Kinematic Pattern Adherence Following Telehealth Gait Retraining In Military Personnel

Running is the primary cause of musculoskeletal injury and lost or limited duty days in military service members (MSMs). Telehealth gait retraining is an accessible healthcare intervention showing promise in altering foot strike patterns that influences kinetic and spatiotemporal parameters, reducing mechanical strain and potentially reducing injury risk. However, it is inconclusive whether biomechanical changes resulting from telehealth gait retraining persist after the intervention is completed. PURPOSE: To determine the long-term efficacy of an 8-week telehealth gait retraining program to target and modify gait-related kinematic parameters. METHODS: Sixteen MSMs with a rearfoot running pattern and history of anterior knee pain were randomized to receive either the standard physical therapy care (n = 8) or a telehealth gait retraining protocol incorporating visual and verbal cues conducted via instructive video feedback (n = 8). 3D motion capture was utilized to collect kinematic gait parameters at baseline and following the intervention. Participants then were assessed one month after the intervention while concurrently performing a cognitive task (i.e., Stroop test) to assess retention of the gait adaptations learned via telehealth. RESULTS: There were no significant differences (p > 0.05) between groups for all kinematic variables at baseline. Following the intervention, the telehealth group exhibited significantly greater ranges of motion at the hips (17.85 ± 2.97 degrees vs. 14.16 ± 6.03 degrees; p = 0.009) and ankles (42.84 ± 4.58 degrees vs. 38.01 ± 8.24 degrees; p = 0.014) in the frontal and sagittal planes, respectively. The telehealth group also displayed a significant difference in ankle impact angles (7.89 ± 7.28 degrees plantar flexion vs. 1.49 ± 10.58 degrees dorsiflexion; p = 0.005), indicating an adoption of a non-rearfoot strike pattern. During the one-month follow-up, the telehealth group exhibited no differences in strike pattern and all kinematic variables compared to their previous visit, indicating retention of the adopted gait patterns. CONCLUSIONS: Our results suggest that telehealth gait retraining produces kinematic adaptations that may be able to address dispositions to injury in military runners and that these changes persist after the intervention is complete.