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Effects of foot strengthening program on the injuries prevalence and on foot and ankle biomechanicst in long distance runners: a randomized controlled clinical trial

Grant number: 14/27311-9
Support type:Scholarships in Brazil - Master
Effective date (Start): September 01, 2015
Effective date (End): August 31, 2016
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Isabel de Camargo Neves Sacco
Grantee:Alessandra Bento Matias
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Background: The human foot is a very complex structure, which allows it to serve for various functions. During the gait, the foot should be stable to the heel at foot-strike and push-off. However, during the mid-support, the foot should become mobile to adapt and attenuate loads.The intrinsic muscles of the foot are routinely activated in the late stance of walking and may have a significant role in the distribution of loads under the foot increasing the flexor function of the medial longitudinal arch, especially at high speeds, as the running. The running has won popularity worldwide and is the first type of exercise chosen by many individuals of all ages for its low cost, versatility, convenience and benefits to health for men and women of diverse cultural, ethnic and economic backgrounds. This method, however, can also cause injuries, especially in the lower limbs and studies observed an incidence of lesions in the lower limbs between 19.4% and 92.4% in long-distance runners. Objectives: The primary objective of this study is to verify the occurrence of injuries in the lower limbs of long distance runners in 6 months of the study after a foot-strengthening program. The secondary objectives are to verify the effects on (i) time to occurrence of the first lesion in 6 and 12 months, (ii) ankle strength, (iii) joint moments of ankle and knee gait and running, (iv) Power ankle gait and race, (v) front ankle kinematics during gait and running, and (vi) dynamic deformation of the longitudinal arch. These same subjects will also be evaluated in 1 follow-up in 4 months in biomechanics lab. Methods: A prospective random parallel controlled clinical trial, will be conducted with blinding of assessors with 90 healthy long distance runners between 18 and 55 years old who will be randomly assigned to the control group or intervention, and the latter will participate in a program strengthening for the ankle / foot complex with exercises. These should be performed 3 times per week at home, and for 8 weeks, the intervention will have a presence monitoring once time a week with physiotherapists responsible for the study. Runners will be monitored remotely via software during the 8-week intervention and also after six months of study. The subjects will be evaluated in 3 times as ankle strength, moments of ankle and knee joint in walking and running, power ankle gait and running, front ankle kinematics during gait and running and dynamic deformation of the longitudinal arch, besides the occurrence lesions weekly through a software in development for six months. Hypotheses: The hypotheses of this study are to reduce the number of injuries related to race in the lower limbs of long distance runners in six months after the start of the study, increased time to occurrence of the first lesion in 6 months, increased time and extensor power ankle , time extensor knee in the second half of the support, increased isometric torque of ankle and decreased deformation of the longitudinal arch during the march, after 8 weeks of specific training.

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
TADDEI, ULISSES T.; MATIAS, ALESSANDRA B.; RIBEIRO, FERNANDA I. A.; INOUE, RAFAEL S.; BUS, SICCO A.; SACCO, ISABEL C. N. Effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: Feasibility study for a randomized controlled trial. PHYSICAL THERAPY IN SPORT, v. 34, p. 216-226, NOV 2018. Web of Science Citations: 0.
MATIAS, ALESSANDRA B.; TADDEI, ULISSES T.; DUARTE, MARCOS; SACCO, ISABEL C. N. Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial. BMC MUSCULOSKELETAL DISORDERS, v. 17, APR 14 2016. Web of Science Citations: 3.

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