTF group compared to CON group, while RE remained unaffected. Modifications to risk facto rs previously linked with TSF risk are evident with increasing levels of fatigue. As fatigue is associated with an inability to effectively attenuate impact, these findings provide support to identify these measures in individuals who are at risk of injury from impact loading during running. Gait retraining was successful in reducing impact loading but without influencing RE. Given these promising short term benefits, runners who are at risk from impact related injuries should consider using this training in order to reduce their injury risk potential.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available