Use of cupping therapy in musculoskeletal disorders: A cross-sectional study on the profile, training, and practice of Brazilian physical therapists.

INTRODUCTION: Cupping therapy is a widely used technique in Brazilian physical therapy for the treatment of musculoskeletal disorders. However, there is limited scientific evidence to support its effectiveness. OBJECTIVE: To investigate the profile, training, clinical practice, and scientific updates of Brazilian Physical Therapists who use cupping therapy as a therapeutic resource for musculoskeletal disorders. METHODS: A cross-sectional study was conducted through an online questionnaire, including 646 Physical Therapists who use cupping therapy in their practice. All data were analysed descriptively. RESULTS: Cupping therapy is a technique that has been widely adopted in clinical practice by Physical Therapists, particularly among young, female professionals who have recently graduated from private universities. The primary reason for interest in this technique among these Physical Therapists is the high demand from patients. Additionally, it is often used in conjunction with other manual therapeutic techniques. They identified easy access, low cost, and ease of use as the key factors that make cupping therapy an attractive option. However, a lack of high-quality scientific evidence, as described in the literature, was identified as a major barrier to its use. CONCLUSION: The Physical Therapists included in this study use cupping therapy in their clinical practice, relying heavily on their own experience and the preferences of their patients, rather than utilizing the third pillar of evidence-based practice, which is to rely on the best available evidence. This study suggests that these Physical Therapists are currently implementing a technique without current scientific recommendations for its use in the treatment of musculoskeletal disorders.

Effect of a telerehabilitation exercise program versus a digital booklet with self-care for patients with chronic non-specific neck pain: a protocol of a randomized controlled trial assessor-blinded, 3 months follow-up.

BACKGROUND: Neck pain is the fourth worldwide leading cause of disability and represents 22% of musculoskeletal disorders. Conservative intervention has been strongly recommended to treat chronic neck pain and Telerehabilitation is the alternative for the treatment of musculoskeletal conditions. There is a lack of high-quality research on the effects of telerehabilitation in patients with neck pain and functional disability. Therefore, this study aims to evaluate the effect of a telerehabilitation exercise program versus a digital booklet only with self-care information in individuals with non-specific chronic neck pain. METHODS: This is a prospectively registered, assessor-blinded, two-arm randomized controlled trial comparing a telerehabilitation exercise program versus a digital booklet with self-care information. Seventy patients will be recruited with non-specific chronic neck pain. Follow-ups will be conducted post-treatment, 6 weeks, and 3 months after randomization. The primary outcome will be disability at post-treatment (6 weeks) measured using neck pain disability. Secondary outcomes will be pain intensity levels, global perceived effect, self-efficacy, quality of life, kinesiophobia, and adherence to treatment. In our hypothesis, patients allocated to the intervention group experience outcomes that are similar to those of those assigned to the self-care digital booklet. Our hypothesis can then be approved or disapproved based on the results of the study. DISCUSSION: This randomized clinical trial will provide reliable information on the use of telerehabilitation to treat patients with chronic non-specific neck pain. TRIAL REGISTRATION: The study was prospectively registered at the Brazilian Registry of Clinical Trials (number: RBR-10h7khvk). Registered on 16 September 2022.

Effectiveness of kinesio taping for chronic stroke patients: a systematic review with meta-analysis.

PURPOSE: Kinesio taping (KT) is an approach that has been used in the rehabilitation of patients with chronic stroke. The aim of this review is to evaluate the effectiveness of KT alone or combined with other interventions for patients with chronic stroke. MATERIALS AND METHODS: The search was performed on CENTRAL, EMBASE, PEDro, and five other databases and two trial registries up to July 2022. We included randomized controlled trials that evaluated the effectiveness of KT compared to control interventions. The primary outcomes were upper limb function and gait. We assessed the risk of bias in the included studies using the PEDro scale. The certainty of the evidence was assessed using the GRADE approach. RESULTS: We included 14 RCTs undertaken in six different countries. PEDro score ranged from 4 to 9 points. There is very-low certainty evidence that KT has no effect on gait, balance, and postural control. We found very-low certainty evidence of a slightly benefit when used in addition to other therapies for gait, balance and postural control, and pain intensity. CONCLUSIONS: Our study findings show KT does not have enough robust evidence for improving upper limb function, gait, balance and postural control, and pain intensity in chronic stroke patients.Implications for rehabilitationKinesio taping (KT) is a method that has gained popularity among some health professionals to treat patients poststroke.There is very-low certainty evidence that KT alone has no effect on gait, balance and postural control compared to no treatment.There is very-low certainty evidence that KT plus other therapies may be slightly beneficial for gait, balance and postural control, and pain intensity intervention.Only one study reported there were no adverse events such as skin reactions or local ulceration for patients poststroke.

Feasibility, Usability, and Implementation Context of an Internet-Based Pain Education and Exercise Program for Chronic Musculoskeletal Pain: Pilot Trial of the ReabilitaDOR Program.

BACKGROUND: Internet-based self-management programs and telerehabilitation initiatives have increased and have been extensively used for delivering health care in many areas. These programs overcome common barriers that patients face with traditional face-to-face health care, such as travel expenditures, lack of time, and high demand on the public health system. During the COVID-19 pandemic, this mode of web-based health care delivery had become more popular. However, there is still a lack of studies testing this mode of delivery in low- and middle-income countries. To gain a better understanding of the context, feasibility, and factors involved in the implementation of a web-based program, pilot and implementation studies are necessary. These studies can better inform whether a strategy is feasible, acceptable, and adequate for its purposes and for optimizing resource allocation. OBJECTIVE: This study aims to evaluate the feasibility, usability, and implementation context of a self-management internet-based program based on exercises and pain education (ReabilitaDOR) in people with chronic musculoskeletal pain and to compare this program with a program using only a web-based self-management booklet. METHODS: The study design was a parallel pilot study of a prospectively registered, assessor-blinded, 2-arm randomized controlled trial with economic evaluation. This study was performed using waiting lists of physiotherapy and rehabilitation centers and advertisements on social media networks. The participants were 65 patients with chronic musculoskeletal pain aged between 18 and 60 years. The effects of an 8-week telerehabilitation program based on exercises and pain education (intervention group) were compared with those of a program based only on a web-based self-management booklet (control group). The main outcome measures were implementation outcomes of patients' perceptions of acceptability, appropriateness, feasibility, and usability of the program and the societal costs and feasibility of the main trial at 8-week posttreatment follow-up. Adverse events were also analyzed. RESULTS: In total, 56 participants were analyzed at the 8-week follow-up. The intervention group showed responses with a mean of 4.5 (SD 0.6) points for acceptability, 4.5 (SD 0.5) points for appropriateness, and 4.5 (SD 0.6) points for feasibility measured on a 1 to 5 scale. All patients in the intervention group showed satisfactory responses to the system usability outcome. There is satisfactory evidence for the feasibility of the main trial. For costs related to the interventions, health care, patients, and loss of productivity at 8 weeks, we found a total expenditure of US $278.30 per patient in the intervention group and US $141.52 per patient in the control group. No adverse events were reported during the intervention period. CONCLUSIONS: We found that the ReabilitaDOR program is feasible, appropriate, and acceptable from the users' implementation perspective. This system was considered usable by all the participants, and the main trial seemed feasible. Cost data were viable to be collected, and the program is likely to be safe. TRIAL REGISTRATION: ClinicalTrials.gov NCT04274439; https://clinicaltrials.gov/ct2/show/NCT04274439.

Neural management plus advice to stay active on clinical measures and sciatic neurodynamic for patients with chronic sciatica: Study protocol for a controlled randomised clinical trial.

Advice to stay active is the primary management strategy for sciatica. Other conservative treatments such as neural management techniques may also contribute to sciatica recovery, but currently, the effects have not been robustly assessed. Thus, the aim of this study is to compare the effects of adding neural management to advice to stay active versus advice to stay active alone in improving pain intensity and functional limitation. Secondarily, to compare the effects of the experimental intervention in the sciatic neurodynamic, pain modulation, and psychosocial factors. A parallel-group, controlled, examiner-blinded superiority clinical trial randomised at a 1:1 allocation will be conducted in 210 participants with chronic sciatica. Patients will be recruited from outpatient physiotherapy clinics and community advertisements. The experimental group will receive neural mobilisation techniques and soft tissue mobilisation techniques for 30 minutes per session, 10 weekly sessions, plus advice to stay active on their activities of daily living, information on physical activity, imaging tests, and sciatica for 5 biweekly sessions lasting 25-30 minutes. The control group will receive advice to stay active only. The re-evaluation will be performed out after 5 weeks, 10 weeks, and 26 weeks after randomisation and primary endpoints will be pain intensity and functional limitation at 10 weeks. Secondary outcomes will include neuropathic symptoms, sciatic neurodynamic, pain modulation, and psychosocial factors. Adverse events and patient satisfaction will be assessed. Ethical approval has been granted from an Institutional Human Research Ethics Committee. Trial registration: Trial was prospectively registered in the Brazilian Registry of Clinical Trials (number: RBR-3db643c).

Effectiveness of virtual reality in children and young adults with cerebral palsy: a systematic review of randomized controlled trial.

BACKGROUND: Cerebral palsy (CP) is one of the main causes of disability in childhood. Virtual reality (VR) has been used as a treatment option in this population, however its effectiveness is unclear. OBJECTIVE: To evaluate the effectiveness of VR in patients with CP. METHODS: We conducted electronic searches in EMBASE, MEDLINE, Cochrane library, PEDro, AMED, PsycoINFO, and LILACS databases and trial site registries such as ClinicalTrials.gov and ICTRP. We included randomized controlled trials that tested the use of VR alone or in combination with other interventions compared to more conventional rehabilitation or usual care in individuals with CP. The primary outcomes were upper and lower limb function, postural control, and balance. The secondary outcomes included global motor function, perception, cognition and spatial functions, motivation, motor learning, and adverse events. Two independent reviewers extracted and assessed included articles for risk of bias using the Cochrane risk of bias tool. We use a meta-analysis with random effect model whenever possible. We analyzed the quality of evidence using theGRADE approach. RESULTS: We included 38 trials (pooled n = 1233 participants) in this review. There is very low quality of evidence that VR plus conventional rehabilitation is better than conventional rehabilitation for upper limb function. There is also very low quality evidence that VR alone is no better than conventional rehabilitation for upper and lower limb function. No adverse events were observed among the 10 trials that provided information on this outcome. CONCLUSION: At present we have very limited to limited confidence in effect estimation for utilization of VR in this population. Future studies may change our confidence in results and effect estimates. PROTOCOL REGISTRATION: PROSPERO CRD 42018102759.

Overall confidence in the results of systematic reviews on exercise therapy for chronic low back pain: a cross-sectional analysis using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) 2 tool.

OBJECTIVE: To evaluate the overall confidence in the results of systematic reviews of exercise therapy for chronic non-specific low back pain using the AMSTAR 2 tool. METHODS: PubMed, Embase, Cochrane Database of Systematic Reviews, PEDro and CINAHL was searched up to February 2017. Two independent reviewers selected systematic reviews of randomized controlled trials that investigated exercise therapy in patients with low back pain. AMSTAR 2 assessment was performed by pairs of reviewers, and the overall confidence in the results of the systematic reviews were rated as 'High', 'Moderate', 'Low' and 'Critically low'. Descriptive analysis was used to summarize the characteristics of included systematic reviews. The percentage of systematic reviews achieving each item from the AMSTAR 2 and the overall confidence in the results were tabulated. RESULTS: The search identified 38 systematic reviews. Most of the reviews included a median of 10 clinical trials and total sample size of 813 participants per review. Five of 38 (13%) reviews were Cochrane reviews, and 8 (21%) systematic reviews had a protocol published or registered prospectively. The overall confidence in the results of 28 reviews (74%) was rated as 'Critically low', 6 (16%) as 'Low', 1 (2%) as Moderate, while 3 of 38 reviews (8%) were rated as 'High'. CONCLUSION: The results demonstrate very low confidence in the results of most systematic reviews of exercise in chronic non-specific low back pain. Clinicians are more likely to deliver the most efficacious interventions to patients by critically appraising systematic reviews using AMSTAR 2 before making their decisions.

The contemporary management of nonspecific lower back pain.

Low back pain (LBP) is extremely common and causes an enormous burden on the society. This perspective article aims to provide an evidence-based summary in the field of LBP. More specifically, we aimed to present epidemiological data on cost, diagnosis, prognosis, prevention and interventions for patients with LBP. It is critical that both clinicians and policymakers follow best practices by using high-value care for patients with LBP. In addition, nonevidence-based procedures must be immediately abandoned. These actions are likely to reduce societal costs and will improve the quality of life of these patients.

Allocation Concealment and Intention-To-Treat Analysis Do Not Influence the Treatment Effects of Physical Therapy Interventions in Low Back Pain Trials: a Meta-epidemiologic Study.

OBJECTIVE: To evaluate if allocation concealment and intention-to-treat (ITT) analysis influence the treatment effects of physical therapy interventions in low back pain (LBP) trials. DATA SOURCES: We searched on PubMed, Embase, Cochrane Database of Systematic Reviews, Physiotherapy Evidence Database (PEDro), and CINAHL up to February 2017. STUDY SELECTION: We included LBP trials that compared physical therapy interventions to placebo or no intervention or minimal intervention with pain or disability outcomes. DATA EXTRACTION: Information about allocation concealment and ITT analysis was extracted from PEDro and pain and disability outcomes converted to a 0-100 scale. A meta-regression was performed to evaluate the influence of these methodological features of interest on treatment effects. Other covariates included in the meta-regression were sample size and sequence generation. DATA SYNTHESIS: We identified 128 eligible trials (pooled N=20,555 participants). A total of 44.5% of the trials achieved allocation concealment, while 32% performed ITT analysis. Meta regression analyses showed no influence of allocation concealment on treatment effects for pain (regression coefficient 0.009; 95% confidence interval [CI] -2.91 to 2.91) and disability (regression coefficient 1.13; 95% CI -1.35 to 3.62), and no influence of ITT analysis for pain (regression coefficient 1.38; 95% CI -1.73 to 4.50) or disability (regression coefficient 1.27; 95% CI -1.39 to 3.64). For the other covariates, there was also no clinically significant influence on the treatment effects. CONCLUSION: There is no influence of allocation concealment or ITT analysis on treatment effects of physical therapy interventions for pain and disability in LBP trials.

Desequilíbrio muscular dos flexores e extensores do joelho associado ao surgimento de lesão musculoesquelética relacionada à corrida: um estudo de coorte prospectivo / Muscle imbalance of flexors and extensors of the knee associated with running-related musculoskeletal injury: a prospective cohort study / Desequilibrio muscular de los flexores y extensores de la rodilla asociado con lesiones musculoesqueléticas en la carrera: un estudio de cohortes prospectivo

Resumo O objetivo deste estudo foi verificar se o desequilíbrio dos músculos do joelho pode estar associado com o surgimento de lesões em corredores. Vinte corredores fizeram uma avaliação isocinética nas velocidades de 60, 180 e 300o/s e foram acompanhados por três meses para verificar a ocorrência de lesões. Quatro atletas (21%) apresentaram lesões que envolveram a região do joelho e o desequilíbrio muscular encontrado foi associado ao surgimento de lesões, nas três velocidades testadas (p < 0,05).

Abstract The aim of this study was to determine whether a muscle imbalance of the knee is associated with running injuries. Twenty runners were evaluated by an isokinetic dynamometer at 60, 180 and 300 degrees/second. Runners were followed for three months to determine the incidence of injuries. We used the chi-square test to verify the association between muscular imbalance and the appearance of injury. Four athletes experienced injuries (21%), all registered in the knee. Muscle imbalance was associated with running-related injuries for the three tested velocities (p < 0.05). To conclude, a muscle imbalance may be associated with running injuries.

Resumen El objetivo de este estudio fue determinar si el desequilibrio muscular de los músculos de la rodilla puede estar asociado con la aparición de lesiones en corredores. Veinte corredores realizaron una evaluación isocinética a velocidades de 60, 180 y 300º/s. Se hizo un seguimiento de los participantes durante tres meses para determinar la incidencia de las lesiones. Se utilizó la prueba de chi cuadrado para determinar la asociación entre la aparición de un desequilibrio muscular y la de las lesiones. Cuatro atletas (21%) presentaron lesiones en la región de la rodilla. El desequilibrio muscular se asoció con la aparición de lesiones en las tres velocidades probadas (p < 0,05). Se concluyó que un desequilibrio muscular puede estar asociado con la aparición de lesiones en corredores.

A consensus definition of running-related injury in recreational runners: a modified Delphi approach.

STUDY DESIGN: Delphi study. OBJECTIVE: To reach a consensus definition of running-related injury in recreational runners through a modified Delphi approach. BACKGROUND: Many studies have suggested the need for a standardized definition of running-related injury to provide uniformity to injury surveillance in running. METHODS: We invited 112 researchers from running-related injury studies identified in a previous systematic review to classify words and terms frequently used in definitions of running-related injury in an online form during 3 rounds of study. In the last round, participants were asked to approve or disapprove the consensus definition. We considered an agreement level of at least 75% to be a consensus. RESULTS: Thirty-eight participants agreed to participate in the study. The response rates were 94.7% (n = 36) for the first round, 83.3% (n = 30) for the second round, and 86.7% (n = 26) for the third round. A consensus definition of running-related injury was reached, with 80% of participants approving the following: "Running-related (training or competition) musculoskeletal pain in the lower limbs that causes a restriction on or stoppage of running (distance, speed, duration, or training) for at least 7 days or 3 consecutive scheduled training sessions, or that requires the runner to consult a physician or other health professional." CONCLUSION: The proposed standardized definition of running-related injury could assist in standardizing the definitions used in sport science research and facilitate between-study comparisons. Future studies testing the validity of the proposed consensus definition, as well as its accurate translation to other languages, are also needed.

Descriptors used to define running-related musculoskeletal injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVES: To systematically review the descriptors used to define running-related musculoskeletal injury and to analyze the implications of different definitions on the results of studies. BACKGROUND: Studies have developed their own definitions of running-related musculoskeletal injuries based on different criteria. This may affect the rates of injury, which can be overestimated or underestimated due to the lack of a standard definition. METHODS: Searches were conducted in the Embase, PubMed, CINAHL, SPORTDiscus, LILACS, and SciELO databases, without limits on date of publication and language. Only articles that reported a definition of running-related injury were included. The definitions were classified according to 3 domains and subcategories: (1) presence of physical complaint (symptom, body system involved, region), (2) interruption of training or competition (primary sports involved, extent of injury, extent of limitation, interruption, period of injury), and (3) need for medical assistance. Spearman rank correlation was performed to evaluate the correlation between the completeness of definitions and the rates of injury reported in the studies. RESULTS: A total of 48 articles were included. Most studies described more than half of the subcategories, but with no standardization between the terms used within each category, showing that there is no consensus for a definition. The injury rates ranged between 3% and 85%, and tended to increase with less specific definitions. CONCLUSION: The descriptors commonly used by researchers to define a running-related injury vary between studies and may affect the rates of injuries. The lack of a standardized definition hinders comparison between studies and rates of injuries.

Prevalência de dor musculoesquelética em praticantes de caminhada: um estudo transversal / La prevalencia de dolor musculo esquelético en practicantes de caminatas: estudio transversal / Prevalence of musculoskeletal pain in walkers: a cross-sectional study

O presente estudo teve como objetivo verificar a prevalência de dor de origem musculoesquelética em praticantes de caminhada e os possíveis fatores associados. Trata-se de um estudo transversal, realizado por meio de um formulário aplicado aos praticantes de caminhada em parques comuns à prática desta atividade. O formulário utilizado foi composto de questões sobre informações pessoais dos participantes, a rotina da prática de caminhada, o histórico de lesões e a presença de dor musculoesquelética no momento da entrevista. Foi realizada uma análise descritiva das características dos participantes e utilizado o teste t independente, teste de Mann-Whitney e teste de qui-quadrado para a comparação dos dados entre os participantes com dor e sem dor no momento da entrevista. Foram entrevistados 136 praticantes de caminhada, sendo que a prevalência de dor musculoesquelética foi de 8%. A articulação do joelho foi a região mais acometida pela dor entre os participantes (45%). Entre as variáveis analisadas, a presença de lesões prévias nos últimos 12 meses demostrou uma associação estatisticamente significativa (p<0,05) com a presença de dor atual. Podemos concluir que a prevalência de dor musculoesquelética em praticantes de caminhada é baixa, porém esteve diretamente associada à presença de lesões prévias nos últimos 12 meses.

Este artículo tuvo el propósito de verificar la prevalencia de dolor musculo esquelético en practicantes de caminatas y los posibles factores asociados a esta práctica. Se trata de estudio transversal, que se realizó mediante un cuestionario aplicado a los practicantes de caminatas en parques y lugares que son comunes a esta actividad. El cuestionario se componía por informaciones personales de los practicantes, la rutina de la práctica, el historial de lesiones y la presencia de dolor musculo esquelético durante la entrevista. Para ello, se ha hecho un análisis descriptivo de las características de los participantes, y se han utilizados la prueba t independiente, la prueba de Mann-Whitney y la prueba de Chi Cuadrado para la comparación de los datos entre los participantes con y sin dolor en la ocasión de la entrevista. Se han entrevistados 136 practicantes de caminatas, y el 8% fue la prevalencia de dolor musculo esquelético encontrada. La zona más afectada por el dolor entre los participantes fue la articulación de rodilla (45%). Entre las variables evaluadas, se ha demostrado que la presencia de lesiones previas de los últimos 12 meses está asociada estadísticamente (p<0,05) a la presencia de dolor actual. Se concluyó que es baja la prevalencia de dolor musculo esquelético en practicantes de caminatas, sin embargo se la asocia a la presencia de lesiones previas de los últimos 12 meses.

The aim of this study was to determine the prevalence of musculoskeletal pain in walkers and the associated factors. This is a cross sectional study, conducted through a questionnaire applied to walkers in parks in which this activity is commonly seen. The form used was composed of questions about personal information, walking practice routine, injury history and the presence of musculoskeletal pain during the interview. We performed a descriptive analysis of the characteristics of the participants and used the independent t test, Mann-Whitney's test e chi-square test for the comparison of data between participants with and without pain at the moment of the interview. We interviewed 136 walkers, and the prevalence of musculoskeletal pain was 8%. The knee joint was the most affected region by pain between the participants (45%). Among the variables analyzed, the presence of previous injuries in the last 12 months showed a statistically significant association (p<0.05) with the presence of pain. We can conclude that the prevalence of musculoskeletal pain in walkers was low, however, it was directly associated with previous injuries in the last 12 months.

Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners?

OBJECTIVE: To determine the distribution of the foot strike patterns among recreational shod runners and to compare the personal and training characteristics between runners with different foot strike patterns. DESIGN: Cross-sectional study. SETTING: Areas of running practice in São Paulo, Brazil. PARTICIPANTS: 514 recreational shod runners older than 18 years and free of injury. OUTCOMES MEASURES: Foot strike patterns were evaluated with a high-speed camera (250 Hz) and photocells to assess the running speed of participants. Personal and training characteristics were collected through a questionnaire. RESULTS: The inter-rater reliability of the visual foot strike pattern classification method was 96.7% and intra-rater reliability was 98.9%. 95.1% (n = 489) of the participants were rearfoot strikers, 4.1% (n = 21) were midfoot strikers, and four runners (0.8%) were forefoot strikers. There were no significant differences between strike patterns for personal and training characteristics. CONCLUSION: This is the first study to demonstrate that almost all recreational shod runners were rearfoot strikers. The visual method of evaluation seems to be a reliable and feasible option to classify foot strike pattern.

What do recreational runners think about risk factors for running injuries? A descriptive study of their beliefs and opinions.

STUDY DESIGN: Qualitative study based on semi-structured interviews. OBJECTIVES: To describe the beliefs and opinions of runners about risk factors associated with running injuries. BACKGROUND: Despite the health benefits of running, a high prevalence of injury has been reported in runners. Preventive strategies for running injuries may be more successful with a better knowledge of runners' beliefs. METHODS: A semi-structured interview of recreational runners was based on the question, "What do you think can cause injuries in runners?" Analysis of the interviews was performed in 3 steps: (1) organizing the data into thematic units, (2) reading and reorganizing the data according to frequency of citation, and (3) interpreting and summarizing the data. The runner interviews were continued until no new beliefs and opinions of runners regarding injuries were being added to the data, indicating saturation of the topic. RESULTS: A total of 95 recreational runners (65 men, 30 women) between the ages of 19 and 71 years were interviewed. Of those interviewed, the average running experience was 5.5 years and approximately 45% had experienced a running-related injury in the past. The factors suggested by the runners were divided into extrinsic and intrinsic factors. The most cited extrinsic factors were "not stretching," "excess of training," "not warming up," "lack of strength," and "wearing the wrong shoes." For the intrinsic factors, the main terms cited were "not respecting the body's limitations" and "foot-type changes." CONCLUSION: Recreational runners mainly attributed injury to factors related to training, running shoes, and exceeding the body's limits. Knowing the factors identified in this study may contribute to the development of better educational strategies to prevent running injuries, as some of the runners' beliefs are not supported by the research literature.