Multicomponent Exercise Program Effects on Performance and Injury Reduction in Recreational Runners

NCT07741539 | Suspended

• 1 other identifier: 202506Y0873
• Study Type: interventional
• Target: 29
• Locations: 1 country
• Sites: 1

Brief Summary

Study aim was to evaluate effectiveness of two home-based exercise programs upon athletic performance, physical parameters and injury reduction in recreational runners. Participants were randomized to multicomponent and traditional strength exercise program in block randomization. Primary outcomes were maximal oxygen uptake (VO2Max) calculated with 20 meter (m) shuttle run test (20m SRT), muscle strength of quadriceps femoris, hamstring and gluteus medius calculated via handheld dynamometer (HHD), plyometric performance measured via countermovement jump (CMJ) and drop jump (DJ), foot posture assessment with foot posture index and navicular drop, core endurance with prone bridge, side bridge and horizontal extension and calf endurance values. Secondary outcome was injury reduction followed via self made questionnaire that was sent each week to the participants in order them to record injury and training characteristic of that with including running and exercise program. Programs were given online without supervision 2-3 times a week. Study consisted of 16-weeks with 8-week training, and 8 weeks follow up including baseline and 8th week assessment. In each assessment all the primary outcomes measured. H0: There will be no improvement in athletic performance, physical parameters, and injury risk after the multi-component exercise program. H1: There will be improvement in athletic performance, physical parameters, and injury risk after the multi-component exercise program.

Conditions

Injury of Body Region; Aerobic Fitness (VO2max); Muscle Strength Development; Plyometric Exercises; Foot Core; Core Endurance; Performance Enhancement

Outcome Measures

Primary Outcomes (10)

• Countermovement Jump

  In order to execute the jump the participant jumped with fast deceleration till 90-degree squat position followed by maximum effort acceleration while holding their hand on their hip. Subjects should perform three jumps, and the best of the three was used. There should be 1-minute rest period between repetitions .

  Baseline and 8th week assessment

• Drop Jump

  The participant will perform drop jump from a 30 cm box. They should keep their hands on their hips while executing the jump all the time. At the start of the jump, the participant must step off the box with one foot. After drop patient should jump maximally as soon as possible after touching the ground. Therefore, minimum ground contact time and maximum vertical distance were expected Three trials should executed, and the best one will used in the analysis

  Baseline and 8th week assessment

• Gluteus Medius Strength

  Isometric strength of the gluteus medius will be assessed using the Microfet 2 handheld dynamometer, which was reliable for measuring the hip muscle system. The participant must exert maximal effort for 5 seconds in a predetermined direction which was hip abduction in this case. Two repetitions will be performed, and the best result will be recorded. Hip abduction will be measured in the side-lying position with the contralateral leg flexed at 30 degrees at the hip and knee. The tested leg will be positioned at 0 degrees hip flexion, 10 degrees hip abduction, and full knee extension. The dynamometer will be placed 5 cm proximally to the lateral condyle of the femur. A strap will be used to secure the patient from the iliac crest to the bed . Before executing the test 3 sets of 5 second submaximal contraction required for warm up.

  Baseline and 8th week assessment

• Quadriceps Femoris Strength

  the handheld dynamometer was applicable for assessing quadriceps peak torque and late torque production rate . The intraclass correlation coefficient for isometric quadriceps measurements was 0.96. The dynamometer was secured by attaching a strap to leg extension machine . The quadriceps muscle strength will be assessed while seated with the knee flexed at 60 degrees. Three trials will be used and the best one will be recorded . There will be three submaximal contractions for adaptation for warm up . The dynamometer will be placed on the anterior tibia, two fingers above the lateral malleolus . Handles will be used to secure participants. Maximum leg extension will be wanted from patient to measure strength after positioning patient for about 6-8 second.

  Baseline and 8th week assessment.

• Hamstring Strength

  The assessment will be performed with the knee flexed at 30 degrees in a seated position in a leg extension machine secured by straps from thigh and handles in the sides \[88,89\]. Three trials will be used, and the best one will be recorded . There will be three submaximal contractions for adaptation and warm up beforehand . The dynamometer will be at the level of the lateral malleolus, and the evaluator stabilizing the dynamometer strap using their body . Maximum leg flexion will be wanted from patient to measure strength after positioning patient for about 6-8 second.

  Baseline and 8th week assessment.

• Calf Endurance

  Calf endurance test was valid test for assessing calf endurance. The participants will perform as many calves raises as possible on a 10-degree inclined surface, extending their knees and using a metronome of 30 beats per minute representing 30 repetitions per minute . Before the test, each participant will warm up with ten bilateral standing heel raises to get used to the metronome speed. The test termination criteria will be explained to the participants which were if the heel can no longer be raised off the incline board, if the digital metronome's pace can no longer be followed and if the knee angle or trunk posture can no longer be maintained or more than fingertip support on the wall is required for balance. A verbal cue was supplied if a termination requirement was met. When two successive prompts went unanswered, the test was stopped .

  Baseline and 8th week assessment

• Core endurance

  The participant will be asked to maintain the maximum duration in seconds throughout the predefined positions. The posterior core will be assessed using the horizontal extension test, the lateral core using the lateral bridge, and the anterior core using the prone bridge.

  Baseline and 8th week assessment

• Foot posture index

  FPI consisted of 6 measurements which were themed from parts of the foot such as forefoot, midfoot and rearfoot. Each evaluation scored with 5 scores consisting of -2 to +2. These evaluations were: talar head palpation, curves above and below lateral malleolus, inversion and eversion of the calcaneus, bulge in the region of talonavicular joint, congruence of the medial longitudinal arch, abduction and adduction of forefoot on the rearfoot (too-many-toes) .Participant will evaluated in a relaxed standing position .

  Baseline and 8th week assessment

• Navicular drop

  The distance from navicular tuberosity will be measured via using a meter in sitting position when subtalar joint was in neutral position. After that same distance will be measured in weight bearing position. The difference between the two measurements will give the navicular drop difference.

  Baseline and 8th week assessment

• Shuttle Run Test

  When the athlete begins the test, their speed was 8.5 kilometers per hour (km/h) and were increased by 0.5 km/h in every minute. The test stopped if the athlete cannot keep up with the pace or fails to complete the shuttle within the predetermined time limits on two consecutive attempts . VO2 max values calculated according to the results described by Ramsbotton and colleagues and the VO2 max conversion table .

  Baseline and 8th week assessment

Secondary Outcomes (1)

• Injury Tracking Assessment

  Baseline to 16th week in each week questionnaire sent.

Study Arms (2)

Multicomponent Exercise Group

EXPERIMENTAL

Other: Multicomponent Exercise Program

Traditional Strength Exercise Group

ACTIVE COMPARATOR

Other: Traditional Exercise Program

Interventions

Multicomponent Exercise Program OTHER

Intervention group received an exercise program that includes same warm-up and cool-down periods containing strength and flexibility exercises with control group. Participants performed the exercises on their own using videos without supervision at home. The multicomponent exercise program which was intervention group included plyometric, strength, and core (lumbopelvic and foot region) exercises. The program was implemented 2-3 times per week. Exercises delivered to participants via Google Drive using exercise videos recorded by researchers, ensuring proper technique was maintained, allowing participants to perform the exercises at home without supervision. Additionally, detailed information about the exercise system and important considerations or precautions while doing the exercise were told in videos. Furthermore, general guidelines including, detailed information about study, drop out criteria, precautions for

Multicomponent Exercise Group

Traditional Exercise Program OTHER

Control group received an exercise program that includes same warm-up and cool-down periods containing strength and flexibility exercises with intervention group. Participants performed the exercises on their own using videos without supervision at home. The control group only received strength and core exercises. The program was implemented 2-3 times per week. Exercises delivered to participants via Google Drive using exercise videos recorded by researchers, ensuring proper technique was maintained, allowing participants to perform the exercises at home without supervision. Additionally, detailed information about the exercise system and important considerations or precautions while doing the exercise were told in videos. Furthermore, general guidelines including, detailed information about study, drop out criteria, precautions for

Traditional Strength Exercise Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• The primary sport must be running.
• Be between 18 and 65 years of age.
• Participate in races.
• Run 20-100 km per week.
• Have at least 12 months of regular running experience.
• At least 3 running training sessions per week.

You may not qualify if:

• Did not injured in the last 3 months.
• Did not undergone surgery in the last 12 months.
• Did not have any issues that limit strength training.
• Did not having any neurological, tumor, cardiovascular, rheumatological, or hormonal diseases.

Sponsors & Collaborators

• Yeditepe University: lead

Study Sites (1)

PT Academy

Istanbul, Kadıköy, 34726, Turkey (Türkiye)

Location

Related Publications (35)

• Edouard P, Steffen K, Peuriere M, Gardet P, Navarro L, Blanco D. Effect of an Unsupervised Exercises-Based Athletics Injury Prevention Programme on Injury Complaints Leading to Participation Restriction in Athletics: A Cluster-Randomised Controlled Trial. Int J Environ Res Public Health. 2021 Oct 28;18(21):11334. doi: 10.3390/ijerph182111334.

  PMID: 34769849 BACKGROUND

• Ramsbottom R, Brewer J, Williams C. A progressive shuttle run test to estimate maximal oxygen uptake. Br J Sports Med. 1988 Dec;22(4):141-4. doi: 10.1136/bjsm.22.4.141.

  PMID: 3228681 BACKGROUND

• Cuenca-Garcia M, Marin-Jimenez N, Perez-Bey A, Sanchez-Oliva D, Camiletti-Moiron D, Alvarez-Gallardo IC, Ortega FB, Castro-Pinero J. Reliability of Field-Based Fitness Tests in Adults: A Systematic Review. Sports Med. 2022 Aug;52(8):1961-1979. doi: 10.1007/s40279-021-01635-2. Epub 2022 Jan 22.

  PMID: 35064915 BACKGROUND

• Penry JT, Wilcox AR, Yun J. Validity and reliability analysis of Cooper's 12-minute run and the multistage shuttle run in healthy adults. J Strength Cond Res. 2011 Mar;25(3):597-605. doi: 10.1519/JSC.0b013e3181cc2423.

  PMID: 20647946 BACKGROUND

• Brijwasi T, Borkar P. A comprehensive exercise program improves foot alignment in people with flexible flat foot: a randomised trial. J Physiother. 2023 Jan;69(1):42-46. doi: 10.1016/j.jphys.2022.11.011. Epub 2022 Dec 14.

  PMID: 36526555 BACKGROUND

• Bennett JE, Reinking MF, Rauh MJ. The relationship between isotonic plantar flexor endurance, navicular drop, and exercise-related leg pain in a cohort of collegiate cross-country runners. Int J Sports Phys Ther. 2012 Jun;7(3):267-78.

  PMID: 22666641 BACKGROUND

• Bonato M, Benis R, La Torre A. Neuromuscular training reduces lower limb injuries in elite female basketball players. A cluster randomized controlled trial. Scand J Med Sci Sports. 2018 Apr;28(4):1451-1460. doi: 10.1111/sms.13034. Epub 2018 Jan 8.

  PMID: 29239030 BACKGROUND

• Redmond AC, Crane YZ, Menz HB. Normative values for the Foot Posture Index. J Foot Ankle Res. 2008 Jul 31;1(1):6. doi: 10.1186/1757-1146-1-6.

  PMID: 18822155 BACKGROUND

• Keenan AM, Redmond AC, Horton M, Conaghan PG, Tennant A. The Foot Posture Index: Rasch analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007 Jan;88(1):88-93. doi: 10.1016/j.apmr.2006.10.005.

  PMID: 17207681 BACKGROUND

• McLaughlin P, Vaughan B, Shanahan J, Martin J, Linger G. Inexperienced examiners and the Foot Posture Index: A reliability study. Man Ther. 2016 Dec;26:238-240. doi: 10.1016/j.math.2016.06.009. Epub 2016 Jun 21.

  PMID: 27372400 BACKGROUND

• Taddei UT, Matias AB, Duarte M, Sacco ICN. Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial. Am J Sports Med. 2020 Dec;48(14):3610-3619. doi: 10.1177/0363546520969205. Epub 2020 Nov 6.

  PMID: 33156692 BACKGROUND

• Corrigan P, Cortes DH, Pohlig RT, Gravare Silbernagel K. Tendon Morphology and Mechanical Properties Are Associated With the Recovery of Symptoms and Function in Patients With Achilles Tendinopathy. Orthop J Sports Med. 2020 Apr 30;8(4):2325967120917271. doi: 10.1177/2325967120917271. eCollection 2020 Apr.

  PMID: 32426410 BACKGROUND

• Bohannon RW, Steffl M, Glenney SS, Green M, Cashwell L, Prajerova K, Bunn J. The prone bridge test: Performance, validity, and reliability among older and younger adults. J Bodyw Mov Ther. 2018 Apr;22(2):385-389. doi: 10.1016/j.jbmt.2017.07.005. Epub 2017 Jul 25.

  PMID: 29861239 BACKGROUND

• Visser TSS, Neill SO, Hebert-Losier K, Eygendaal D, de Vos RJ. Normative values for calf muscle strength-endurance in the general population assessed with the Calf Raise Application: A large international cross-sectional study. Braz J Phys Ther. 2025 May-Jun;29(3):101188. doi: 10.1016/j.bjpt.2025.101188. Epub 2025 Feb 27.

  PMID: 40020545 BACKGROUND

• Reinking MF, Bockrath-Pugliese K, Worrell T, Kegerreis RL, Miller-Sayers K, Farr J. Assessment of quadriceps muscle performance by hand-held, isometric, and isokinetic dynamometry in patients with knee dysfunction. J Orthop Sports Phys Ther. 1996 Sep;24(3):154-9. doi: 10.2519/jospt.1996.24.3.154.

  PMID: 8866274 BACKGROUND

• Neil SE, Myring A, Peeters MJ, Pirie I, Jacobs R, Hunt MA, Garland SJ, Campbell KL. Reliability and validity of the Performance Recorder 1 for measuring isometric knee flexor and extensor strength. Physiother Theory Pract. 2013 Nov;29(8):639-47. doi: 10.3109/09593985.2013.779337. Epub 2013 May 31.

  PMID: 23724831 BACKGROUND

• Ferrauti A, Bergermann M, Fernandez-Fernandez J. Effects of a concurrent strength and endurance training on running performance and running economy in recreational marathon runners. J Strength Cond Res. 2010 Oct;24(10):2770-8. doi: 10.1519/JSC.0b013e3181d64e9c.

  PMID: 20885197 BACKGROUND

• Whiteley R, Jacobsen P, Prior S, Skazalski C, Otten R, Johnson A. Correlation of isokinetic and novel hand-held dynamometry measures of knee flexion and extension strength testing. J Sci Med Sport. 2012 Sep;15(5):444-50. doi: 10.1016/j.jsams.2012.01.003. Epub 2012 Mar 15.

  PMID: 22424705 BACKGROUND

• Lesnak J, Anderson D, Farmer B, Katsavelis D, Grindstaff TL. VALIDITY OF HAND-HELD DYNAMOMETRY IN MEASURING QUADRICEPS STRENGTH AND RATE OF TORQUE DEVELOPMENT. Int J Sports Phys Ther. 2019 Apr;14(2):180-187.

  PMID: 30997270 BACKGROUND

• Habets B, Smits HW, Backx FJG, van Cingel REH, Huisstede BMA. Hip muscle strength is decreased in middle-aged recreational male athletes with midportion Achilles tendinopathy: A cross-sectional study. Phys Ther Sport. 2017 May;25:55-61. doi: 10.1016/j.ptsp.2016.09.008. Epub 2016 Sep 13.

  PMID: 28161188 BACKGROUND

• Young W, Elliott S. Acute effects of static stretching, proprioceptive neuromuscular facilitation stretching, and maximum voluntary contractions on explosive force production and jumping performance. Res Q Exerc Sport. 2001 Sep;72(3):273-9. doi: 10.1080/02701367.2001.10608960. No abstract available.

  PMID: 11561392 BACKGROUND

• Brumitt J, Dorociak R, Dunn S, Critchfield C, Benner J, Cuddeford T. Lower preseason reactive strength index scores are associated with injury in female collegiate volleyball players but not male collegiate basketball players. J Sci Med Sport. 2021 Jun;24(6):549-554. doi: 10.1016/j.jsams.2020.11.018. Epub 2020 Dec 10.

  PMID: 33376076 BACKGROUND

• Li F, Wang R, Newton RU, Sutton D, Shi Y, Ding H. Effects of complex training versus heavy resistance training on neuromuscular adaptation, running economy and 5-km performance in well-trained distance runners. PeerJ. 2019 Apr 25;7:e6787. doi: 10.7717/peerj.6787. eCollection 2019.

  PMID: 31086736 BACKGROUND

• Piacentini MF, De Ioannon G, Comotto S, Spedicato A, Vernillo G, La Torre A. Concurrent strength and endurance training effects on running economy in master endurance runners. J Strength Cond Res. 2013 Aug;27(8):2295-303. doi: 10.1519/JSC.0b013e3182794485.

  PMID: 23207882 BACKGROUND

• Markovic G, Dizdar D, Jukic I, Cardinale M. Reliability and factorial validity of squat and countermovement jump tests. J Strength Cond Res. 2004 Aug;18(3):551-5. doi: 10.1519/1533-4287(2004)182.0.CO;2.

  PMID: 15320660 BACKGROUND

• Mikkola J, Rusko H, Nummela A, Pollari T, Hakkinen K. Concurrent endurance and explosive type strength training improves neuromuscular and anaerobic characteristics in young distance runners. Int J Sports Med. 2007 Jul;28(7):602-11. doi: 10.1055/s-2007-964849. Epub 2007 Mar 20.

  PMID: 17373596 BACKGROUND

• Rivera CE. Core and Lumbopelvic Stabilization in Runners. Phys Med Rehabil Clin N Am. 2016 Feb;27(1):319-37. doi: 10.1016/j.pmr.2015.09.003.

  PMID: 26616187 BACKGROUND

• Nielsen RO, Ronnow L, Rasmussen S, Lind M. A prospective study on time to recovery in 254 injured novice runners. PLoS One. 2014 Jun 12;9(6):e99877. doi: 10.1371/journal.pone.0099877. eCollection 2014.

  PMID: 24923269 BACKGROUND

• Hespanhol Junior LC, Huisstede BM, Smits DW, Kluitenberg B, van der Worp H, van Middelkoop M, Hartgens F, Verhagen E. The NLstart2run study: Economic burden of running-related injuries in novice runners participating in a novice running program. J Sci Med Sport. 2016 Oct;19(10):800-4. doi: 10.1016/j.jsams.2015.12.004. Epub 2015 Dec 12.

  PMID: 26726004 BACKGROUND

• Hespanhol Junior LC, van Mechelen W, Postuma E, Verhagen E. Health and economic burden of running-related injuries in runners training for an event: A prospective cohort study. Scand J Med Sci Sports. 2016 Sep;26(9):1091-9. doi: 10.1111/sms.12541. Epub 2015 Aug 17.

  PMID: 26282068 BACKGROUND

• Lovalekar M, Hauret K, Roy T, Taylor K, Blacker SD, Newman P, Yanovich R, Fleischmann C, Nindl BC, Jones B, Canham-Chervak M. Musculoskeletal injuries in military personnel-Descriptive epidemiology, risk factor identification, and prevention. J Sci Med Sport. 2021 Oct;24(10):963-969. doi: 10.1016/j.jsams.2021.03.016. Epub 2021 Mar 31.

  PMID: 33824080 BACKGROUND

• Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021 Sep;10(5):513-522. doi: 10.1016/j.jshs.2021.04.001. Epub 2021 Apr 20.

  PMID: 33862272 BACKGROUND

• Buist I, Bredeweg SW, van Mechelen W, Lemmink KA, Pepping GJ, 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 Jan;36(1):33-9. doi: 10.1177/0363546507307505. Epub 2007 Oct 16.

  PMID: 17940147 BACKGROUND

• Kemler E, Blokland D, Backx F, Huisstede B. Differences in injury risk and characteristics of injuries between novice and experienced runners over a 4-year period. Phys Sportsmed. 2018 Nov;46(4):485-491. doi: 10.1080/00913847.2018.1507410. Epub 2018 Aug 21.

  PMID: 30071170 BACKGROUND

• Wu H, Brooke-Wavell K, Fong DTP, Paquette MR, Blagrove RC. Do Exercise-Based Prevention Programs Reduce Injury in Endurance Runners? A Systematic Review and Meta-Analysis. Sports Med. 2024 May;54(5):1249-1267. doi: 10.1007/s40279-024-01993-7. Epub 2024 Jan 23.

  PMID: 38261240 BACKGROUND

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 23, 2026
• First Posted: August 3, 2026
• Study Start: September 10, 2025
• Primary Completion: May 10, 2026
• Study Completion (Estimated): May 10, 2027
• Last Updated: August 3, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: As soon as possible.
• Access Criteria: Researchers who need it for science.

Locations

TU (1)