No effect of a graded training program on the number of running-related injuries in novice runners

Background: Although running has positive effects on health and fitness, the incidence of a running-related injury (RRI) is high. Research on prevention of RRI is scarce; to date, no studies have involved novice runners. Hypothesis: A graded training program for novice runners will lead to a decrease in the absolute number of RRIs compared with a standard training program. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: GRONORUN (Groningen Novice Running) is a 2-armed randomized controlled trial comparing a standard 8-week training program (control group) and an adapted, graded, 13-week training program (intervention group), on the risk of sustaining an RRI. Participants were novice runners (N = 532) preparing for a recreational 4-mile (6.7-km) running event. The graded 13-week training program was based on the 10% training rule. Both groups registered information on running characteristics and RRI using an Internet-based running log. The primary outcome measure was RRIs per 100 participants. An RRI was defined as any musculoskeletal complaint of the lower extremity or back causing a restriction of running for at least 1 week. Results: The graded training program was not preventive for sustaining an RRI (χ2 = 0.016, df = 1, P = .90). The incidence of RRI was 20.8% in the graded training program group and 20.3% in the standard training program group. Conclusions: This randomized controlled trial showed no effect of a graded training program (13 weeks) in novice runners, applying the 10% rule, on the incidence of RRI compared with a standard 8-week training program

The GRONORUN 2 study: effectiveness of a preconditioning program on preventing running related injuries in novice runners. The design of a randomized controlled trial

Background: Distance running is a popular recreational exercise. It is a beneficial activity for health and well being. However, running may also cause injuries, especially of the lower extremities. In literature there is no agreement what intrinsic and extrinsic factors cause running related injuries (RRIs). In theory, most RRIs are elicited by training errors, this too much, too soon. In a preconditioning program runners can adapt more gradually to the high mechanical loads of running and will be less susceptible to RRIs. In this study the effectiveness of a 4-week preconditioning program on the incidence of RRIs in novice runners prior to a training program will be studied. Methods/Design: The GRONORUN 2 (Groningen Novice Running) study is a two arm randomized controlled trial studying the effect of a 4-week preconditioning (PRECON) program in a group of novice runners. All participants wanted to train for the recreational Groningen 4-Mile running event. The PRECON group started a 4-week preconditioning program with walking and hopping exercises 4 weeks before the start of the training program. The control (CON) and PRECON group started a frequently used 9-week training program in preparation for the Groningen 4-Mile running event. During the follow up period participants registered their running exposure, other sporting activities and running related injuries in an Internet based running log. The primary outcome measure was the number of RRIs. RRI was defined as a musculoskeletal ailment or complaint of the lower extremities or back causing a restriction on running for at least three training sessions. Discussion: The GRONORUN 2 study will add important information to the existing running science. The concept of preconditioning is easy to implement in existing training programs and will hopefully prevent RRIs especially in novice runners

Protective Activity of Streptococcus pneumoniae Spr1875 Protein Fragments Identified Using a Phage Displayed Genomic Library

There is considerable interest in pneumococcal protein antigens capable of inducing serotype-independent immunoprotection and of improving, thereby, existing vaccines. We report here on the immunogenic properties of a novel surface antigen encoded by ORF spr1875 in the R6 strain genome. An antigenic fragment encoded by spr1875, designated R4, was identified using a Streptococcus pneumoniae phage displayed genomic library after selection with a human convalescent serum. Immunofluorescence analysis with anti-R4 antisera showed that Spr1875 was expressed on the surface of strains belonging to different serotypes. Moreover, the gene was present with little sequence variability in 27 different pneumococcal strains isolated worldwide. A mutant lacking Spr1875 was considerably less virulent than the wild type D39 strain in an intravenous mouse model of infection. Moreover, immunization with the R4 recombinant fragment, but not with the whole Spr1875 protein, induced significant protection against sepsis in mice. Lack of protection after immunization with the whole protein was related to the presence of immunodominant, non-protective epitopes located outside of the R4 fragment. In conclusion, our data indicate that Spr1875 has a role in pneumococcal virulence and is immunogenic. As the R4 fragment conferred immunoprotection from experimental sepsis, selected antigenic fragments of Spr1875 may be useful for the development of a pneumococcal protein-based vaccine

The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? Design of a Randomized Controlled Trial

BACKGROUND: Running is a popular form of recreational exercise. Beside the positive effects of running on health and fitness, the risk of a running related injury has to be considered. The incidence of injuries in runners is high and varies from 30–79%. However, few intervention studies on prevention of running related injuries have been performed and none of these studies involved novice runners. METHODS: GRONORUN (Groningen Novice Running) is a two armed randomized controlled trial, comparing the effects of two different training programs for novice runners on the incidence of running related injuries. Participants are novice runners, who want to train for a four mile running event. The control group will train according a standard 8 week training program. The intervention group will use a more gradual, 13 week training program which is based on "the ten percent training rule". During the thirteen week follow up participants register information on running and RRI's in an internet based running log. The primary outcome measure is RRI. An injury is defined as a musculoskeletal ailment of the lower extremity or back, causing a restriction of running for at least one week. DISCUSSION: The GRONORUN trial is the first randomized controlled trial to study a preventive intervention in novice runners. Many different training programs for novice runners are offered, but none are evidence based

The GronoRun study. Incidence, risk factors, and prevention of injuries in novice and recreational runners

Door overbelasting lopen veel hardlopers blessures op. Ruim een kwart van de deelnemers aan de 4 Mijl van Groningen raakte in de voorbereiding op het hardloopevenement geblesseerd. Rustiger trainen helpt niet om de kans op blessures te verminderen. Dat blijkt uit onderzoek van bewegingswetenschapster Ida Buist van het Universitair Medisch Centrum Groningen. Zij promoveert 17 december 2008 op dit onderzoek aan de Rijksuniversiteit Groningen. Volgens de Nederlandse atletiekunie lopen in Nederland maar liefst vier miljoen mensen hard. Wetenschappelijke belangstelling was er tot op heden vooral voor de toplaag: naar blessures bij ervaren hardlopers werd al veel onderzoek gedaan. Met haar onderzoek naar blessures bij beginnende hardlopers betreedt Buist een relatief onontgonnen gebied. Grootste onderzoek Het GronoRun-onderzoek van Ida Buist is het grootste hardlooponderzoek van Nederland. Zij volgde meerdere groepen recreatieve hardlopers bij hun voorbereiding op de 4 Mijl van Groningen. Deelnemers volgden een door Buist aangereikt trainingsschema en registreerden informatie over het hardlopen en eventueel opgelopen blessures in een trainingslogboek op www.hardlooponderzoek.nl. Van de eerste onderzochte groep van 629 hardlopers (die een trainingsschema van acht weken volgden) raakte 25.9 procent tenminste eenmaal geblesseerd, zo blijkt uit het onderzoek. “Geblesseerd” betekende daarbij: minstens één dag niet of niet volledig kunnen trainen. Rustiger trainen helpt niet Minder intensief trainen vermindert de kans op blessures niet, zo blijkt uit vervolgonderzoek. Hiervoor volgde Buist twee groepen hardlopers (samen 468 hardlopers): een groep die zich in acht weken voorbereidde op de 4 Mijl van Groningen en een groep met een trainingsschema van dertien weken. Voor beide groepen gold als regel dat het aantal gelopen minuten per week met niet meer dan tien procent mocht toenemen. In deze studie werd een relatief “strenge” definitie van het begrip blessure gehanteerd. Een enkele blaar, of lichte spierpijn werd niet meegerekend; deelnemers golden pas als geblesseerd wanneer ze drie keer of vaker niet konden trainen. Of de deelnemers zich in acht of dertien weken voorbereidden, bleek niets uit te maken: in beide groepen liep twintig procent van de hardlopers een blessure op. Mannen met een buikje Uit het onderzoek blijkt dat beginnende lopers die het afgelopen jaar een blessure hebben gehad de meeste kans hebben op een hardloopblessure. Mannelijke beginnende hardlopers met een hogere BMI (Body Mass Index) lopen daarbij het grootste gevaar. Minder hart- en vaatziekten Ondanks het hoge aantal blessures, vindt Buist hardlopen een verantwoorde sport. ‘Hardlopen heeft dezelfde voordelen als veel andere sporten: het vermindert de kans op hart- en vaatziekten, overgewicht en tal van andere klachten. Het is een prima manier om aan je fitheid te werken.’ Een voordeel van hardlopen is dat het zeer laagdrempelig is. Buist: ‘Je kunt het in je eentje doen, wanneer het jou uitkomt en je hoeft er niet voor naar een sportfaciliteit te reizen.’ Belangrijk is dat hardlopers niet te strikt vasthouden aan vooraf vastgestelde schema’s. Buist: ‘Overbelasting is vaak de oorzaak van blessures. Hardlopers moeten naar hun lichaam luisteren. Een trainingsschema is niet zaligmakend.’ Vervolgonderzoek Inmiddels wordt aan het Sportmedisch centrum van het UMCG onderzoek gedaan naar de effectiviteit van speciale oefeningen om blessures bij hardlopers te voorkomen. Ook voor dit GronoRun2-onderzoek worden vele honderden mensen gevolgd. De resultaten van dit onderzoek worden naar verwachting in 2009 bekend.

The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners:a randomised controlled trial

Objectives There is no consensus on the aetiology and prevention of running-related injuries in runners. Preconditioning studies among different athlete populations show positive effects on the incidence of sports injuries. Hypothesis A 4-week preconditioning programme in novice runners will reduce the incidence of running-related injuries. Study design Randomised controlled clinical trial; level of evidence, 1. Methods Novice runners (N=432) prepared for a four-mile recreational running event. Participants were allocated to the 4-week preconditioning (PRECON) group (N=211) or the control group (N=221). The PRECON group started a 4-week training programme, prior to the running programme, with walking and hopping exercises. After the 4-week period both groups started a 9-week running programme. In both groups information was registered on running exposure and running-related injuries (RRIs) using an internet-based running log. Primary outcome measure was RRIs per 100 runners. An RRI was defined as any musculoskeletal complaint of the lower extremity or lower back causing restriction of running for at least a week. Results The incidence of RRIs was 15.2% in the PRECON group and 16.8% in the control group. The difference in RRIs between the groups was not significant (chi(2)=0.161, df=1, p=0.69). Conclusion This prospective study demonstrated that a 4-week PRECON programme with walking and hopping exercises had no influence on the incidence of RRIs in novice runners

Predictors of Running-Related Injuries in Novice Runners Enrolled in a Systematic Training Program A Prospective Cohort Study

BACKGROUND: The popularity of running is still growing. As participation increases, running-related injuries also increase. Until now, little is known about the predictors for injuries in novice runners. HYPOTHESIS: Predictors for running-related injuries (RRIs) will differ between male and female novice runners. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Participants were 532 novice runners (226 men, 306 women) preparing for a recreational 4-mile (6.7-km) running event. After completing a baseline questionnaire and undergoing an orthopaedic examination, they were followed during the training period of 13 weeks. An RRI was defined as any self-reported running-related musculoskeletal pain of the lower extremity or back causing a restriction of running for at least 1 week. RESULTS: Twenty-one percent of the novice runners had at least one RRI during follow-up. The multivariate adjusted Cox regression model for male participants showed that body mass index (BMI) (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.05-1.26), previous injury in the past year (HR, 2.7; 95% CI, 1.36-5.55), and previous participation in sports without axial load (HR, 2.05; 95% CI, 1.03-4.11) were associated with RRI. In female participants, only navicular drop (HR, 0.85; 95% CI, 0.75-0.97) remained a significant predictor for RRI in the multivariate Cox regression modeling. Type A behavior and range of motion (ROM) of the hip and ankle did not affect risk. CONCLUSION: Male and female novice runners have different risk profiles. Higher BMI, previous injury, and previous sports participation without axial loading are important predictors for RRI in male participants. Further research is needed to detect more predictors for female novice runners