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. 2016 Dec;11(7):1106–1124.

Protocol of the Treatment Intervention Program

Session Location Exercises
Week -1 Research center

  1. Informed consent

  2. Practice session on lower leg strengthening exercises (Appendix 2) and core strengthening exercises (Appendix 3)
Week 1: Wednesday Research center

  1. Baseline measurement

  2. Check-up on supporting exercises
Week 1: Friday Research center

  1. Detailed briefing of the training program

  2. Practice session on perception exercises (Appendix 4) and flexibility exercises (Appendix 5)

  3. Check-up on physical limitations (e.g., range of motion of knee and ankle joints) by manual therapist
Week 2: Monday Research center

  1. Lower leg strengthening exercises, core strengthening exercises, perception drills, flexibility exercises (Appendices 2-5)

  2. Treadmill marching session: 4x5 min with stepwise speed increase from 5.0 to 6.0 km/hr (2 min break in between), barefoot, without load, with alternating use of metronome at 125 bpm, using verbal cues (e.g., “make shorter strides”, “turn up the step frequency”, “relax the lower leg and foot muscles”, “extend in hip”, etc.)

  3. Practice session on stretching exercises1
Week 2: Wednesday Home base

  1. Flexibility exercises (Appendix 5)

  2. Indoor track marching: 3x10 min with stepwise speed increase from 5.0 to 6.0 km/hr (2 min break in between), barefoot, without load, with use of metronome-app (125 bpm)

  3. Stretching exercises
Week 2: Friday Research center

  1. Lower leg strengthening exercises, core strengthening exercises, perception drills, flexibility exercises (Appendices 2-5)

  2. Treadmill marching session: 3x12 min with stepwise speed increase from 5.0 to 6.0 km/hr (1 min break in between), with running shoes, without load, with alternating use of metronome (125 to 130 bpm), using verbal cues, and EMG monitoring of the m. tibialis anterior (alternating between visible and not visible for the patient)

  3. Stretching exercises
Week 3: Monday Research center

  1. Briefing on lacing up military boots by a orthopedic shoe technician

  2. Lower leg strengthening exercises, core strengthening exercises, perception drills, flexibility exercises (Appendices 2-5)

  3. Treadmill marching sessions: 3x8 min with stepwise speed increase from 5.0 to 6.0 km/hr (1 min break in between) with military boots, without load, alternating with and without metronome (125 to 130 bpm), using verbal cues and EMG monitoring of the m. tibialis anterior (alternating between visible and not visible for the participant)

  4. Field track marching (800 m, with stepwise speed increase from 4.0 to 6.0 km/hr) with military boots without load, alternating with and without metronome (125 to 130 bpm), without verbal cues

  5. Stretching exercises
Week 3: Wednesday Home base

  1. Flexibility exercises (Appendix 5)

  2. Field track marching: 3x10 min with stepwise speed increase from 5.0 to 6.0 km/hr (1 min break in between) with military boots, alternating with and without metronome-app (125to 130 bpm)

  3. Stretching exercises
Week 3: Friday Research center

  1. Perception exercises, flexibility exercises (Appendix 4-5)

  2. Treadmill marching session: 3x8 min with stepwise speed increase from 5.0 to 6.0 km/hr (1 min break in between) with military boots with backpack (individualized load), with alternating use of metronome (125 to 130 bpm), using verbal cues, and EMG monitoring of the m. tibialis anterior (alternating between visible and not visible for the patient)

  3. Stretching exercises
Week 4: Monday Home base

  1. Flexibility exercises (Appendix 5)

  2. Field track marching session: 3x10 min with stepwise speed increase from 5.0 to 6.0 km/hr (1 min break in between) with military boots with backpack (individualized load), alternating with and without metronome-app (125 to 130 bpm)

  3. Stretching exercises
Week 4: Wednesday Home base

  1. Flexibility exercises (Appendix 5)

  2. Field track marching: 3x12 min with stepwise speed increase from 5.0 to 6.0 km/hr (1 min break in between) with military boots with backpack (individualized load), alternating with and without metronome-app (125 to 130 bpm)

  3. Stretching exercises
Week 4: Friday Research center

  1. Flexibility exercises (Appendix 5)

  2. Field track marching session: 30 min non-stop at 6.0 km/hr with military boots with backpack (individualized load), ocassional verbal cues on stride frequency (observer with ‘silent’ metronome)

  3. Stretching exercises
Week 5: Monday Home base

  1. Flexibility exercises (Appendix 5)

  2. Field track marching session: 3x7 min at 5.0 km/hr with running shoes, without load

  3. Stretching exercises
Week 5: Wednesday Research center

  1. Post-treatment measurement

  2. Written and verbal evaluation