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Running-related injuries among trail runners are very common and footwear selection may 7 modulate the injury risk. However, most previous studies were conducted in a laboratory 8 environment. The objective of this study was to examine the effects of two contrasting 9 footwear design, minimalist (MIN) and maximalist shoes (MAX), on the running 10 biomechanics of trail runners during running on a natural trail. Eighteen habitual rearfoot 11 strike trail runners completed level, uphill and downhill running at their preferred speeds in 12 both shod conditions. Peak tibial acceleration, strike index and footstrike pattern were 13 compared between the two footwear and slopes. Interactions of footwear and slope were not 14 detected for all the selected variables. There was no significant effect from footwear (F=1.23, 15 p=0.27) and slope (F=2.49, p=0.09) on peak tibial acceleration and there was no footwear 16 effect on strike index (F=3.82, p=0.056). A significant main effect of slope on strike index 17 (F=13.24, p<0.001) was found. Strike index during uphill running was significantly greater 18 (i.e., landing with a more anterior foot strike) when compared with level (p<0.001, Cohen's 19 d=1.72) or downhill running (p<0.001, Cohen's d=1.

The present study compared the effect between walking exercise and a newly developed sensor-based gait retraining on the peaks of knee adduction moment (KAM), knee adduction angular impulse (KAAI), knee flexion moment (KFM) and symptoms and functions in patients with early medial knee osteoarthritis (OA). Eligible participants (n = 71) with early medial knee OA (Kellgren-Lawrence grade I or II) were randomized to either walking exercise or gait retraining group. Knee loading-related parameters including KAM, KAAI and KFM were measured before and after 6-week gait retraining. We also examined clinical outcomes including visual analog pain scale (VASP) and Knee Injury and Osteoarthritis Outcome Score (KOOS) at each time point. After gait retraining, KAM1 and VASP were significantly reduced (both Ps < 0.001) and KOOS significantly improved (p = 0.004) in the gait retraining group, while these parameters remained similar in the walking exercise group (Ps ≥ 0.448). However, KAM2, KAAI and KFM did not change in both groups across time (Ps ≥ 0.120). A six-week sensor-based gait retraining, compared with walking exercise, was an effective intervention to lower medial knee loading, relieve knee pain and improve symptoms for patients with early medial knee OA.

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