Evaluation of Video Telehealth Versus Standard Gait Retraining

Telehealth-based gait retraining has the potential to improve outcomes for Warfighters recovering from running-related injuries in remote and austere environments. Since 1992, the U.S. military has valued the use of telehealth to meet its unique obligations and missions. The goal of telehealth is to provide seamless communication of medical information between a patient and medical provider. Studies have shown statistically significant improvement in healthcare endpoints in the military as a direct result of telehealth care. Through the use of telehealth, it is possible to monitor, train, consult and inform end users in their deployed environment. It enables healthcare professionals to maintain or even improve an end user’s condition and quality of life, and at the same time reduce in-hospital and travel costs.

Forty-five percent of physical training and sports-related injuries in the military are due to running. Nearly all military service members run for physical training. Annual running injury incidence has recently been reported between 19-79%. While running-related injuries are multifactorial, average vertical loading rate has been the variable most linked to running related injury. Approximately 80% of runners use a rearfoot strike (RFS) pattern whereby the heel hits the ground first on each step. Runners using a RFS pattern have been shown to have up to 3.4 times greater risk of sustaining a running-related injury compared to runners who use a non-rearfoot strike (NRFS). Alterations in running gait, to include foot strike pattern may reduce injuries.

Recently, running with biofeedback in a lab setting has been used effectively for rehabilitation of runners recovering from patellofemoral knee pain (PFPS) and for reducing stress fracture risk. Florkiewicz et al. trained nine runners recovering from various lower-extremity injuries in 8 sessions over 10 weeks to increase cadence and transition from a RFS to a (NRFS) pattern. While gait retraining in a lab setting has been successful with the use of real-time in-clinic biofeedback, to our knowledge, this is the first research project that uses gait retraining via video telehealth to modify gait of previously injured runners.