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Am J Sports Med. 2018 Feb;46(2):388-395. doi: 10.1177/0363546517736277. Epub 2017 Oct 24.

Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial.

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Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA.
Faculty of Sport & Health Sciences, University of St Mark & St John, Plymouth, UK.



The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury.


To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period.


Randomized controlled trial; Level of evidence, 1.


A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants' running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform.


A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group ( P < .001, Cohen's d > 0.99), whereas the loading rates were either similar or slightly increased in the control group after training ( P = .001 to 0.461, Cohen's d = 0.03 to -0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls.


A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification. Registration: HKUCTR-1996 (University of Hong Kong Clinical Trials Registry).


biofeedback; injury prevention; kinetics; running

[Indexed for MEDLINE]

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