Gait retraining to promote mid-foot landing in habitual rear-foot landing runners

![CDATA[Rationale/Objectives: Running-related injuries are common and a high loading rate has been reported as one of the biomechanical risk factors. Some studies suggested that switching from a rear-foot strike (RFS) to a mid- (MFS) or fore-foot (FFS) landing could reduce loading rate. However, FFS has been associated with increased tension in the Achilles tendon, and switching to MFS is considered safer and more gradual. Unfortunately, there is a lack of evidence to demonstrate the biomechanical effects of a gait retraining promoting MFS landing. Thus, this study aimed to evaluate the effect of such program on the runners’ biomechanics. Methods: Twelve RFS runners underwent eight sessions of gait retraining. During each session, real-time footstrike information was displayed to the participants and they were instructed to maintain a MFS landing. Instrumented gait analyses were conducted before and after the training. Footstrike angle, average and instantaneous loading rate (VALR and VILR), ankle and knee stiffness were measured. Results: There was a significant reduction in footstrike angle (p=0.002, d=1.53), yet no difference was found in VALR and VILR (p>0.140, d=0.42-0.43). Ankle stiffness was comparable to the baseline value (p=0.912, d=0.03), but there was an increase in the knee joint stiffness (p=0.007, d=1.04). Conclusions: The gait retraining to promote MFS was effective in reducing runners’ footstrike angle and was coupled with an increase in knee joint stiffness. However, changes in VALR and VILR and ankle joint stiffness were inconsistent among trained runners. Further research is necessary to understand the efficacy of MFS-focused gait retraining programs.]]