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Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis.
Gait Posture. 2019 03; 69:13-24.GP

Abstract

INTRODUCTION

Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT).

OBJECTIVE

To systematically review evidence for kinematic risk factors for LLT in runners.

METHODS

Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor.

RESULTS

Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation, moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT.

SIGNIFICANCE

Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.

Authors+Show Affiliations

University of Groningen, University Medical Center Groningen, Department of Sports and Exercise Medicine, The Netherlands. Electronic address: s.h.mousavi@umcg.nl.University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran.University of Groningen, University Medical Center Groningen, Department of Orthopedic Surgery, The Netherlands.University of Groningen, University Medical Center Groningen, Department of Sports and Exercise Medicine, The Netherlands.University of Groningen, University Medical Center Groningen, Department of Sports and Exercise Medicine, The Netherlands.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30658311

Citation

Mousavi, Seyed Hamed, et al. "Kinematic Risk Factors for Lower Limb Tendinopathy in Distance Runners: a Systematic Review and Meta-analysis." Gait & Posture, vol. 69, 2019, pp. 13-24.
Mousavi SH, Hijmans JM, Rajabi R, et al. Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis. Gait Posture. 2019;69:13-24.
Mousavi, S. H., Hijmans, J. M., Rajabi, R., Diercks, R., Zwerver, J., & van der Worp, H. (2019). Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis. Gait & Posture, 69, 13-24. https://doi.org/10.1016/j.gaitpost.2019.01.011
Mousavi SH, et al. Kinematic Risk Factors for Lower Limb Tendinopathy in Distance Runners: a Systematic Review and Meta-analysis. Gait Posture. 2019;69:13-24. PubMed PMID: 30658311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis. AU - Mousavi,Seyed Hamed, AU - Hijmans,Juha M, AU - Rajabi,Reza, AU - Diercks,Ron, AU - Zwerver,Johannes, AU - van der Worp,Henk, Y1 - 2019/01/11/ PY - 2018/10/05/received PY - 2018/12/05/revised PY - 2019/01/09/accepted PY - 2019/1/19/pubmed PY - 2019/11/13/medline PY - 2019/1/19/entrez KW - Biomechanics KW - Gait KW - Injury KW - Running KW - Tendinopathy SP - 13 EP - 24 JF - Gait & posture JO - Gait Posture VL - 69 N2 - INTRODUCTION: Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT). OBJECTIVE: To systematically review evidence for kinematic risk factors for LLT in runners. METHODS: Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor. RESULTS: Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation, moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT. SIGNIFICANCE: Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT. SN - 1879-2219 UR - https://www.unboundmedicine.com/medline/citation/30658311/Kinematic_risk_factors_for_lower_limb_tendinopathy_in_distance_runners:_A_systematic_review_and_meta-analysis L2 - https://linkinghub.elsevier.com/retrieve/pii/S0966-6362(18)31675-8 DB - PRIME DP - Unbound Medicine ER -