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Effects of a foot and ankle complex strengthening program on the occurrence of injuries and biomechanics in long distance runners: a controlled, randomized clinical trial

Grant number: 16/17077-4
Support Opportunities:Scholarships in Brazil - Doctorate (Direct)
Effective date (Start): May 01, 2017
Effective date (End): June 30, 2020
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Isabel de Camargo Neves Sacco
Grantee:Alessandra Bento Matias
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated research grant:15/14810-0 - Biomechanical and functional aspects of the musculoskeletal system of runners: chronic effects of therapeutic exercise and aging, AP.TEM
Associated scholarship(s):17/26844-1 - Running in minimal footwear, partial minimal and barefoot: joint kinetics and loading rates patterns, BE.EP.DD


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's attack and the impulse. However, during the mid-stance, the foot should become mobile to adapt and mitigate the charges. The intrinsic muscles of the foot are routinely activated in the late phase 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 race. The races have gained popularity around the world and is the first type of exercise chosen by many individuals of all ages for their low cost, versatility, convenience and benefits to health for men and women of diverse cultural, ethnic and economic backgrounds. This modality, however, can also cause injuries, especially in the lower limbs and van Gent et al (2014) observed an incidence of injuries in lower limbs between 19.4% and 92.4% in the long-distance runners. Objective: The primary objective of this study is to verify the occurrence of injuries in lower limbs of long distance runners in the 12 months of study after a foot-strengthening program. Are secondary objectives to verify the effects on (i) time to occurrence of the first injury in 12 months; (ii) time articulating ankle in walking and running; (iii) power ankle in gait and running; (iv) front kinematics ankle in gait and running; and (v) dynamic deformation of the longitudinal arch. These same subjects will be evaluated in 3 times and follow-up in 2 months in biomechanics laboratory and in 12 months for injury. There will be a prospective controlled clinical trial, parallel with random allocation and blinding of assessors with 111 healthy long distance runners aged 18 and 55 who will be randomly assigned to the control group or intervention. The intervention group will participate in a strengthening program the complex ankle/foot seven years. These should be performed daily, and for 8 weeks, the intervention will have a face tracking 1 to week with physiotherapists responsible for the study. Runners will be monitored remotely via software during the 8-week intervention and also after for twelve months of study. The subject will be evaluated in 3 times as the joint ankle moments during gait and running, power ankle in gait and running, front kinematics of the ankle gait and running and dynamic deformation of the longitudinal arch, besides the occurrence of injuries weekly through a software development for twelve months. Are hypotheses of this study to decrease the number of injuries related to running in the lower limbs of long distance runners in the twelve months after the start of the study, increasing the time to occurrence of the first injury in 12 months, increasing the time and decreased deformation of the longitudinal arch during the march, after 16 weeks of specific training. (AU)

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Scientific publications (7)
(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)
SUDA, ENEIDA YURI; WATARI, RICKY; MATIAS, ALESSANDRA BENTO; SACCO, ISABEL C. N.. Recognition of Foot-Ankle Movement Patterns in Long-Distance Runners With Different Experience Levels Using Support Vector Machines. FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY, v. 8, . (17/15449-4, 15/14810-0, 19/19291-1, 16/17077-4)
MATIAS, ALESSANDRA B.; CARAVAGGI, PAOLO; TADDEI, ULISSES T.; LEARDINI, ALBERTO; SACCO, ISABEL C. N.. Rearfoot, Midfoot, and Forefoot Motion in Naturally Forefoot and Rearfoot Strike Runners during Treadmill Running. APPLIED SCIENCES-BASEL, v. 10, n. 21, . (17/26844-1, 16/17077-4, 17/23975-8, 15/14810-0)
MATIAS, ALESSANDRA B.; CARAVAGGI, PAOLO; LEARDINI, ALBERTO; TADDEI, ULISSES T.; ORTOLANI, MAURIZIO; SACCO, ISABEL. Repeatability of skin-markers based kinematic measures from a multi-segment foot model in walking and running. JOURNAL OF BIOMECHANICS, v. 110, p. 6-pg., . (17/23975-8, 16/17077-4, 17/26844-1, 15/14810-0)
E.Y. SUDA; M.F. VIEIRA; A.B. MATIAS; R.S. GOMIDE; I.C.N. SACCO. Running intralimb coordination patterns after a foot core exercise program in recreational runners. Brazilian Journal of Medical and Biological Research, v. 57, . (16/17077-4, 17/15449-4, 17/26844-1, 15/14810-0)
SUDA, ENEIDA YURI; MATIAS, ALESSANDRA BENTO; BUS, SICCO A.; SACCO, ISABEL C. N.. Impact of diabetic neuropathy severity on foot clearance complexity and variability during walking. GAIT & POSTURE, v. 74, p. 194-199, . (17/15449-4, 16/17077-4)
MATIAS, ALESSANDRA B.; WATARI, RICKY; TADDEI, ULISSES T.; CARAVAGGI, PAOLO; INOUE, RAFAEL S.; THIBES, RAISSA B.; SUDA, ENEIDA Y.; VIEIRA, MARCUS F.; SACCO, ISABEL C. N.. Effects of Foot-Core Training on Foot-Ankle Kinematics and Running Kinetics in Runners: Secondary Outcomes From a Randomized Controlled Trial. FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY, v. 10, p. 16-pg., . (17/15449-4, 17/26844-1, 16/17077-4, 15/14810-0, 17/23975-8, 19/19291-1)
WATARI, RICKY; SUDA, ENEIDA Y.; SANTOS, JOAO P. S.; MATIAS, ALESSANDRA B.; TADDEI, ULISSES T.; SACCO, ISABEL C. N.. Subgroups of Foot-Ankle Movement Patterns Can Influence the Responsiveness to a Foot-Core Exercise Program: A Hierarchical Cluster Analysis. FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY, v. 9, . (17/15449-4, 16/17077-4, 19/19291-1, 15/14810-0)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
MATIAS, Alessandra Bento. Effects of foot core strengthening on running foot biomechanics: a randomized controlled trial. 2021. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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