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Sports Med. 2019 Dec 4. doi: 10.1007/s40279-019-01237-z. [Epub ahead of print]

Is Motorized Treadmill Running Biomechanically Comparable to Overground Running? A Systematic Review and Meta-Analysis of Cross-Over Studies.

Author information

Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.
Institute of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands.
Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia.
Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia.
East Carolina University, Greenville, NC, USA.
Aix Marseille University, CNRS, ISM, Marseille, France.
La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, VIC, Australia.
Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
The Biomechanics Lab, Adelaide, SA, Australia.
School of Physical Therapy and Rehabilitation Sciences, University of Montana, Missoula, MT, USA.



Treadmills are often used in research, clinical practice, and training. Biomechanical investigations comparing treadmill and overground running report inconsistent findings.


This study aimed at comparing biomechanical outcomes between motorized treadmill and overground running.


Four databases were searched until June 2019. Crossover design studies comparing lower limb biomechanics during non-inclined, non-cushioned, quasi-constant-velocity motorized treadmill running with overground running in healthy humans (18-65 years) and written in English were included. Meta-analyses and meta-regressions were performed where possible.


33 studies (n = 494 participants) were included. Most outcomes did not differ between running conditions. However, during treadmill running, sagittal foot-ground angle at footstrike (mean difference (MD) - 9.8° [95% confidence interval: - 13.1 to - 6.6]; low GRADE evidence), knee flexion range of motion from footstrike to peak during stance (MD 6.3° [4.5 to 8.2]; low), vertical displacement center of mass/pelvis (MD - 1.5 cm [- 2.7 to - 0.8]; low), and peak propulsive force (MD - 0.04 body weights [- 0.06 to - 0.02]; very low) were lower, while contact time (MD 5.0 ms [0.5 to 9.5]; low), knee flexion at footstrike (MD - 2.3° [- 3.6 to - 1.1]; low), and ankle sagittal plane internal joint moment (MD - 0.4 Nm/kg [- 0.7 to - 0.2]; low) were longer/higher, when pooled across overground surfaces. Conflicting findings were reported for amplitude of muscle activity.


Spatiotemporal, kinematic, kinetic, muscle activity, and muscle-tendon outcome measures are largely comparable between motorized treadmill and overground running. Considerations should, however, particularly be given to sagittal plane kinematic differences at footstrike when extrapolating treadmill running biomechanics to overground running. Protocol registration CRD42018083906 (PROSPERO International Prospective Register of Systematic Reviews).


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