Using the variability of continuous relative phase as a measure to discriminate between healthy and injured runners

Several studies have used variability of continuous relative phase (CRP) to investigate overuse injuries, since low variability is thought to be related to running injuries. This study investigates whether the analysis of CRP variability leads to additional information about possible differences or similarities between healthy and injured runners. Further, a decision about future applications of CRP variability should be based on the ability to implement and interpret data. 18 healthy female runners (CO) and 18 female runners who suffered from iliotibial band syndrome (ITBS) were evaluated by calculating CRP variability for 4 coupling pairs. Besides analyzing continuous variability of CRP, we also averaged it for the whole stance phase and for four predefined stance phase intervals. Confidence intervals were displayed and independent t-tests for comparing the two groups were conducted. During initial and terminal stance phase as well as after heel-off an increase in CRP variability was detected for both groups of runners. In contrast, the foot flat period was characterized by stable joint coordination and a decrease in variability. This paper presents possible interpretations of CRP variability but no statistically significant differences in CRP variability were found between the two groups of runners. Despite the missing statistical significance, a relationship between high CRP variability and injury seems to be conceivable, since the injured runners demonstrated an increased variability for all couplings in the first half of the stance phase. Further application of CRP variability in biomechanical research is essential to determine whether a relationship exists between injury and coordination variability.