Biomechanical adaptations following a music‐based biofeedback gait retraining program to reduce peak tibial accelerations

Purpose: The present study aimed to determine whether runners can reduce impact measures after a six-session in-the-field gait retraining program with real-time musical biofeedback on axial peak tibial acceleration (PTA(a)) and identify the associated biomechanical adaptations. Methods: Twenty trained high-impact runners were assigned to either the biofeedback or the music-only condition. The biofeedback group received real-time feedback on the PTA(a) during the gait retraining program, whereas the music-only condition received a sham treatment. Three-dimensional gait analysis was conducted in the laboratory before (PRE) and within one week after completing the gait retraining program (POST). Subjects were instructed to replicate the running style from the last gait retraining session without receiving feedback while running overground at a constant speed of 2.9 m.s(-1). Results: Only the biofeedback group showed significant reductions in both PTAa (Delta(x) over bar = -26.9%, p = 0.006) and vertical instantaneous loading rate (Delta(x) over bar = -29.2%, p = 0.003) from PRE to POST. In terms of biomechanical adaptations, two strategies were identified. Two subjects transitioned toward a more forefoot strike. The remaining eight subjects used a pronounced rearfoot strike and posteriorly inclined shank at initial contact combined with less knee extension at toe-off while reducing vertical excursion of the center of mass. Conclusions: After completing a music-based biofeedback gait retraining program, runners can reduce impact while running overground in a laboratory. We identified two distinct self-selected strategies used by the participants to achieve reductions in impact