The Effectiveness of a 6-Week Intervention Program Aimed at Modifying Running Style in Patients With Chronic Exertional Compartment Syndrome

Author:

Helmhout Pieter H.1,Diebal Angela R.2,van der Kaaden Lisanne3,Harts Chris C.1,Beutler Anthony4,Zimmermann Wes O.1

Affiliation:

1. Department of Training Medicine and Training Physiology/Military Sports Medical Center, Personnel Command, Royal Netherlands Army, Utrecht, the Netherlands.

2. Physical Therapist Assistant Program, Fort Sam Houston, San Antonio, Texas, USA.

3. Human Movement Sciences, Free University, Amsterdam, the Netherlands.

4. Department of Family Medicine, Uniformed Services University, Bethesda, Maryland, USA.

Abstract

Background: Previous studies have reported on the promising effects of changing running style in patients with chronic exertional compartment syndrome (CECS) using a 6-week training program aimed at adopting a forefoot strike technique. This study expands that work by comparing a 6-week in-house, center-based run training program with a less extensive, supervised, home-based run training program (50% home training). Hypothesis: An alteration in running technique will lead to improvements in CECS complaints and running performance, with the less supervised program producing less dramatic results. Study Design: Cohort study; Level of evidence, 3. Methods: Nineteen patients with CECS were prospectively enrolled. Postrunning intracompartmental pressure (ICP), run performance, and self-reported questionnaires were taken for all patients at baseline and after 6 weeks of running intervention. Questionnaires were also taken from 14 patients (7 center-based, 6 home-based) 4 months posttreatment. Results: Significant improvement between preintervention and postintervention rates was found for running distance (43%), ICP values (36%), and scores on the questionnaires Single Assessment Numeric Evaluation (SANE; 36%), Lower Leg Outcome Survey (LLOS; 18%), and Patient Specific Complaints (PSC; 60%). The mean posttreatment score on the Global Rating of Change (GROC) was between +4 and +5 (“somewhat better” to “moderately better”). In 14 participants (74%), no elevation of pain was reported posttreatment, compared with 3 participants (16%) at baseline; in all these cases, the running test was aborted because of a lack of cardiorespiratory fitness. Self-reported scores continued to improve 4 months after the end of the intervention program, with mean improvement rates of 48% (SANE), 26% (LLOS), and 81% (PSC). The mean GROC score improved to +6 points (“a great deal better”). Conclusion: In 19 patients diagnosed with CECS, a 6-week forefoot running intervention performed in both a center-based and home-based training setting led to decreased postrunning lower leg ICP values, improved running performances, and self-assessed leg condition. The influence of training group was not statistically significant. Overall, this is a promising finding, taking into consideration the significantly reduced investments in time and resources needed for the home-based program.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine

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