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In a randomized controlled cross-over study ten male runners (26.7 ± 4.9 years; recent 5-km time: 18:37 ± 1:07 min:s) performed an incremental treadmill test (ITT) and a 3-km time trial (3-km TT) on a treadmill while wearing either carbon fiber insoles with downwards curvature or insoles made of butyl rubber (control condition) in light road racing shoes (Saucony Fastwitch 9). Oxygen uptake, respiratory exchange ratio, heart rate, blood lactate concentration, stride frequency, stride length and time to exhaustion were assessed during ITT. After ITT, all runners rated their perceived exertion, perceived shoe comfort and perceived shoe performance. Running time, heart rate, blood lactate levels, stride frequency and stride length were recorded during, and shoe comfort and shoe performance after, the 3-km TT. All parameters obtained during or after the ITT did not differ between the two conditions [range: p = 0.188 to 0.948 (alpha value: 0.05); Cohen's d = 0.021 to 0.479] despite the rating of shoe comfort showing better scores for the control insoles (p = 0.001; d = −1.646). All parameters during and after the 3-km TT showed no differences (p = 0.200 to 1.000; d = 0.000 to 0.501) between both conditions except for shoe comfort showing better scores for control insoles (p = 0.017; d = −0.919). Running with carbon fiber insoles with downwards curvature did not change running performance or any submaximal or maximal physiological or biomechanical parameter and perceived exertion compared to control condition. Shoe comfort is impaired while running with carbon fiber insoles. Wearing carbon fiber insoles with downwards curvature during treadmill running is not beneficial when compared to running with control insoles.
Recent advances in spiked shoe design, characterized by increased longitudinal stiffness, thicker midsole foams, and reconfigured geometry are considered to improve sprint performance. However, so far there is no empirical data on the effects of advanced spikes technology on maximal sprinting speed (MSS) published yet. Consequently, we assessed MSS via ‘flying 30m’ sprints of 44 trained male (PR: 10.32 s - 12.08 s) and female (PR: 11.56 s - 14.18 s) athletes, wearing both traditional and advanced spikes in a randomized, repeated measures design. The results revealed a statistically significant increase in MSS by 1.21% on average when using advanced spikes technology. Notably, 87% of participants showed improved MSS with the use of advanced spikes. A cluster analysis unveiled that athletes with higher MSS may benefit to a greater extent. However, individual responses varied widely, suggesting the influence of multiple factors that need detailed exploration. Therefore, coaches and athletes are advised to interpret the promising performance enhancements cautiously and evaluate the appropriateness of the advanced spike technology for their athletes critically.
High-tech running shoes and spikes ("super-footwear") are currently being debated in sports. There is direct evidence that distance running super shoes improve running economy; however, it is not well established to which extent world-class performances are affected over the range of track and road running events.
This study examined publicly available performance datasets of annual best track and road performances for evidence of potential systematic performance effects following the introduction of super footwear. The analysis was based on the 100 best performances per year for men and women in outdoor events from 2010 to 2022, provided by the world governing body of athletics (World Athletics).
We found evidence of progressing improvements in track and road running performances after the introduction of super distance running shoes in 2016 and super spike technology in 2019. This evidence is more pronounced for distances longer than 1500 m in women and longer than 5000 m in men. Women seem to benefit more from super footwear in distance running events than men.
While the observational study design limits causal inference, this study provides a database on potential systematic performance effects following the introduction of super shoes/spikes in track and road running events in world-class athletes. Further research is needed to examine the underlying mechanisms and, in particular, potential sex differences in the performance effects of super footwear.
Purpose
To (1) identify neuromuscular and biomechanical injury risk factors in elite youth soccer players and (2) assess the predictive ability of a machine learning approach.
Material and Methods
Fifty-six elite male youth soccer players (age: 17.2 ± 1.1 years; height: 179 ± 8 cm; mass: 70.4 ± 9.2 kg) performed a 3D motion analysis, postural control testing, and strength testing. Non-contact lower extremities injuries were documented throughout 10 months. A least absolute shrinkage and selection operator (LASSO) regression model was used to identify the most important injury predictors. Predictive performance of the LASSO model was determined in a leave-one-out (LOO) prediction competition.
Results
Twenty-three non-contact injuries were registered. The LASSO model identified concentric knee extensor peak torque, hip transversal plane moment in the single-leg drop landing task and center of pressure sway in the single-leg stance test as the three most important predictors for injury in that order. The LASSO model was able to predict injury outcomes with a likelihood of 58% and an area under the ROC curve of 0.63 (sensitivity = 35%; specificity = 79%).
Conclusion
The three most important variables for predicting the injury outcome suggest the importance of neuromuscular and biomechanical performance measures in elite youth soccer. These preliminary results may have practical implications for future directions in injury risk screening and planning, as well as for the development of customized training programs to counteract intrinsic injury risk factors. However, the poor predictive performance of the final model confirms the challenge of predicting sports injuries, and the model must therefore be evaluated in larger samples.
Background
Internal tibial loading is influenced by modifiable factors with implications for the risk of stress injury. Runners encounter varied surface steepness (gradients) when running outdoors and may adapt their speed according to the gradient. This study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different gradients.
Methods
Twenty recreational runners ran on a treadmill at 3 different speeds (2.5 m/s, 3.0 m/s, and 3.5 m/s) and gradients (level: 0%; uphill: +5%, +10%, and +15%; downhill: –5%, –10%, and –15%). Force and marker data were collected synchronously throughout. Bending moments were estimated at the distal third centroid of the tibia about the medial–lateral axis by ensuring static equilibrium at each 1% of stance. Stress was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ellipse. Two-way repeated-measures analysis of variance were conducted using both functional and discrete statistical analyses.
Results
There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior stress. Higher running speeds resulted in greater tibial loading. Running uphill at +10% and +15% resulted in greater tibial loading than level running. Running downhill at –10% and –15% resulted in reduced tibial loading compared to level running. There was no difference between +5% or –5% and level running.
Conclusion
Running at faster speeds and uphill on gradients ≥+10% increased internal tibial loading, whereas slower running and downhill running on gradients ≥–10% reduced internal loading. Adapting running speed according to the gradient could be a protective mechanism, providing runners with a strategy to minimize the risk of tibial stress injuries.
Purpose
To summarize the mechanical loading of the spine in different activities of daily living and sports.
Methods
Since the direct measurement is not feasible in sports activities, a mathematical model was applied to quantify spinal loading of more than 600 physical tasks in more than 200 athletes from several sports disciplines. The outcome is compression and torque (normalized to body weight/mass) at L4/L5.
Results
The data demonstrate high compressive forces on the lumbar spine in sport-related activities, which are much higher than forces reported in normal daily activities and work tasks. Especially ballistic jumping and landing skills yield high estimated compression at L4/L5 of more than ten times body weight. Jumping, landing, heavy lifting and weight training in sports demonstrate compression forces significantly higher than guideline recommendations for working tasks.
Conclusion
These results may help to identify acute and long-term risks of low back pain and, thus, may guide the development of preventive interventions for low back pain or injury in athletes.
Appraising the Methodological Quality of Sports Injury Video Analysis Studies: The QA-SIVAS Scale
(2023)
Background
Video analysis (VA) is commonly used in the assessment of sports injuries and has received considerable research interest. Until now, no tool has been available for the assessment of study quality. Therefore, the objective of this study was to develop and evaluate a valid instrument that reliably assesses the methodological quality of VA studies.
Methods
The Quality Appraisal for Sports Injury Video Analysis Studies (QA-SIVAS) scale was developed using a modified Delphi approach including expert consensus and pilot testing. Reliability was examined through intraclass correlation coefficient (ICC3,1) and free-marginal kappa statistics by three independent raters. Construct validity was investigated by comparing QA-SIVAS with expert ratings by using Kendall’s tau analysis. Rating time was studied by applying the scale to 21 studies and computing the mean time for rating per study article.
Results
The QA-SIVAS scale consists of an 18-item checklist addressing the study design, data source, conduct, report, and discussion of VA studies in sports injury research. Inter- and intra-rater reliability were excellent with ICCs > 0.97. Expert ratings revealed a high construct validity (0.71; p < 0.001). Mean rating time was 10 ± 2 min per article.
Conclusion
QA-SIVAS is a reliable and valid instrument that can be easily applied to sports injury research. Future studies in the field of VA should adhere to standardized methodological criteria and strict quality guidelines.
Injury prevention is essential in running due to the risk of overuse injury development. Tailoring running shoes to individual needs may be a promising strategy to reduce this risk. Novel manufacturing processes allow the production of individualised running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualise footwear to reduce injury risk are poorly understood. Therefore, this scoping review provides an overview of (1) footwear design features that have the potential for individualisation; and (2) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing the risk of overuse injuries. We included studies in the English language on adults that analysed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, sex) for running-related biomechanical risk factors or injury incidences; (2) footwear comfort perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analysed male runners. Female runners may be more susceptible to footwear-induced changes and overuse injury development; future research should target more heterogonous sampling. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualisation. However, the literature addressing individualised footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualisation.
Background:
Ankle braces aim to reduce lateral ankle sprains. Next to protection, factors influencing user compliance, such as sports performance, motion restriction, and users’ perceptions, are relevant for user compliance and thus injury prevention. Novel adaptive protection systems claim to change their mechanical behavior based on the intensity of motion (eg, the inversion velocity), unlike traditional passive concepts of ankle bracing.
Purpose:
To compare the performance of a novel adaptive brace with 2 passive ankle braces while considering protection, sports performance, freedom of motion, and subjective perception.
Study Design:
Controlled laboratory study.
Methods:
The authors analyzed 1 adaptive and 2 passive (one lace-up and one rigid brace) ankle braces, worn in a low-cut, indoor sports shoe, which was also the no-brace reference condition. We performed material testing using an artificial ankle joint system at high and low inversion velocities. Further, 20 male, young, healthy team sports athletes were analyzed using 3-dimensional motion analysis in sports-related movements to address protection, sports performance, and active range of motion dimensions. Participants rated subjective comfort, stability, and restriction experienced when using the products.
Results:
Subjective stability rating was not different between the adaptive and passive systems. The rigid brace was superior in restricting peak inversion during the biomechanical testing compared with the passive braces. However, in the material test, the adaptive brace increased its stiffness by approximately 400% during the fast compared with the slow inversion velocities, demonstrating its adaptive behavior and similar stiffness values to passive braces. We identified minor differences in sports performance tasks. The adaptive brace improved active ankle range of motion and subjective comfort and restriction ratings.
Conclusion:
The adaptive brace offered similar protective effects in high-velocity inversion situations to those of the passive braces while improving range of motion, comfort, and restriction rating during noninjurious motions.
Clinical Relevance:
Protection systems are only effective when used. Compared with traditional passive ankle brace technologies, the novel adaptive brace might increase user compliance by improving comfort and freedom of movement while offering similar protection in injurious situations.
Relationships between External, Wearable Sensor-Based, and Internal Parameters: A Systematic Review
(2023)
Micro electro-mechanical systems (MEMS) are used to record training and match play of intermittent team sport athletes. Paired with estimates of internal responses or adaptations to exercise, practitioners gain insight into players’ dose–response relationship which facilitates the prescription of the training stimuli to optimize performance, prevent injuries, and to guide rehabilitation processes. A systematic review on the relationship between external, wearable-based, and internal parameters in team sport athletes, compliant with the PRISMA guidelines, was conducted. The literature research was performed from earliest record to 1 September 2020 using the databases PubMed, Web of Science, CINAHL, and SportDISCUS. A total of 66 full-text articles were reviewed encompassing 1541 athletes. About 109 different relationships between variables have been reviewed. The most investigated relationship across sports was found between (session) rating of perceived exertion ((session-)RPE) and PlayerLoad™ (PL) with, predominantly, moderate to strong associations (r = 0.49–0.84). Relationships between internal parameters and highly dynamic, anaerobic movements were heterogenous. Relationships between average heart rate (HR), Edward’s and Banister’s training impulse (TRIMP) seem to be reflected in parameters of overall activity such as PL and TD for running-intensive team sports. PL may further be suitable to estimate the overall subjective perception. To identify high fine-structured loading—relative to a certain type of sport—more specific measures and devices are needed. Individualization of parameters could be helpful to enhance practicality.