Implementation Of Telehealth Gait Retraining For Targeting Musculoskeletal Injury Kinematics In Military Personnel

Running is the most common mechanism of injury in the military service member (MSM) population. Specifically, cumulative stresses incurred using suboptimal kinematic patterns continuously predispose MSMs to increased risks of running-related injury. The gold-standard laboratory-grade equipment and time requirements necessary for biomechanical analyses of gait are unavailable for the MSM population. Recently, the advent of telehealth has diversified options and access to clinical treatment for a variety of pathologies. However, the effectiveness of telehealth to address risk factors contributing to running-related injury for MSMs is, to date, largely unexplored. PURPOSE: To evaluate the efficacy of telehealth gait retraining in addressing kinematic risk factors associated with running-related musculoskeletal injury in military personnel. METHODS: Twenty-eight MSMs were recruited for participation following a referral from a physical therapist and randomly allocated to either receive the standard practices for care in accordance with the Military Health System (n = 15) or receive supplemental telehealth consisting of video feedback concerning running form (i.e., visual and verbal cues to adopt a non-rearfoot strike pattern and to increase step rate by 10 %from baseline) via video shared over a cloud-based coaching platform (n = 13) over the course of eight weeks. Lower-limb kinematic data were collected using a 3D motion capture system as participants ran on a treadmill at a self-selected pace prior to (i.e., baseline) and immediately following the intervention (i.e., post-intervention). RESULTS: There were no significant differences in all collected variables between groups at baseline. Following the intervention, the telehealth group demonstrated significantly greater bilateral hip ranges of motion in both the sagittal (52.79 ± 7.62 degrees vs. 45.42 ± 8.14 degrees; p > 0.001) and frontal planes (18.75 ± 4.46 degrees vs. 16.19 ± 4.49 degrees; p = 0.024) as well as significantly greater average hip flexion at ground contact (32.87 ± 4.34 degrees vs 26.45 ± 9.06 degrees; p > 0.001). CONCLUSION: MSMs demonstrated significantly greater sagittal and frontal plane hip ranges of motion following telehealth gait retraining to adopt a NRFS pattern during gait.