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The effect of running on knee joint cartilage: A systematic review and meta-analysis.
Dong, X, Li, C, Liu, J, Huang, P, Jiang, G, Zhang, M, Zhang, W, Zhang, X
Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine. 2021;:147-155
Abstract
OBJECTIVE Although running causes inevitable stress to the joints, data regarding its effect on the cartilage of the knee are conflicting. This systematic review and meta-analysis aimed to evaluate the effect of running on knee joint cartilage. METHODS PubMed, EMBASE, SportDiscus, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) and cohort studies. The outcome indicators were cartilage oligomeric matrix protein (COMP), cartilage volume and thickness, and T2. RESULTS A total of two RCTs and 13 cohort studies were included. There was no significant difference in cartilage volume between the running and control groups (MD, -115.88 U/I; 95% CI, -320.03 to 88.27; p = 0.27). However, running would decrease cartilage thickness (MD, -0.09 mm; 95%CI, -0.18 to -0.01; p = 0.03) and T2 (MD, -2.78 ms; 95% CI, -4.12 to -1.45; p < 0.001). Subgroup analysis demonstrated that COMP immediately or at 0.5 h after running was significantly increased, but there were no significant changes at 1 h or 2 h. CONCLUSIONS Running has advantages in promoting nutrition penetrating into the cartilage as well as squeezing out the metabolic substance, such as water. Our study found that running had a short-term adverse effect on COMP and did not affect cartilage volume or thickness.
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The effects of the Nordic hamstring exercise on sprint performance and eccentric knee flexor strength: A systematic review and meta-analysis of intervention studies among team sport players.
Bautista, IJ, Vicente-Mampel, J, Baraja-Vegas, L, Segarra, V, Martín, F, Van Hooren, B
Journal of science and medicine in sport. 2021;(9):931-938
Abstract
OBJECTIVES The primary aim of this study was to investigate the effects of the Nordic hamstring exercise (NHE) on sprint performance (i.e., 5, 10 and 20m) and explore associations between study characteristics and sprint outcomes in team sport players. Secondary aims were to (1) investigate the effects of the NHE on eccentric strength of the knee flexors (ESKF) with categorical subgroup analysis to determine differences between recreationally, well-trained individuals and young athletes, (2) determine the relation between ESKF and sprint performance in team sport players, and (3) explore the effect of study characteristics (i.e., weekly volume, time duration and body mass) on ESKF. METHODS Electronic databases were searched until the 20th of June 2020. 17 studies met the inclusion criteria. Random-effects meta-analyses were used to determine the mean difference (MD) or standardized change of mean difference (SCMD) between NHE and control group for sprint time and ESKF, respectively. RESULTS NHE interventions showed a positive effect on sprint performance (-0.04s [-0.08, -0.01]). Sub-group meta-analyses indicated no significant differences in 5 and 20m sprint performance (MDsprint(5m)=-0.02s [-0.10, 0.06]) and (MD sprint(20m)=-0.05s [-0.30, 0.19]), respectively. A significant difference was however found for 10m sprint performance (MDsprint(10m)=-0.06s [-0.10, -0.01]). Meta-analysis on the effects of the NHE on ESKF showed a significant benefit of 0.83 SCMD [0.55, 1.12] in favour of the intervention group. CONCLUSIONS Studies with some concerns or high risk of bias show that training programs involving the NHE can have small beneficial effects on sprint performance in team sport players. Studies with some concerns or high risk of bias showed moderate beneficial effects on ESKF among a sample of relatively untrained individuals. However, for well-trained team sport players, the improvements in ESKF were less consistent, suggesting a higher training intensity during the NHE may be required to induce adaptations.
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Is Motorized Treadmill Running Biomechanically Comparable to Overground Running? A Systematic Review and Meta-Analysis of Cross-Over Studies.
Van Hooren, B, Fuller, JT, Buckley, JD, Miller, JR, Sewell, K, Rao, G, Barton, C, Bishop, C, Willy, RW
Sports medicine (Auckland, N.Z.). 2020;(4):785-813
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Abstract
BACKGROUND Treadmills are often used in research, clinical practice, and training. Biomechanical investigations comparing treadmill and overground running report inconsistent findings. OBJECTIVE This study aimed at comparing biomechanical outcomes between motorized treadmill and overground running. METHODS 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. RESULTS 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. CONCLUSIONS 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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The effects of fatigue on the running profile of elite team sport athletes. A systematic review and meta-analysis.
Garrett, JM, Gunn, R, Eston, RG, Jakeman, J, Burgess, DJ, Norton, K
The Journal of sports medicine and physical fitness. 2019;(8):1328-1338
Abstract
INTRODUCTION With the underlying mechanisms of fatigue shown to be task-specific, gaining an understanding of changes within the running profile due to fatigue may provide a greater task-specific method for monitoring neuromuscular fatigue (NMF) in elite team sport athletes. This review aimed to identify, review and summarize the literature to understand the effects of fatigue on the running profile of elite team sport athletes. EVIDENCE ACQUISITION MEDLINE, SPORTDiscus, EMBASE and CINAHL were searched. To manage heterogeneity in athlete characteristics and sport demands, studies were limited to elite male field/court team sports, in which changes in running, gait or stride characteristics were assessed. EVIDENCE SYNTHESIS Thirteen studies were included in the analysis with changes in sprint time, kinematic variables; contact time, center of mass vertical displacement and vertical stiffness, GPS accelerometer vector variables; z and y, and mechanical parameters; velocity and V0, all shown to be sensitive measures of fatigue. Due to having at least three sets of data points, meta-analysis was run for sprint time, with results showing a significant increase immediately postexercise (effect size [ES]±95% confidence interval [CI]; 1.67±1.61, P=0.04), but no change 24 hours postexercise (ES±95% CI; 0.93±3.21, P=0.57). CONCLUSIONS The findings indicate that fatigue has a negative impact on the running profile in elite team sport athletes, offering an alternative task-specific measure of monitoring NMF in this population. However, due to large discrepancies in protocols, future research is required to allow greater uniformity in variables and methods.
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A Systematic Review and Meta-Analysis of Crossover Studies Comparing Physiological, Perceptual and Performance Measures Between Treadmill and Overground Running.
Miller, JR, Van Hooren, B, Bishop, C, Buckley, JD, Willy, RW, Fuller, JT
Sports medicine (Auckland, N.Z.). 2019;(5):763-782
Abstract
BACKGROUND Treadmills are routinely used to assess running performance and training parameters related to physiological or perceived effort. These measurements are presumed to replicate overground running but there has been no systematic review comparing performance, physiology and perceived effort between treadmill and overground running. OBJECTIVE The objective of this systematic review was to compare physiological, perceptual and performance measures between treadmill and overground running in healthy adults. METHODS AMED (Allied and Contemporary Medicine), CINAHL (Cumulative Index to Nursing and Allied Health), EMBASE, MEDLINE, SCOPUS, SPORTDiscus and Web of Science databases were searched from inception until May 2018. Included studies used a crossover study design to compare physiological (oxygen uptake [[Formula: see text]O2], heart rate [HR], blood lactate concentration [La]), perceptual (rating of perceived exertion [RPE] and preferred speed) or running endurance and sprint performance (i.e. time trial duration or sprint speed) outcomes between treadmill (motorised or non-motorised) and overground running. Physiological outcomes were considered across submaximal, near-maximal and maximal running intensity subgroups. Meta-analyses were used to determine mean difference (MD) or standardised MD (SMD) ± 95% confidence intervals. RESULTS Thirty-four studies were included. Twelve studies used a 1% grade for the treadmill condition and three used grades > 1%. Similar [Formula: see text]O2 but lower La occurred during submaximal motorised treadmill running at 0% ([Formula: see text]O2 MD: - 0.55 ± 0.93 mL/kg/min; La MD: - 1.26 ± 0.71 mmol/L) and 1% ([Formula: see text]O2 MD: 0.37 ± 1.12 mL/kg/min; La MD: - 0.52 ± 0.50 mmol/L) grade than during overground running. HR and RPE during motorised treadmill running were higher at faster submaximal speeds and lower at slower submaximal speeds than during overground running. [Formula: see text]O2 (MD: - 1.25 ± 2.09 mL/kg/min) and La (MD: - 0.54 ± 0.63 mmol/L) tended to be lower, but HR (MD: 0 ± 1 bpm), and RPE (MD: - 0.4 ± 2.0 units [6-20 scale]) were similar during near-maximal motorised treadmill running to during overground running. Maximal motorised treadmill running caused similar [Formula: see text]O2 (MD: 0.78 ± 1.55 mL/kg/min) and HR (MD: - 1 ± 2 bpm) to overground running. Endurance performance was poorer (SMD: - 0.50 ± 0.36) on a motorised treadmill than overground but sprint performance varied considerably and was not significantly different (MD: - 1.4 ± 5.8 km/h). CONCLUSIONS Some, but not all, variables differ between treadmill and overground running, and may be dependent on the running speed at which they are assessed. PROTOCOL REGISTRATION CRD42017074640 (PROSPERO International Prospective Register of Systematic Reviews).
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The effect of foot orthoses and insoles on running economy and performance in distance runners: A systematic review and meta-analysis.
Crago, D, Bishop, C, Arnold, JB
Journal of sports sciences. 2019;(22):2613-2624
Abstract
Foot orthoses and insoles are prescribed to runners, however their impact on running economy and performance is uncertain. The aim of this systematic review and meta-analysis was to determine the effect of foot orthoses and insoles on running economy and performance in distance runners. Seven electronic databases were searched from inception until June 2018. Eligible studies investigated the effect of foot orthoses or insoles on running economy (using indirect calorimetry) or running performance. Standardised mean differences (SMDs) were computed and meta-analyses were conducted using random effects models. Methodological quality was assessed using the Quality Index. Nine studies met the criteria and were included: five studies investigated the effect of foot orthoses on running economy and four investigated insoles. Foot orthoses were associated with small negative effects on running economy compared to no orthoses (SMD 0.42 [95% CI 0.17,0.72] p = 0.007). Shock absorbing insoles were also associated with negative effects on running economy, but an imprecise estimate (SMD 0.26 [95% CI -0.33,0.84] p = 0.83). Quality Index scores ranged from 4 to 15 out of 17. Foot orthoses and shock absorbing insoles may adversely affect running economy in distance runners. Future research should consider their potential effects on running performance.
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Isolated ingestion of caffeine and sodium bicarbonate on repeated sprint performance: A systematic review and meta-analysis.
Lopes-Silva, JP, Choo, HC, Franchini, E, Abbiss, CR
Journal of science and medicine in sport. 2019;(8):962-972
Abstract
OBJECTIVES This study is a systematic review and meta-analysis aimed at investigating the isolated effects of caffeine and sodium bicarbonate (NaHCO3) ingestion on repeated sprint ability (RSA). METHODS Following a search through PubMed and Scopus, 13 studies (7 with caffeine and 6 with NaHCO3) were found to meet inclusion criteria. Random-effects of standardized mean difference (SMD) for total work and best sprint performance was examined. Study quality was assessed using QualSyst. RESULTS The meta-analysis indicated that caffeine ingestion did not improve the total work done (weighted average effect size Hedges's g = -0.01, 95%CI: -0.32 to 0.31, p = 0.97), best sprint (weighted average effect size Hedges's g = -0.02, 95% CI: -0.32 to 0.27; p = 0.87) or last sprint performance (weighed average effect size Hedge's g = -0.27, 95%CI: -0.68 to 0.14; p = 0.20), when compared with a placebo condition. Similarly, NaHCO3 ingestion did not improve the total work done (weighted average effect size Hedges's g = 0.43, 95% CI: -0.11 to 0.97, p = 0.12), best sprint (weighted average effect size Hedges's g = 0.02, 95% CI -0.30 to 0.34; p = 0.90) or last sprint performance (weighted average effect size Hedge's g = 0.20, 95%CI: -0.13 to 0.52, p = 0.14), compared with a placebo condition. Quality assessment of selected articles was classified as strong. CONCLUSION This meta-analysis provides evidence that repeated sprint ability is not affected by acute ingestion of caffeine or NaHCO3.
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Zinc status at baseline is not related to acute changes in serum zinc concentration following bouts of running or cycling.
Chu, A, Petocz, P, Samman, S
Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS). 2018;:105-110
Abstract
Zinc status is implicated in physiological functions related to exercise performance and physical activity. We have previously demonstrated significant changes in serum zinc concentrations following a bout of aerobic exercise, suggestive of a relationship between zinc metabolism and exercise-related functions. In the present study, we aim to determine the association between pre-exercise serum zinc concentration and immediate changes in serum zinc concentration following an aerobic exercise bout. We have previously conducted a systematic literature search of PubMed, Web of Science, Scopus and SPORTDiscus, for studies that investigated the acute effects of aerobic exercise on zinc biomarkers. In the current study, we undertook a secondary analysis using mixed effects meta-regression modelling to determine the relationship between baseline serum zinc concentration and the change in serum zinc concentration immediately after exercise. Meta-regression models revealed no significant relationship between baseline serum zinc concentration and the change in serum zinc concentration following a bout of exercise when all comparisons were included (slope -0.11 ± 0.07 [standard error]; P > 0.05). When comparisons were stratified by exercise modality, no significant relationships were observed for exercise bouts involving cycling or running. The current analyses were limited by the available literature and low statistical power of the meta-regression models. Based on the current available data, the present analysis revealed limited evidence for a relationship between pre-exercise serum zinc concentration and immediate changes in serum zinc levels following a bout of aerobic exercise. Subgroup meta-regression analyses stratified by the mode of exercise bouts did not differ from the overall results. This suggests that zinc status at baseline is not related to acute changes in serum zinc concentration following bouts of aerobic exercise.
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Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis.
Hamstra-Wright, KL, Bliven, KC, Bay, C
British journal of sports medicine. 2015;(6):362-9
Abstract
Medial tibial stress syndrome (MTSS) is a common injury in runners and military personnel. There is a lack of agreement on the aetiological factors contributing to MTSS, making treatment challenging and highlighting the importance of preventive efforts. Understanding the risk factors for MTSS is critical for developing preventive measures. The purpose of this systematic review and meta-analysis was to assess what factors put physically active individuals at risk to develop MTSS. Selected electronic databases were searched. Studies were included if they contained original research that investigated risk factors associated with MTSS, compared physically active individuals with MTSS and physically active individuals without MTSS, were in the English language and were full papers in peer-reviewed journals. Data on research design, study duration, participant selection, population, groups, MTSS diagnosis, investigated risk factors and risk factor definitions were extracted. The methodological quality of the studies was assessed. When the means and SDs of a particular risk factor were reported three or more times, that risk factor was included in the meta-analysis. There were 21 studies included in the systematic review and nine risk factors qualified for inclusion in the meta-analysis. Increased BMI (weighted mean difference (MD)=0.79, 95% CI 0.38 to 1.20, p<0.001), navicular drop (MD=1.19 mm, 95% CI 0.54 to 1.84, p<0.001), ankle plantarflexion range of motion (ROM; MD=5.94°, 95% CI 3.65 to 8.24, p<0.001) and hip external rotation ROM (MD=3.95°, 95% CI 1.78 to 6.13, p<0.001) were risk factors for MTSS. Dorsiflexion and quadriceps-angle were clearly not risk factors for MTSS. There is a need for high-quality, prospective studies using consistent methodology evaluating MTSS risk factors. Our findings suggest that interventions focused on addressing increased BMI, navicular drop, ankle plantarflexion ROM and hip external rotation ROM may be a good starting point for preventing and treating MTSS in physically active individuals such as runners and military personnel.
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Risk factors associated with lower extremity stress fractures in runners: a systematic review with meta-analysis.
Wright, AA, Taylor, JB, Ford, KR, Siska, L, Smoliga, JM
British journal of sports medicine. 2015;(23):1517-23
Abstract
BACKGROUND Stress fractures are common overuse injuries with up to 95% occurring in the lower extremities. Among runners, stress fractures account for 15-20% of all musculoskeletal injuries. PURPOSE We systematically reviewed and critiqued the evidence regarding risk factors associated with increased risk of lower extremity stress fractures in runners. STUDY DESIGN Systematic review. METHODS A systematic, computerised literature search of Medline, Embase, PubMed, SPORTDiscus, and CINAHL databases (from database inception through 9 January 2014) using keywords related to risk factors and stress fractures. This systematic review with meta-analysis utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the search and reporting phases of the study. Inverse variance meta-analyses, using a random effects model were used to summarise ORs. RESULTS 8 articles met the inclusion criteria; 7 were considered low risk. 4 articles qualified for meta-analysis. Results of the meta-analysis identified previous history of stress fracture and female sex as the primary risk factors for future stress fracture with a pooled OR of 4.99 (95% CI 2.91 to 8.56; p<0.001; I(2)=0%) and 2.31 (95% CI 1.24 to 4.29; p<0.01; I(2)=0%), respectively. CONCLUSIONS Currently, only previous history of stress fracture and female sex are risk factors for lower extremity stress fractures strongly supported by the data.