Full length articleBiomechanical adaptations during running differ based on type of exercise and fitness level
Introduction
Over 80% of musculoskeletal injuries are from participation in recreational physical activity or sport, with injuries to the lower extremity accounting for 60% of all musculoskeletal injuries [1]. Neuromuscular fatigue has been theorized as a contributing factor associated with lower extremity musculoskeletal injury in athletes because injuries are most common at the end of games [2]. In order to better understand the neuromuscular effects of fatigue, often defined as a decline in force or power production [3], the effects of exercise on movement patterns during functional tasks has been well-studied, however exercise protocols used to induce fatigue vary widely.
Several laboratory-based exercise protocols exist, most often inducing fatigue using controlled and isolated repetitive movements until task failure [4]. There is some advantage to isolating muscle fatigue with controlled, uni-planar exercises, however overall generalization to sport environment is limited [4]. Other exercise protocols utilize a combination of anaerobic exercises, such as squat jumps and short sprints, or single leg landings and squats [5]. These protocols result in fatigue using exercises that simulate movements experienced during sport and activity, however do not incorporate the aerobic component of prolonged sport participation. Graded treadmill exercise has been used to test cardiopulmonary fitness [6] and is commonly used to induce neuromuscular fatigue due to the fatiguing aerobic component [7].
Although this exercise may induce fatigue, it does not stimulate the demands of sport. In college soccer, for example, walking only makes up approximately 15–20% of games [8] and most lower extremity injuries occur during high-speed movements [9], suggesting that exercise protocols including high-speed activities and simulate the demands of sport may be best suited for assessing fatigue-related adaptations that are more generalizable to highly active athletes participating in prolonged and intense sport environments.
Along with type of exercise, demands of exercise required to illicit fatigue may differ based on fitness level. Current research investigating the influence of neuromuscular fatigue often group all participants together, assuming that all individuals respond similarly to fatiguing exercise, however injuries to the lower extremity are most common in more fit and physically active individuals [1], with injury risk increasing for high-level athletes [10]. High level athletes have increased strength compared to recreational athletes [11], and may require different sport-specific demands to evaluate fatigue-related biomechanical adaptations that may increase injury risk in more fit athletes [1], [12]. Therefore, the purpose of this study was to compare changes in running gait before and after walking exercise and sport-specific exercise between different fitness levels.
Section snippets
Design
This was a descriptive laboratory study with a repeated measures design. The independent variable in this study was fitness level (2 levels: higher fit and lower fit). The dependent variables included pre-post change in sagittal, frontal, and transverse plane knee, hip, and trunk kinematics and internal knee and hip moments.
Subjects
Twenty-four individuals (15F/9M, 19.7 ± 0.9 yrs, 172.8 ± 9.1 cm, 70.5 ± 10.2 kg) without history of lower extremity or trunk surgery or lower extremity or trunk injury within the
Results
The sport exercise resulted in a significantly higher post-exercise heart rate compared to the walking exercise (Sport = 189.1 ± 10.5bpm, Walking = 180.9 ± 12.9bpm, P < 0.0001), however there was no difference in RPE (Sport = 17.7 ± 1.5, Walking = 16.6 ± 1.9, P = 0.256). There was no difference in maximal HR (P = 0.477) or RPE (P = 0.186) between fitness levels after either the walking or sport exercise.
Discussion
The results of this study indicate that biomechanical adaptations after fatiguing exercise are different based on fitness level. Both the higher and lower fit groups demonstrated differences in running gait after each type of exercise. Both groups displayed minimal changes in kinematic and kinetic gait behavior after the walking protocol. In contrast to the walking exercise, both groups demonstrated triplanar changes in lower extremity and trunk kinematics and kinetics after the sport exercise.
Conclusion
Alterations in movement patterns after exercise are dependent on fitness level. There were fewer changes in gait mechanics after the walking exercise, however the sport exercise resulted in triplanar alterations in both higher and lower fit individuals. Higher fit individuals demonstrated increased knee extension, hip extension, knee valgus, and trunk movement after exercise mimicking sport demand. The lower fit group demonstrated a more knee-dominant strategy to attenuate forces when fatigued
Conflicts of interest statement
None.
Funding
This study was funded by the University of Virginia Curry Foundation IDEA Grant.
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