The Association Between the Acute:Chronic Workload Ratio and Running-Related Injuries in Dutch Runners: A Prospective Cohort Study

Author(s)

Nakaoka, Gustavo ^{[1, 2]} ; Barboza, Saulo Delfino ^{[3, 4, 5]} ; Verhagen, Evert ^{[3, 4, 6]} ; van Mechelen, Willem ^{[3, 4, 6, 7, 8, 9]} ; Hespanhol, Luiz ^{[1, 2, 3, 4]}

Affiliation

^[1] Univ Cidade Sao Paulo UNICID, Masters Program Phys Therapy, Rua Cesario Galeno 448, BR-03071100 Sao Paulo, SP - Brazil

^[2] Univ Cidade Sao Paulo UNICID, Doctoral Program Phys Therapy, Rua Cesario Galeno 448, BR-03071100 Sao Paulo, SP - Brazil

^[3] Locat VU Univ Med Ctr Amsterdam VUmc, Amsterdam Publ Hlth Res Inst APH, Amsterdam Univ Med Ctr, Dept Publ & Occupat Hlth DPOH, Amsterdam - Netherlands

^[4] Locat VU Univ Med Ctr Amsterdam VUmc, Amsterdam Movement Sci, Amsterdam Univ Med Ctr, Amsterdam Collaborat Hlth & Safety Sports ACHSS, Amsterdam - Netherlands

^[5] Univ Ribeirao Preto, Master Program Hlth & Educ, Sao Paulo - Brazil

^[6] Univ Cape Town, Div Exercise Sci & Sports Med ESSM, Dept Human Biol, Fac Hlth Sci, Cape Town - South Africa

^[7] Univ Queensland, Sch Human Movement & Nutr Sci, Fac Hlth & Behav Sci, Brisbane, Qld - Australia

^[8] Univ Coll Dublin, Sch Publ Hlth Physiotherapy & Populat Sci, Dublin - Ireland

^[9] Univ Med Ctr Groningen, Ctr Human Movement Sci, Groningen - Netherlands

• Document type: Journal article
• Source: SPORTS MEDICINE; v. 51, n. 11, p. 2437-2447, NOV 2021.
• Web of Science Citations: 0

Abstract

Objective To investigate the association between the acute:chronic workload ratio (ACWR) and running-related injuries (RRI). Methods This is a secondary analysis using a database composed of data from three studies conducted with the same RRI surveillance system. Longitudinal data comprising running exposure (workload) and RRI were collected biweekly during the respective cohorts' follow-up (18-65 weeks). ACWR was calculated as the most recent (i.e., acute) external workload (last 2 weeks) divided by the average external (i.e., chronic) workload of the last 4, 6, 8, 10 and 12 weeks. Three methods were used to calculate the ACWR: uncoupled, coupled and exponentially weighted moving averages (EWMA). Bayesian logistic mixed models were used to analyse the data. Results The sample was composed of 435 runners. Runners whose ACWR was under 0.70 had about 10% predicted probability of sustaining RRI (9.6%; 95% credible interval {[}CrI] 7.5-12.4), while those whose ACWR was higher than 1.38 had about 1% predicted probability of sustaining RRI (1.3%; 95% CrI 0.7-1.7). The association between the ACWR and RRI was significant, varying from a small to a moderate association (1-10%). The higher the ACWR, the lower the RRI risk. Conclusions The ACWR showed an inversely proportional association with RRI risk that can be represented by a smooth L-shaped, second-order, polynomial decay curve. The ACWR using hours or kilometres yielded similar results. The coupled and uncoupled methods revealed similar associations with RRIs. The uncoupled method presented the best discrimination for ACWR strata. The EWMA method yielded sparse and non-significant results. (AU)

• FAPESP's process: 16/09220-1 - Development and evaluation process of a prevention program on running-related injuries
• Grantee: Luiz Carlos Hespanhol Junior
• Support Opportunities: Research Grants - Young Investigators Grants