Effects of running technique characteristics on the patellofemoral joint load: A systematic review and meta-analysis

Recent studies have shown that gait retraining can significantly affect the biomechanical load on the patellofemoral joint. It is of great significance to understand the effects of these running technique characteristics on patellofemoral joint load for developing effective prevention and rehabilitation strategies for injury.

A systematic review was conducted on the relevant studies from PubMed, Web of Science, EBSCO, CNKI, and Wanfang database, and the data were synthesized. Data including patellofemoral joint contact force (PFCF) and patellofemoral joint stress (PFJS) were extracted and pooled for analysis.

A total of 2102 studies were retrieved, and 32 studies were finally included after applying the inclusion and exclusion criteria. According to subgroup analysis results, some running technique characteristics notably decreased PFCF (SMD = - 0.60; 95 % CI: - 0.71, - 0.49; z = 10.98, p = 0.000), including forefoot strike (FFS), decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer; whereas some characteristics significantly increased PFCF (SMD = 0.46; 95 % CI: 0.29, 0.62; z = 5.47, p = 0.000), including increased step length, decreased step rate, increased speed, and trunk backward lean. Additionally, some characteristics remarkably decreased PFJS (SMD = - 0.59; 95 % CI: - 0.72, - 0.47; z = 9.02, p = 0.000), including FFS, decreased step length, increased step rate, decreased speed, and trunk forward lean; whereas some characteristics significantly increased PFJS (SMD = 0.43; 95 % CI: 0.24, 0.62; z = 4.39, p = 0.000), such as increased step length, decreased step rate, and trunk backward lean.

Some specific running technique characteristics can significantly influence patellofemoral joint load. Technique characteristics, such as FFS, decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer, can effectively decrease the load. Conversely, increased step length, decreased step rate, increased speed, and trunk backward lean tended to increase the load.