Far too little attention has been paid to health effects of air pollution and physical (in)activity on musculoskeletal health. The purpose of the Healthy aging in industrial environment study (4HAIE) is to investigate the potential impact of physical activity in highly polluted air on musculoskeletal health. A total of 1500 active runners and inactive controls aged 18–65 will be recruited. The sample will be recruited using quota sampling based on location (the most air-polluted region in EU and a control region), age, sex, and activity status. Participants will complete online questionnaires and undergo a two-day baseline laboratory assessment, including biomechanical, physiological, psychological testing, and magnetic resonance imaging. Throughout one-year, physical activity data will be collected through Fitbit monitors, along with data regarding the incidence of injuries, air pollution, psychological factors, and behavior collected through a custom developed mobile application. Herein, we introduce a biomechanical and musculoskeletal protocol to investigate musculoskeletal and neuro-mechanical health in this 4HAIE cohort, including a design for controlling for physiological and psychological injury factors. In the current ongoing project, we hypothesize that there will be interactions of environmental, biomechanical, physiological, and psychosocial variables and that these interactions will cause musculoskeletal diseases/protection.

In large cohort studies, due to the time-consuming nature of the measurement of movement biomechanics, more than one evaluator needs to be involved. This may increase the potential occurrence of error due to inaccurate positioning of markers to the anatomical locations. The purpose of this study was to determine the reliability and objectivity of lower limb segments length by multiple evaluators in a large cohort study concerning healthy aging in an industrial environment. A total of eight evaluators performed marker placements on five participants on three different days. Evaluators placed markers bilaterally on specific anatomical locations of the pelvis, thigh, shank and foot. On the right foot, markers were placed in anatomical locations to define a multi-segmental foot model. The position of the marker at the anatomical locations was recorded by a motion capture system. The reliability and objectivity of lower limb segment lengths was determined by the intraclass correlation coefficient of a two-way random model and of the two-way mixed model, respectively. For all evaluators for all segments, the average reliability and objectivity was greater than 0.8, except for the metatarsus segment (0.683). Based on these results, we can conclude that multiple evaluators can be engaged in a large cohort study in the placement of anatomical markers.

Background: Despite the increasing incidence of Achilles tendon (AT) ruptures, there is a lack of information on the possible risks associated with regular running and walking for exercise after an injury. There are some known kinematic gait changes after an AT rupture, especially at the knee. However, it is not clear whether runners with AT ruptures may be at risk for secondary knee injuries during shod or barefoot running/walking. Purpose/Hypothesis: The purpose of this study was to compare the kinematics and kinetics of barefoot walking and barefoot and shod running between athletes with a history of AT ruptures and a healthy control group. We hypothesized that there would be increased knee joint loads in the affected limb of the AT rupture group, especially during shod running. Study Design: Controlled laboratory study. Methods: Ten patients who had undergone surgical treatment of a unilateral acute AT rupture (6.1 ± 3.7 years postoperatively ) and 10 control participants were matched according to age, sex, physical activity, weight, height, and footfall type. The kinematics and kinetics of barefoot walking and barefoot and shod running were recorded using a high-speed motion capture system synchronized with force platforms. Results: The main outcome measures were lower extremity joint angles and moments during the stance phase of walking and running. After AT repair, athletes had increased internal knee abduction moments during shod and barefoot running compared with the healthy control group ( P < .05, η² > 0.14). There were no significant differences in kinematics and kinetics during walking between the AT rupture and healthy control groups ( P ≥ .05). Conclusion: After an AT rupture, athletes had increased internal knee abduction moments during running compared with the healthy control group. Clinical Relevance: The increased abduction loads on the knee in patients with an AT rupture could lead to further running-related injuries. However, barefoot walking may be used as a proprioceptive exercise without an increased risk of overuse injuries in these patients.

There are relatively few running studies that have attempted to prospectively identify biomechanical risk factors associated with Achilles tendon (AT) injuries. Therefore, the aim was to prospectively determine potential running biomechanical risk factors associated with the development of AT injuries in recreational, healthy runners. At study entry, 108 participants completed a set of questionnaires. They underwent an analysis of their running biomechanics at self-selected running speed. The incidence of AT running-related injuries (RRI) was assessed after 1-year using a weekly questionnaire standardized for RRI. Potential biomechanical risk factors for the development of AT RRI injury were identified using multivariable logistic regression. Of the 103 participants, 25% of the sample (15 males and 11 females) reported an AT RRI on the right lower limb during the 1-year evaluation period. A more flexed knee at initial contact (odds ratio = 1.146, P = .034) and at the midstance phase (odds ratio = 1.143, P = .037) were significant predictors for developing AT RRI. The results suggested that a 1-degree increase in knee flexion at initial contact and midstance was associated with a 15% increase in the risk of an AT RRI, thus causing a limitation of training or a stoppage of running in runners.

Coordinative patterns require experience and learning to be acquired, producing movements that offer efficient solutions to various situations and involving certain degree of variability. This coordination variability implies functionality in movement, but it can be impacted by the type of sport practice from early years. The purpose of this work is to analyze the coordination variability and coordination patterns in a specific action such as single-leg landing in children practicing gymnastics, volleyball and non-sporting children. Thirty children (15 girls) performed 10 successful trials of single-leg landing from a height of 25 cm. A motion capture system (9 cameras) was used to capture 3D thigh and shank kinematics. To identify the significant effect of children's groups on coordination and coordination variability during single-leg landing, one-dimensional Statistical Parametric Mapping (SPM) was used. Regarding the coordination patterns, in the frontal plane, during the attenuation phase of single-leg landing, the control group exhibited a higher frequency of Anti-Phase with proximal dominancy compared to the sport groups (i.e., gymnastics, and volleyball). In addition, in the sagittal plane during the second peak phase, volleyball players exhibited a higher coordination variability than the gymnastics. The children in the control group showed a greater frequency of antiphasic movements, which indicates the influence of training at an early age, being a determining factor in the increase or not of variability.

Introduction: Plantar fasciitis (PF) is one of the most common running-related injuries. Purpose: The aim of this prospective study was to determine the incidence of PF and identify potential risk or protective factors for PF in runners and non-runners. Methods: Data from 1206 participants from the 4HAIE cohort study (563 females/643 males; 715 runners/491 non-runners; 18–65 yr of age) were included in the analysis. We collected biomechanical data during overground running using a three-dimensional motion capture system at the baseline and running distance data via retrospective questionnaires and followed the participants for 12 months following the baseline data collection. Participants were asked weekly about any sports-related injury (including PF). A binary logistic regression was performed to reveal potential associations between running distance and biomechanical risk factors and PF while controlling for running distance, sex, and age. Results: The total incidence of PF was 2.3% (28 PF from 1206 participants), 2.5% in runners and 2.0% in non-runners ( P = 0.248). Runners who ran more than 40 km·wk ⁻¹ had six times higher odds of suffering PF than individuals who ran 6–20 km·wk ⁻¹ ( P = 0.009). There was a significant association between maximal ankle eversion and PF; that is, runners with a greater eversion angle during the stance period had higher risk of PF ( P = 0.024). No other biomechanical variables indicated significant associations with PF. Conclusions: Regular running with a moderate weekly volume and more toeing out of the foot relative to the shank may reduce the risk against PF in runners, which may be useful for researchers, runners, coaches, and health professionals to minimize PF injury risk.