The Start-to-Run Distance and Running-Related Injury Among Obese Novice Runners: A Randomized Trial

Abstract

Background/Purpose: High body mass index is associated with an increased risk of running-related injury among novice runners. However, the amount of running participation plays a fundamental explanatory role in regards to running-related injury development. Therefore, the purpose of the present study was to investigate if the risk of running-related injury among obese novice runners (BMI 30-35) was different when the start-to-run distance was 3km per week instead of 6km per week. Hypothesis:A start-to-run distance of 3km per week is associated with 20% fewer running-related injuries and significantly fewer symptoms of overuse injury than a start-to-run distance of 6km per week among obese novice runners. Study design: Randomized trialMethods: Fifty-six obese novice runners with a body mass index between 30-35 were enrolled and randomized to receive one of the two following Interventions: (i) a 4-week running program with a start-to-run distance of 3km per week including three sessions with 1km running per session (n=29), or (ii) a 4-week running program with a startto-run distance of 6km per week including three sessions with 2km running per session (reference group, n=27). In both programs, the weekly running distance was increased by 10% each week throughout the follow-up. Results:The intention-to-treat analysis revealed a protective cumulative risk difference of -16.3% (95%CI: -43.8%; 11.3%, p=0.25) after four weeks. Importantly, some participants completed much more running than prescribed (n=5) and some never uploaded any training (n=15). Therefore, a supplementary per-protocol analysis was performed revealing a cumulative risk difference of -31.2% (95%CI: -57.0%; -5.2%, p=0.02) after four weeks. Furthermore, in the per-protocol analysis, the cumulative risk difference of overuse-injury symptoms was -47.8% (95%CI: -81.0%; -14.6%, p=0.01) after four weeks of running Conclusions: A 3km reduction from 6km per week to 3km per week in the start-to-run distance appears to be associated with fewer running-related injuries and significantly fewer symptoms of overuse injury.

Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial

“…21,50,52 A gradual increase in load tolerance through repeated training with properly dosed gain in running experience has been shown to reduce RRI risk. 1 For example, a 4week running program for obese novice runners that started with 3 km per week, compared with 6 km per week, reduced cumulative RRI risk by 16.3%. 8 The protection against cumulative RRI risk conferred by foot exercises in our study is not expected to appear immediately, because the increased load tolerance in the IG runners stemmed from muscle gain obtained through months of foot exercise.…”

Randomised controlled trials (RCTs) in sports injury research: authors—please report the compliance with the intervention

“…In four trials/studies, the association between a training programme and running-related injury (RRI) was investigated. These four trials were: Groningen Novice Running (GRONORUN) study,2 6 RUNCLEVER,1 12 ProjectRun21 (PR21)13 and Start 2 Run (S2R) 14. In four other trials,3 15–17 the association between running shoe technology and RRI was examined.…”

“…At baseline, novice runners were allocated into one of the following two running programmes: a short-distance programme (3 km) or a long-distance programme (6 km). No study protocol has been published, but the results have been presented elsewhere 14…”

Adherence and Health-Related Outcomes of Beginner Running Programs: A 10-Week Observational Study

“…Follow-up studies of participants enrolled in the group-based Start to Run program in the Netherlands indicate that 84% reported meeting Dutch physical activity guidelines (Ooms, Leemrijse, Collard, Schipper-van Veldhoven, & Veenhof, 2018) and 70% continued to run (Fokkema et al, 2018) six months later, suggesting that such schemes can lead to sustained changes in behaviour. Although compliance data for such community-based group programs have not been published, session attendance in beginner running programs held in the context of research trials has ranged from 45 to 72% (Bertelsen, Hansen, Rasmussen, & Nielsen, 2018;Buist et al, 2008;Looyestyn, Kernot, Boshoff, & Mayer, 2018). It is important to understand the factors that contribute to non-adherence to beginner running programs since improving participation levels would be expected to lead to greater health and wellbeing benefits.…”