Decreasing multiple risk factors for tibial stress fractures through gait retraining - Rehabilitation Institute of Chicago

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Thu, Apr 14

Speaker: Rebecca Fellin (University of Delaware)

Title: Decreasing multiple risk factors for tibial stress fractures through gait retraining

Abstract:  Recently, physical activity has been extensively promoted to maintain good health.

Running is a popular form of physical activity, but unfortunately, up to 79% of runners are injured each year. One more serious type of injury that runners sustain is a tibial stress fracture (TSF). Various biomechanical risk factors, such as excessive external loads, have been identified as risk factors for TSF. We have demonstrated that gait retraining during treadmill running, which includes real time feedback of a subject’s external loading from one limb, has been effective to decrease external loading on that limb. Ideally, this lower loading decreases the risk of TSF. While this intervention is effective at decreasing vertical loading on the trained limb, there are other biomechanical risk factors for TSF that this protocol did not target. We explored the impact of gait retraining on other TSF risk factors. Preliminarily, our results indicate this gait retraining protocol may decrease global risk for sustaining a TSF by decreasing multiple risk factors despite only providing feedback for one risk factor.  Finally, while external loading is important, it does not provide direct evidence of bony loading. To further validate this gait retraining protocol, we explored tibial strain rates using a finite element model to identify within subject changes following gait retraining. Preliminary data indicate that tibial strain rates decrease following gait retraining in the region of the tibia where stress fractures are the most common. Based upon our preliminary results, it appears this gait retraining protocol may be effective at decreasing multiple risk factors for TSF including risk factors not targeted by this intervention.

Host: Arun Jayaraman