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Using Wearable Sensor Technology to Analyze Running Technique and Prospective Running-Related Injuries During United States Military Cadet Basic Training- OJSM 2025

a weart, l brown, e florkiewics, g fresinger, k east, n reilly, j song, d goss

Background: Running biomechanics have been linked to the development of running-related injuries in recreational and military runners.

Purpose/Hypothesis: The purpose of this study was to determine if personal characteristics or running biomechanical variables are associated with running-related injury incidence or time to injury in military cadets undergoing training. It was hypothesized that a rearfoot strike pattern, greater rate of impact, or a lower step rate would be related to a greater running-related injury incidence and a decreased time to injury.

Study Design: Cohort study; Level of evidence, 2.

Methods: Military cadets wore an on-shoe wearable sensor that analyzed biomechanical variables of foot strike pattern, rate of impact, running pace, step rate, step length, and contact time during cadet basic training (60 days). Running-related injuries during cadet basic training were determined by medical record review. Personal and running variables between the injured and uninjured cadets were compared using independent t tests and chi-square analyses. Time to injury and hazard ratios (HRs) were estimated using Kaplan-Meier survival curves and Cox proportional hazard regression models, respectively.

Results: Of the 674 cadets who completed the study, 11% sustained a running-related injury. A significantly greater proportion of the injured participants were female (χ2 = 7.95; P = .005) and had a prior history of injury (χ2 = 7.36; P = .007). Univariate Cox proportional hazard regression models revealed greater injury risk in females (HR, 1.96; 95% CI, 1.22-3.16; P = .005) and cadets with a prior injury history (HR, 1.86; 95% CI, 1.18-2.93; P = .008). After adjusting Cox models for prior injury, females were found to be at a 1.89 times (95% CI, 1.17-3.04; P = .009) greater risk of injury. Running biomechanical variables were not associated with injury risk.

Conclusion: Study results indicated that non-modifiable risk factors such as female sex and prior injury history increased the risk of running-related injury in cadets undergoing military training. Running biomechanical variables measured by the wearable sensor were not associated with injury in this study.

Weart A., Brown L., Florkiewicz E., Freisinger G., East K., Reilly N., Song J., Goss D. (2025) Using Wearable Sensor Technology to Analyze Running Technique and Prospective Running-Related Injuries During United States Military Cadet Basic Training. Orthopaedic Journal of Sports Medicine. https://doi: 10.1177/23259671241309273