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.

Background Air pollution has been linked to increased mortality and morbidity. The Program 4 of the Healthy Aging in Industrial Environment study investigates whether the health and wellbeing benefits of physical activity (PA) can be fully realized in individuals living in highly polluted environments. Herein, we introduce the behavioral, psychological and neuroimaging protocol of the study. Methods This is a prospective cohort study of N = 1500 individuals aged 18–65 years comparing: (1) individuals living in the highly polluted, industrial region surrounding the city of Ostrava (n = 750), and (2) controls from the comparison region with relative low pollution levels in Southern Bohemia (n = 750). Quota sampling is used to obtain samples balanced on age, gender, PA status (60% active runners vs. 40% insufficiently active). Participants are screened and complete baseline assessments through online questionnaires and in-person lab-based assessments of physiological, biomechanical, neuroimaging and cognitive function parameters. Prospective 12-month intensive monitoring of air pollution and behavioral parameters (PA, inactivity, and sleep) follows, with a focus on PA-related injuries and psychological factors through fitness trackers, smartphones, and mobile apps. Subsequently, there will be a 5-year follow-up of the study cohort. Discussion The design of the study will allow for (1) the assessment of both short-term variation and long-term change in behavioral parameters, (2) evaluation of the incidence of musculoskeletal injuries and psychological factors impacting behavior and injury recovery, and (3) the impact that air pollution status (and change) has on behavior, psychological resilience, and injury recovery. Furthermore, the integration of MRI techniques and cognitive assessment in combination with data on behavioral, biological and environmental variables will provide an opportunity to examine brain structure and cognitive function in relation to health behavior and air pollution, as well as other factors affecting resilience against and vulnerability to adverse changes in brain structure and cognitive aging. This study will help inform individuals about personal risk factors and decision-makers about the impact of environmental factors on negative health outcomes and potential underlying biological, behavioral and psychological mechanisms. Challenges and opportunities stemming from the timing of the study that coincided with the COVID-19 pandemic are also discussed.

BackgroundPrevious research indicated that running barefoot or in minimalist shoes led to lower impact loading in an adolescent and adult population. Running as fundamental locomotor skill signi cantly develops during early childhood (preschool age). However, no study has focused on effect of footwear condition on lower limb impact loading during running in this age. Therefore, the purpose of this study was to assess effect of footwear conditions (barefoot, minimalist and standard running shoes) on running impact loading in the preschool years. MethodsFourty-eight habitually shod preschool children were divided into 4 age groups. Children performed simple running game in 3 different footwear conditions (random counter-balanced order), 3-dimensional biomechanical analysis were carried out during overground running. The key dependent variables included vertical ground reaction force (VGRF) and vertical instantaneous loading rate (VILR). Statistical parametric mapping was performed to reveal possible differences in VGRF and one-way repeated measures ANOVA in VILR. ResultsThree-year-old children displayed signi cantly lower impact peak of VGRF in barefoot condition compared to minimalist (3-7% stance, P = 0.012) and standard running shoes (7-11% stance, P = 0.009). Furthermore, in 3-year-old in minimalist shoes had higher loading than in standard running shoes (0-4% stance, P = 0.007). There were also differences in VILR, where 3-year-old had lower loading in barefoot than in minimalist (P = 0.010, d = 1.19) or standard running shoes (P = 0.045, d = 0.98). No differences were found in older children. ConclusionRunning in minimalist shoes did not imitate barefoot running and did not lower impact forces compared to standard running shoes in 3-year-old children. On the contrary, increased loading was observed in minimalist shoes in early running developmental stages. Professionals who work with children should consider effect of minimalist shoes on impact loading (running on hard surfaces).

The purpose of this study was to compare lower extremity coordination variability between runners with history of Achilles tendon rupture and healthy controls. Twenty participants, 10 Achilles tendons repaired and 10 controls, were recruited. The groups were matched according to age, sex, volume of running, speed, body mass, height, and footfall type. Achilles tendon mechanical properties were determined using a sonographic technique. A motion capture system was used to record running kinematics. A vector coding technique was used to investigate segment coordination variability and the mean phase angle. Statistical parametric mapping was used to examine the relationship in coordination variability between groups. Higher foot eversion and shank internal rotation coordination variability were found in participants with a history of Achilles tendon rupture compared to healthy controls during the portion of the stance phase between 47.2% and 50.3% when the maximal ground reaction force occurs. The current study provides the empirical evidence for increased coordination variability in a specifically affected group of runners. Altered coordination variability between the foot and shank may indicate a risk of abnormal loading of the musculoskeletal structures of the lower extremity in runners with a history of Achilles tendon rupture.

Background Previous research indicated that running barefoot or in minimalist shoes led to lower impact loading in an adolescent and adult population. Running as fundamental locomotor skill significantly develops during early childhood (preschool age). However, no study has focused on effect of footwear condition on lower limb impact loading during running in this age. Therefore, the purpose of this study was to assess effect of footwear conditions (barefoot, minimalist and standard running shoes) on running impact loading in the preschool years. Methods Fourty-eight habitually shod preschool children were divided into 4 age groups. Children performed simple running game in 3 different footwear conditions (random counter-balanced order), 3-dimensional biomechanical analysis were carried out during overground running. The key dependent variables included vertical ground reaction force (VGRF) and vertical instantaneous loading rate (VILR). Statistical parametric mapping was performed to reveal possible differences in VGRF and one-way repeated measures ANOVA in VILR. Results Three-year-old children displayed significantly lower impact peak of VGRF in barefoot condition compared to minimalist (3-7% stance, P = 0.012) and standard running shoes (7-11% stance, P = 0.009). Furthermore, in 3-year-old in minimalist shoes had higher loading than in standard running shoes (0-4% stance, P = 0.007). There were also differences in VILR, where 3-year-old had lower loading in barefoot than in minimalist (P = 0.010, d = 1.19) or standard running shoes (P = 0.045, d = 0.98). No differences were found in older children. Conclusion Running in minimalist shoes did not imitate barefoot running and did not lower impact forces compared to standard running shoes in 3-year-old children. On the contrary, increased loading was observed in minimalist shoes in early running developmental stages. Professionals who work with children should consider effect of minimalist shoes on impact loading (running on hard surfaces).