Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain: A randomized controlled trial

Background Patellofemoral Pain (PFP) is one of the main injuries in runners. Consistent evidence support strengthening programs to modulate symptoms, however, few studies investigated the effects of gait retraining programs. Objective To investigate the effects of two different two-week partially supervised gait retraining programs on pain, function, and lower limb kinematics of runners with PFP. Methods Randomized controlled trial. Thirty runners were allocated to gait retraining groups focusing on impact (n = 10) or cadence (n = 10), or to a control group (n = 10). Impact group received guidance to reduce tibial acceleration by 50%, while cadence group was asked to increase cadence by 7.5-10%. The control group did not receive any intervention. Usual and running pain, knee function, and lower limb kinematics (contralateral pelvic drop, hip adduction, knee flexion, ankle dorsiflexion, tibia inclination, and foot inclination) were evaluated before (T-0), immediately after the intervention (T-2), and six months after the protocol (T-24). Results A significant group x time interaction was found for running pain (p = 0.010) and knee function (p = 0.019). Both programs had greater improvements in running pain compared to no intervention at T-24 (Impact x Control-mean difference (MD) -3.2, 95% CI -5.1 to -1.3, p = 0.001; Cadence x Control-MD -2.9, 95% CI -4.8 to -1.0, p = 0.002). Participants of the impact group had greater improvements in knee function compared to no intervention at T-2 (Impact x Control-MD 10.8, 95% CI 1.0 to 20.6, p = 0.027). No between-group differences in usual pain and lower limb kinematics were found (p>0.05). Conclusion Compared to no intervention, both programs were more effective in improving running pain six months after the protocol. The program focused on impact was more effective in improving knee function immediately after the intervention.