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1.  The NLstart2run study: health effects of a running promotion program in novice runners, design of a prospective cohort study 
BMC Public Health  2013;13:685.
Running is associated with desirable lifestyle changes. Therefore several initiatives have been undertaken to promote running. Exact data on the health effects as a result of participating in a short-term running promotion program, however, is scarce. One important reason for dropout from a running program is a running-related injury (RRI). The incidence of RRIs is high, especially in novice runners. Several studies examined potential risk factors for RRIs, however, due to the often underpowered studies it is not possible to reveal the complex mechanism leading to an RRI yet.
The primary objectives are to determine short- and long-term health effects of a nationwide “Start to Run” program and to identify determinants for RRIs in novice runners. Secondary objectives include examining reasons and determinants for dropout, medical consumption and economical consequences of RRIs as a result of a running promotion program.
The NLstart2run study is a multi-center prospective cohort study with a follow-up at 6, 12, 24 and 52 weeks. All participants that sign up for the Start to Run program in 2013, which is offered by the Dutch Athletics Federation, will be asked to participate in the study.
During the running program a digital running log will be completed by the participants every week to administer exposure and running related pain. After the running program the log will be completed every second week. An RRI is defined as any musculoskeletal ailment of the lower extremity or back that the participant attributed to running and hampers running ability for at least one week.
The NLstart2run study will provide insight into the short- and long-term health effects as a result of a short-term running promotion program. Reasons and determinants for dropout from a running promotion program will be examined as well. The study will result in several leads for future RRI prevention and as a result minimize dropout due to injury. This information may increase the effectiveness of future running promotion programs and will thereby contribute positively to public health.
Trial registration
The Netherlands National Trial Register NTR3676. The NTR is part of the WHO Primary Registries.
PMCID: PMC3849042  PMID: 23890182
2.  Comparison of vertical ground reaction forces during overground and treadmill running. A validation study 
One major drawback in measuring ground-reaction forces during running is that it is time consuming to get representative ground-reaction force (GRF) values with a traditional force platform. An instrumented force measuring treadmill can overcome the shortcomings inherent to overground testing. The purpose of the current study was to determine the validity of an instrumented force measuring treadmill for measuring vertical ground-reaction force parameters during running.
Vertical ground-reaction forces of experienced runners (12 male, 12 female) were obtained during overground and treadmill running at slow, preferred and fast self-selected running speeds. For each runner, 7 mean vertical ground-reaction force parameters of the right leg were calculated based on five successful overground steps and 30 seconds of treadmill running data. Intraclass correlations (ICC(3,1)) and ratio limits of agreement (RLOA) were used for further analysis.
Qualitatively, the overground and treadmill ground-reaction force curves for heelstrike runners and non-heelstrike runners were very similar. Quantitatively, the time-related parameters and active peak showed excellent agreement (ICCs between 0.76 and 0.95, RLOA between 5.7% and 15.5%). Impact peak showed modest agreement (ICCs between 0.71 and 0.76, RLOA between 19.9% and 28.8%). The maximal and average loading-rate showed modest to excellent ICCs (between 0.70 and 0.89), but RLOA were higher (between 34.3% and 45.4%).
The results of this study demonstrated that the treadmill is a moderate to highly valid tool for the assessment of vertical ground-reaction forces during running for runners who showed a consistent landing strategy during overground and treadmill running. The high stride-to-stride variance during both overground and treadmill running demonstrates the importance of measuring sufficient steps for representative ground-reaction force values. Therefore, an instrumented treadmill seems to be suitable for measuring representative vertical ground-reaction forces during running.
PMCID: PMC3518245  PMID: 23186326
Running; Kinetics; Biomechanics; Validity; Overuse injuries
The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries.
A systematic search was performed in PubMed, Web of Science, Embase, and SportDiscus. Studies were included if they examined novice, recreational, or elite runners between the ages of 18 and 65. Exposure variables were training characteristics defined as volume, distance or mileage, time or duration, frequency, intensity, speed or pace, or similar terms. The outcome of interest was Running Related Injuries (RRI) in general or specific RRI in the lower extremity or lower back. Methodological quality was evaluated using quality assessment tools of 11 to 16 items.
After examining 4561 titles and abstracts, 63 articles were identified as potentially relevant. Finally, nine retrospective cohort studies, 13 prospective cohort studies, six case-control studies, and three randomized controlled trials were included. The mean quality score was 44.1%. Conflicting results were reported on the relationships between volume, duration, intensity, and frequency and RRI.
It was not possible to identify which training errors were related to running related injuries. Still, well supported data on which training errors relate to or cause running related injuries is highly important for determining proper prevention strategies. If methodological limitations in measuring training variables can be resolved, more work can be conducted to define training and the interactions between different training variables, create several hypotheses, test the hypotheses in a large scale prospective study, and explore cause and effect relationships in randomized controlled trials.
Level of evidence:
PMCID: PMC3290924  PMID: 22389869
Duration; frequency; injuries; intensity; running; training; volume
4.  The GRONORUN 2 study: effectiveness of a preconditioning program on preventing running related injuries in novice runners. The design of a randomized controlled trial 
Distance running is a popular recreational exercise. It is a beneficial activity for health and well being. However, running may also cause injuries, especially of the lower extremities. In literature there is no agreement what intrinsic and extrinsic factors cause running related injuries (RRIs). In theory, most RRIs are elicited by training errors, this too much, too soon. In a preconditioning program runners can adapt more gradually to the high mechanical loads of running and will be less susceptible to RRIs. In this study the effectiveness of a 4-week preconditioning program on the incidence of RRIs in novice runners prior to a training program will be studied.
The GRONORUN 2 (Groningen Novice Running) study is a two arm randomized controlled trial studying the effect of a 4-week preconditioning (PRECON) program in a group of novice runners. All participants wanted to train for the recreational Groningen 4-Mile running event. The PRECON group started a 4-week preconditioning program with walking and hopping exercises 4 weeks before the start of the training program. The control (CON) and PRECON group started a frequently used 9-week training program in preparation for the Groningen 4-Mile running event.
During the follow up period participants registered their running exposure, other sporting activities and running related injuries in an Internet based running log. The primary outcome measure was the number of RRIs. RRI was defined as a musculoskeletal ailment or complaint of the lower extremities or back causing a restriction on running for at least three training sessions.
The GRONORUN 2 study will add important information to the existing running science. The concept of preconditioning is easy to implement in existing training programs and will hopefully prevent RRIs especially in novice runners.
Trial registration
The Netherlands National Trial Register NTR1906. The NTR is part of the WHO Primary Registries.
PMCID: PMC2936887  PMID: 20809930
5.  The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? Design of a Randomized Controlled Trial 
Running is a popular form of recreational exercise. Beside the positive effects of running on health and fitness, the risk of a running related injury has to be considered. The incidence of injuries in runners is high and varies from 30–79%. However, few intervention studies on prevention of running related injuries have been performed and none of these studies involved novice runners.
GRONORUN (Groningen Novice Running) is a two armed randomized controlled trial, comparing the effects of two different training programs for novice runners on the incidence of running related injuries. Participants are novice runners, who want to train for a four mile running event. The control group will train according a standard 8 week training program. The intervention group will use a more gradual, 13 week training program which is based on "the ten percent training rule". During the thirteen week follow up participants register information on running and RRI's in an internet based running log. The primary outcome measure is RRI. An injury is defined as a musculoskeletal ailment of the lower extremity or back, causing a restriction of running for at least one week.
The GRONORUN trial is the first randomized controlled trial to study a preventive intervention in novice runners. Many different training programs for novice runners are offered, but none are evidence based.
PMCID: PMC1821023  PMID: 17331264

Results 1-5 (5)