Looking into the Efficacy of Outdoor Gait-Training | Find Your Stride | Edinburgh Podiatrist

Introduction

The study titled Transference of outdoor gait-training to treadmill running biomechanics and strength measures: A randomised controlled trial by Alexandra F. DeJong Lempke et al. (2024) investigates the efficacy of an outdoor gait-training intervention in improving running biomechanics and lower extremity strength among runners experiencing exercise-related lower leg pain (ERLLP). This blog post summarises the key findings and implications of the study, emphasising the potential significance of outdoor gait-training on treadmill and general running performance.

Running on a treadmill is very different to running outdoors

Background

Runners with ERLLP often face challenges related to pain and inefficient running mechanics. Previous studies have demonstrated that outdoor gait-training can significantly reduce pain and improve contact time during outdoor running. However, the extent to which these benefits translate to treadmill running—a common setting for clinical assessment and training—remains unclear. This study addresses this gap by comparing the effects of a four-week outdoor gait-training intervention combined with home exercises (FBHE) to home exercises alone (HE) on treadmill running biomechanics and lower extremity strength.

Study Design

This randomised controlled trial involved 17 runners diagnosed with ERLLP who were divided into two groups: FBHE (3 males, 6 females; age 23 ± 4 years; BMI 22.0 ± 4.6 kg/m²) and HE (3 males, 5 females; age 25 ± 5 years; BMI 24.0 ± 4.0 kg/m²). Both groups participated in eight sessions of home exercises over four weeks. The FBHE group utilised wearable sensors during gait-training to specifically target reductions in contact time. Comprehensive assessments of treadmill running biomechanics and clinical strength measures were conducted at baseline and after the intervention.

Key Findings

The analysis revealed significant improvements in the FBHE group post-intervention. Specifically, the FBHE group exhibited a noteworthy reduction in contact time (Mean Difference [MD]: -42 ms to -39 ms; p < 0.001 - 0.02) compared to baseline and the HE group. Additionally, this group showed an increase in cadence (MD: +21 steps/min; p = 0.003) and a decrease in loading impulse (MD: -51; p < 0.001) during treadmill running. However, there were no significant changes in strength measures, indicating that while biomechanical adaptations occurred, strength improvements did not manifest significantly.

Implications for Clinical Practice

The results of this study suggest that implementing outdoor gait-training interventions can lead to favorable changes in treadmill running biomechanics for patients with ERLLP. The observed reductions in contact time and improvements in cadence could therefore enhance running performance across the board and reduce injury risk. Clinicians are encouraged to incorporate data-driven outdoor gait-training strategies into rehabilitation protocols to optimise patient outcomes across various running environments.

Conclusion

In summary, the randomised controlled trial by DeJong Lempke et al. provides valuable insights into the transference of outdoor gait-training benefits to treadmill running biomechanics. These findings not only expand the understanding of effective treatment strategies for runners with ERLLP but also highlight the importance of integrating innovative training modalities in clinical practice.

Find Your Stride!