Impact Sound Across Rearfoot, Midfoot, and Forefoot Strike During Overground Running.

CONTEXT: Three foot-strike techniques are common in runners. If these techniques generate different sounds at the point of impact with the ground, lower limb kinetics may be influenced. No previous authors have determined whether such relationships exist. OBJECTIVES: To determine foot-ground impact sound characteristics and compare the impact-sound characteristics across foot-strike techniques and the relationships between impact-sound characteristics and vertical loading rates. DESIGN: Cross-sectional study. SETTING: Gait analysis laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 30 runners (15 women, 15 men; age = 23.5 ± 4.0 years, height = 1.67 ± 0.1 m, mass = 58.1 ± 8.2 kg) completed overground running trials with rearfoot-strike, midfoot-strike (MFS), and forefoot-strike (FFS) techniques in a gait analysis laboratory. MAIN OUTCOME MEASURE(S): Impact sound was measured using a shotgun microphone, and the peak sound amplitude, median frequency, and sound duration were analyzed. Separate linear regressions, clustering participants due to repeated measures, were used to compare the sound characteristics across foot-strike techniques. Kinetic data were collected from a force plate, and the vertical loading rates were calculated. Pearson correlation was used to determine the relationship between sound characteristics and kinetics. RESULTS: Landing with an MFS or FFS resulted in greater peak sound amplitude (P < .001) and shorter sound duration (P < .001) than a rearfoot strike. The MFS exhibited the highest median frequency among the 3 foot-strike patterns, followed by the FFS (P < .001). We did not find a significant relationship between vertical loading rates and any impact sound characteristics (P > .115). CONCLUSIONS: The results suggest that impact-sound characteristics may be used to differentiate foot-strike patterns in runners. However, these did not relate to lower limb kinetics. Therefore, clinicians should not solely rely on impact sound to infer impact loading.

History for some or lesson for all? A systematic review and meta-analysis on the immediate and long-term mental health impact of the 2002-2003 Severe Acute Respiratory Syndrome (SARS) outbreak.

BACKGROUND: The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. METHODS: We conducted a systematic search of the literature using databases such as Medline, Pubmed, Embase, PsycInfo, Web of Science Core Collection, CNKI, the National Central Library Online Catalog and dissertation databases to identify studies in the English or Chinese language published between January 2003 to May 2020 which reported psychological distress and mental health morbidities among SARS patients, healthcare workers, and the general public in regions with major SARS outbreaks. RESULTS: The literature search yielded 6984 titles. Screening resulted in 80 papers for the review, 35 of which were included in the meta-analysis. The prevalence of post-recovery probable or clinician-diagnosed anxiety disorder, depressive disorder, and post-traumatic stress disorder (PTSD) among SARS survivors were 19, 20 and 28%, respectively. The prevalence of these outcomes among studies conducted within and beyond 6 months post-discharge was not significantly different. Certain aspects of mental health-related quality of life measures among SARS survivors remained impaired beyond 6 months post-discharge. The prevalence of probable depressive disorder and PTSD among healthcare workers post-SARS were 12 and 11%, respectively. The general public had increased anxiety levels during SARS, but whether there was a clinically significant population-wide mental health impact remained inconclusive. Narrative synthesis revealed occupational exposure to SARS patients and perceived stigmatisation to be risk factors for adverse mental health outcomes among healthcare workers, although causality could not be determined due to the limitations of the studies. CONCLUSIONS: The chronicity of psychiatric morbidities among SARS survivors should alert us to the potential long-term mental health complications of covid-19 patients. Healthcare workers working in high-risk venues should be given adequate mental health support. Stigmatisation against patients and healthcare workers should be explored and addressed. The significant risk of bias and high degree of heterogeneity among included studies limited the certainty of the body of evidence of the review.