Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Study protocol

The design of the run Clever randomized trial: running volume, −intensity and running-related injuries

Authors: Daniel Ramskov, Rasmus Oestergaard Nielsen, Henrik Sørensen, Erik Parner, Martin Lind, Sten Rasmussen

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Injury incidence and prevalence in running populations have been investigated and documented in several studies. However, knowledge about injury etiology and prevention is needed. Training errors in running are modifiable risk factors and people engaged in recreational running need evidence-based running schedules to minimize the risk of injury. The existing literature on running volume and running intensity and the development of injuries show conflicting results. This may be related to previously applied study designs, methods used to quantify the performed running and the statistical analysis of the collected data. The aim of the Run Clever trial is to investigate if a focus on running intensity compared with a focus on running volume in a running schedule influences the overall injury risk differently.

Methods/design

The Run Clever trial is a randomized trial with a 24-week follow-up. Healthy recreational runners between 18 and 65 years and with an average of 1–3 running sessions per week the past 6 months are included. Participants are randomized into two intervention groups: Running schedule-I and Schedule-V. Schedule-I emphasizes a progression in running intensity by increasing the weekly volume of running at a hard pace, while Schedule-V emphasizes a progression in running volume, by increasing the weekly overall volume. Data on the running performed is collected by GPS. Participants who sustain running-related injuries are diagnosed by a diagnostic team of physiotherapists using standardized diagnostic criteria. The members of the diagnostic team are blinded. The study design, procedures and informed consent were approved by the Ethics Committee Northern Denmark Region (N-20140069).

Discussion

The Run Clever trial will provide insight into possible differences in injury risk between running schedules emphasizing either running intensity or running volume. The risk of sustaining volume- and intensity-related injuries will be compared in the two intervention groups using a competing risks approach. The trial will hopefully result in a better understanding of the relationship between the running performed and possible differences in running-related injury risk and the injuries developed.

Trial registration

Clinical Trials NCT02349373 – January 23, 2015.
Literature
1.
go back to reference Van Bottenberg BM, Scheerder J, Hover P. Don’ t miss the next boat : Europe’s opportunities and challenges in the second wave of running. New Stud Athl. 2010;(3):125–43. Van Bottenberg BM, Scheerder J, Hover P. Don’ t miss the next boat : Europe’s opportunities and challenges in the second wave of running. New Stud Athl. 2010;(3):125–43.
3.
go back to reference Brown WJ, Burton NW, Sahlqvist S, Heesch KC, McCarthy KB, Ng N, van Uffelen JGZ. Physical activity in three regional communities in Queensland. Aust J Rural Health. 2013;21:112–20.CrossRefPubMed Brown WJ, Burton NW, Sahlqvist S, Heesch KC, McCarthy KB, Ng N, van Uffelen JGZ. Physical activity in three regional communities in Queensland. Aust J Rural Health. 2013;21:112–20.CrossRefPubMed
4.
go back to reference Breuer C, Hallmann K, Wicker P. Determinants of sport participation in different sports. Manag Leis. 2011;16(4):269–86.CrossRef Breuer C, Hallmann K, Wicker P. Determinants of sport participation in different sports. Manag Leis. 2011;16(4):269–86.CrossRef
5.
go back to reference Laub TB. Sports participation in Denmark 2011. Danish Institute for Sports Studies; 2011. Laub TB. Sports participation in Denmark 2011. Danish Institute for Sports Studies; 2011.
6.
go back to reference Lee D-CC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64(5):472–81.CrossRefPubMedPubMedCentral Lee D-CC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64(5):472–81.CrossRefPubMedPubMedCentral
7.
go back to reference Koplan JP, Powell KE, Sikes RK, Shirley RW, Campbell CC. An epidemiologic study of the benefits and risks of running. Jama. 1982;248(23):3118–21.CrossRefPubMed Koplan JP, Powell KE, Sikes RK, Shirley RW, Campbell CC. An epidemiologic study of the benefits and risks of running. Jama. 1982;248(23):3118–21.CrossRefPubMed
8.
go back to reference Hespanhol Jr LC, Pillay JD, van Mechelen W, Verhagen E, Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults. Sport Med. 2015;45(10):1455–68. Hespanhol Jr LC, Pillay JD, van Mechelen W, Verhagen E, Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults. Sport Med. 2015;45(10):1455–68.
9.
go back to reference Videbæk S, Bueno AM, Nielsen RO, Rasmussen S. Incidence of running-related injuries Per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Med. 2015;45(7):1017–26.CrossRefPubMedPubMedCentral Videbæk S, Bueno AM, Nielsen RO, Rasmussen S. Incidence of running-related injuries Per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Med. 2015;45(7):1017–26.CrossRefPubMedPubMedCentral
10.
11.
go back to reference Van Gent RN, Siem D, Van Middelkoop M, Van Os AG, Bierma Zeinstra SMA, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41(8):469–80. discussion 480.CrossRefPubMedPubMedCentral Van Gent RN, Siem D, Van Middelkoop M, Van Os AG, Bierma Zeinstra SMA, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41(8):469–80. discussion 480.CrossRefPubMedPubMedCentral
12.
go back to reference Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A prospective study of running injuries: the Vancouver Sun Run ‘In Training’ clinics. Br J Sports Med. 2003;37(3):239–44.CrossRefPubMedPubMedCentral Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A prospective study of running injuries: the Vancouver Sun Run ‘In Training’ clinics. Br J Sports Med. 2003;37(3):239–44.CrossRefPubMedPubMedCentral
13.
go back to reference Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case–control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95–101.CrossRefPubMedPubMedCentral Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case–control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95–101.CrossRefPubMedPubMedCentral
14.
go back to reference Malisoux L, Nielsen RO, Urhausen A, Theisen D. A step towards understanding the mechanisms of running-related injuries. J Sci Med Sport. 2014. Malisoux L, Nielsen RO, Urhausen A, Theisen D. A step towards understanding the mechanisms of running-related injuries. J Sci Med Sport. 2014.
15.
go back to reference Nielsen RO, Buist I, Sørensen H, Lind M, Rasmussen S. Training errors and running related injuries: a systematic review. Int J Sports Phys Ther. 2012;7(1):58–75.PubMedPubMedCentral Nielsen RO, Buist I, Sørensen H, Lind M, Rasmussen S. Training errors and running related injuries: a systematic review. Int J Sports Phys Ther. 2012;7(1):58–75.PubMedPubMedCentral
16.
go back to reference Buist I, Bredeweg SW, Lemmink KAPM, Pepping GJ, Zwerver J, Van Mechelen W, Diercks RL. The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? design of a randomized controlled trial. BMC Musculoskelet Disord. 2007;8:24.CrossRefPubMedPubMedCentral Buist I, Bredeweg SW, Lemmink KAPM, Pepping GJ, Zwerver J, Van Mechelen W, Diercks RL. The GRONORUN study: is a graded training program for novice runners effective in preventing running related injuries? design of a randomized controlled trial. BMC Musculoskelet Disord. 2007;8:24.CrossRefPubMedPubMedCentral
17.
go back to reference Bredeweg SW, Zijlstra S, Buist I. The GRONORUN 2 study: effectiveness of a preconditioning program on preventing running related injuries in novice runners. The design of a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:196.CrossRefPubMedPubMedCentral Bredeweg SW, Zijlstra S, Buist I. The GRONORUN 2 study: effectiveness of a preconditioning program on preventing running related injuries in novice runners. The design of a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:196.CrossRefPubMedPubMedCentral
18.
go back to reference Pollock ML, Gettman LR, Milesis CA, Bah MD, Durstine L, Johnson RB. Effects of frequency and duration of training on attrition and incidence of injury. Med Sci Sports. 1977;9(1):31–6.PubMed Pollock ML, Gettman LR, Milesis CA, Bah MD, Durstine L, Johnson RB. Effects of frequency and duration of training on attrition and incidence of injury. Med Sci Sports. 1977;9(1):31–6.PubMed
19.
go back to reference Buist I, Bredeweg SW, van Mechelen W, Lemmink KAPM, Pepping G-J, Diercks RL. No effect of a graded training program on the number of running-related injuries in novice runners: a randomized controlled trial. Am J Sports Med. 2008;36(1):33–9.CrossRefPubMed Buist I, Bredeweg SW, van Mechelen W, Lemmink KAPM, Pepping G-J, Diercks RL. No effect of a graded training program on the number of running-related injuries in novice runners: a randomized controlled trial. Am J Sports Med. 2008;36(1):33–9.CrossRefPubMed
20.
go back to reference Bredeweg SW, Zijlstra S, Bessem B, Buist I. The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners: a randomised controlled trial. Br J Sports Med. 2012;46:865–70.CrossRefPubMed Bredeweg SW, Zijlstra S, Bessem B, Buist I. The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners: a randomised controlled trial. Br J Sports Med. 2012;46:865–70.CrossRefPubMed
21.
go back to reference Nielsen RO, Nohr EA, Rasmussen S, Sørensen H. Classifying running-related injuries based upon etiology, with emphasis on volume and pace. Int J Sports Phys Ther. 2013;8(2):172–9.PubMedPubMedCentral Nielsen RO, Nohr EA, Rasmussen S, Sørensen H. Classifying running-related injuries based upon etiology, with emphasis on volume and pace. Int J Sports Phys Ther. 2013;8(2):172–9.PubMedPubMedCentral
22.
go back to reference Petersen J, Nielsen ROR, Rasmussen S, Sørensen H. Comparisons of increases in knee and ankle joint moments following an increase in running speed from 8 to 12 to 16 kilometers per hour. Clin Biomech (Bristol, Avon). 2014;29(9):959–64.CrossRef Petersen J, Nielsen ROR, Rasmussen S, Sørensen H. Comparisons of increases in knee and ankle joint moments following an increase in running speed from 8 to 12 to 16 kilometers per hour. Clin Biomech (Bristol, Avon). 2014;29(9):959–64.CrossRef
23.
go back to reference Petersen J, Sørensen H, Nielsen RO, The Cumulative Loads Increase in the Knee Joint at Slow-Speed Running Compared With Faster Running: A Biomechanical Study. J Orthop Sports Phys Ther. 2015;45(4):316-22. Petersen J, Sørensen H, Nielsen RO, The Cumulative Loads Increase in the Knee Joint at Slow-Speed Running Compared With Faster Running: A Biomechanical Study. J Orthop Sports Phys Ther. 2015;45(4):316-22.
24.
go back to reference Nielsen RO, Parner ET, Nohr EA, Sørensen H, Lind M, Rasmussen S, Excessive Progression in Weekly Running Distance and Risk of Running-related Injuries: An Association Modified by Type of Injury. J Orthop Sports Phys Ther. 2014;44(10):739–47. Nielsen RO, Parner ET, Nohr EA, Sørensen H, Lind M, Rasmussen S, Excessive Progression in Weekly Running Distance and Risk of Running-related Injuries: An Association Modified by Type of Injury. J Orthop Sports Phys Ther. 2014;44(10):739–47.
25.
go back to reference Clarsen B, Myklebust G, Bahr R. Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire. Br J Sports Med. 2013;47(8):495–502.CrossRefPubMed Clarsen B, Myklebust G, Bahr R. Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire. Br J Sports Med. 2013;47(8):495–502.CrossRefPubMed
27.
go back to reference Balady GJ, Chaitman B, Driscoll D, Foster C, Froelicher E, Pate R, Rippe J, Bazzarre T. American college of sports medicine position stand and american heart association. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Med Sci Sports Exerc. 1998;30(6):1009–18. Balady GJ, Chaitman B, Driscoll D, Foster C, Froelicher E, Pate R, Rippe J, Bazzarre T. American college of sports medicine position stand and american heart association. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Med Sci Sports Exerc. 1998;30(6):1009–18.
28.
go back to reference Wendel-Vos G. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003;56(12):1163–9.CrossRefPubMed Wendel-Vos G. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003;56(12):1163–9.CrossRefPubMed
29.
go back to reference Bompa TO. Periodization - Theory and Methodology of Training, 4th ed. Leeds: Human Kinetics Publishers; 1999. Bompa TO. Periodization - Theory and Methodology of Training, 4th ed. Leeds: Human Kinetics Publishers; 1999.
30.
go back to reference Seiler S. What is best practice for training intensity and duration distribution in endurance athletes? Int J Sports Physiol Perform. 2010;5(3):276–91.CrossRefPubMed Seiler S. What is best practice for training intensity and duration distribution in endurance athletes? Int J Sports Physiol Perform. 2010;5(3):276–91.CrossRefPubMed
31.
go back to reference J. Daniels, Jack. Gilbert, Oxygen power, 1st ed. Cortland: 90 N main st, Cortland, NY 13045, 1979. J. Daniels, Jack. Gilbert, Oxygen power, 1st ed. Cortland: 90 N main st, Cortland, NY 13045, 1979.
32.
go back to reference Daniels J. Daniels’ Running Formula, 2nd ed. Leeds: Human Kinetics Publishers; 2005. Daniels J. Daniels’ Running Formula, 2nd ed. Leeds: Human Kinetics Publishers; 2005.
33.
go back to reference Clarsen B, Rønsen O, Myklebust G, Flørenes TW, Bahr R. The oslo sports trauma research center questionnaire on health problems: a new approach to prospective monitoring of illness and injury in elite athletes. Br J Sports Med. 2014;48(9):754–60.CrossRefPubMed Clarsen B, Rønsen O, Myklebust G, Flørenes TW, Bahr R. The oslo sports trauma research center questionnaire on health problems: a new approach to prospective monitoring of illness and injury in elite athletes. Br J Sports Med. 2014;48(9):754–60.CrossRefPubMed
34.
go back to reference Nielsen RO, Buist I, Parner ET, Nohr EA, Sorensen H, Lind M, Rasmussen S. Predictors of running-related injuries among 930 novice runners: a 1-year prospective follow-up study. Orthop J Sport Med. 2013;1(1):2325967113487316. Nielsen RO, Buist I, Parner ET, Nohr EA, Sorensen H, Lind M, Rasmussen S. Predictors of running-related injuries among 930 novice runners: a 1-year prospective follow-up study. Orthop J Sport Med. 2013;1(1):2325967113487316.
35.
go back to reference Lun V, Meeuwisse WH, Stergiou P, Stefanyshyn D. Relation between running injury and static lower limb alignment in recreational runners. Br J Sports Med. 2004;38(5):576–80.CrossRefPubMedPubMedCentral Lun V, Meeuwisse WH, Stergiou P, Stefanyshyn D. Relation between running injury and static lower limb alignment in recreational runners. Br J Sports Med. 2004;38(5):576–80.CrossRefPubMedPubMedCentral
36.
go back to reference Greenland S. An introduction to instrumental variables for epidemiologists. Int J Epidemiol. 2000;29(4):722–9.CrossRefPubMed Greenland S. An introduction to instrumental variables for epidemiologists. Int J Epidemiol. 2000;29(4):722–9.CrossRefPubMed
37.
go back to reference Parner ET, Andersen PK. Regression analysis of censored data using pseudo-observations. Stata J. 2010;10(3):408–22. Parner ET, Andersen PK. Regression analysis of censored data using pseudo-observations. Stata J. 2010;10(3):408–22.
38.
go back to reference Putter H, Fiocco M, Geskus RB. “Tutorial in biostatistics: Competing risks and multi-state models”, no. October. 2007;2005:2389–430. Putter H, Fiocco M, Geskus RB. “Tutorial in biostatistics: Competing risks and multi-state models”, no. October. 2007;2005:2389–430.
39.
40.
go back to reference Hansen SN, Andersen PK, Parner ET. Events per variable for risk differences and relative risks using pseudo-observations. Lifetime Data Anal. 2014;20(4):584–98.CrossRefPubMed Hansen SN, Andersen PK, Parner ET. Events per variable for risk differences and relative risks using pseudo-observations. Lifetime Data Anal. 2014;20(4):584–98.CrossRefPubMed
42.
go back to reference Knechtle B, Barandun U, Knechtle P, Zingg MA, Rosemann T, Rüst A. Prediction of half-marathon race time in recreational female and male runners. Springerplus. 2014;3:248. Knechtle B, Barandun U, Knechtle P, Zingg MA, Rosemann T, Rüst A. Prediction of half-marathon race time in recreational female and male runners. Springerplus. 2014;3:248.
43.
go back to reference Hespanhol Junior LC, Pena Costa LO, Lopes AD. Previous injuries and some training characteristics predict running-related injuries in recreational runners: A prospective cohort study. J Geophys Res. 2013;59:263–9. Hespanhol Junior LC, Pena Costa LO, Lopes AD. Previous injuries and some training characteristics predict running-related injuries in recreational runners: A prospective cohort study. J Geophys Res. 2013;59:263–9.
46.
go back to reference Townshend AD, Worringham CJ, Stewart IB. Assessment of speed and position during human locomotion using nondifferential GPS. Med Sci Sports Exerc. 2008;40(1):124–32.CrossRefPubMed Townshend AD, Worringham CJ, Stewart IB. Assessment of speed and position during human locomotion using nondifferential GPS. Med Sci Sports Exerc. 2008;40(1):124–32.CrossRefPubMed
47.
go back to reference Nielsen RO, Cederholm P, Buist I, Sørensen H, Lind M, Rasmussen S. Can GPS be used to detect deleterious progression in training volume among runners? J Strength Cond Res. 2013;27(6):1471–8.CrossRefPubMed Nielsen RO, Cederholm P, Buist I, Sørensen H, Lind M, Rasmussen S. Can GPS be used to detect deleterious progression in training volume among runners? J Strength Cond Res. 2013;27(6):1471–8.CrossRefPubMed
48.
go back to reference Johnston RJ, Watsford ML, Kelly SJ, Pine MJ, Spurrs RW. Validity and interunit reliability of 10 Hz and 15 Hz GPS units for assessing athlete movement demands. J Strength Cond Res. 2014;28(6):1649–55.CrossRefPubMed Johnston RJ, Watsford ML, Kelly SJ, Pine MJ, Spurrs RW. Validity and interunit reliability of 10 Hz and 15 Hz GPS units for assessing athlete movement demands. J Strength Cond Res. 2014;28(6):1649–55.CrossRefPubMed
49.
go back to reference Vickery WM, Dascombe BJ, Baker JD, Higham DG, Spratford WA, Duffield R. Accuracy and reliability of GPS devices for measurement of sports-specific movement patterns related to cricket, tennis, and field-based team sports. J Strength Cond Res. 2014;28:1697–705.CrossRefPubMed Vickery WM, Dascombe BJ, Baker JD, Higham DG, Spratford WA, Duffield R. Accuracy and reliability of GPS devices for measurement of sports-specific movement patterns related to cricket, tennis, and field-based team sports. J Strength Cond Res. 2014;28:1697–705.CrossRefPubMed
50.
go back to reference Witte TH, Wilson AM. Accuracy of non-differential GPS for the determination of speed over ground. J Biomech. 2004;37:1891–8.CrossRefPubMed Witte TH, Wilson AM. Accuracy of non-differential GPS for the determination of speed over ground. J Biomech. 2004;37:1891–8.CrossRefPubMed
51.
go back to reference Arensman I. Test af Garmin Forerunner (Testing the Garmin Forerunner). Denmark: Aalborg University; 2010. Arensman I. Test af Garmin Forerunner (Testing the Garmin Forerunner). Denmark: Aalborg University; 2010.
52.
go back to reference Ramskov D, Sørensen H, Parner E, Nielsen R, Lind M, Rasmussen S. The run clever study protocol: the design of a randomized controlled trial. Br J Sports Med. 2014;48(7):653.CrossRef Ramskov D, Sørensen H, Parner E, Nielsen R, Lind M, Rasmussen S. The run clever study protocol: the design of a randomized controlled trial. Br J Sports Med. 2014;48(7):653.CrossRef
Metadata
Title
The design of the run Clever randomized trial: running volume, −intensity and running-related injuries
Authors
Daniel Ramskov
Rasmus Oestergaard Nielsen
Henrik Sørensen
Erik Parner
Martin Lind
Sten Rasmussen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1020-0

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue