VIB3101 RESEARCH PROJECT IN SPORT AND EXERCISE SCIENCES
SEMESTER 2, SESSION 2022/2023
DIFFERENCES IN KINEMATICS BETWEEN THE SIGHTED AND VISUALLY
IMPAIRED PERSON RUNNING ON TREADMILL
PREPARED BY:
FILZAH BAHIRAH BINTI ZULFIKRI
U2005227
NUR SITI ZULAIKA BINTI ZULKIFLY
U2005173
PREPARED FOR:
DR. ASHRIL BIN YUSOF
SUPERVISED BY:
DR. RIZAL MOHD RAZMAN
Table of Contents
CHAPTER 1: INTRODUCTION .............................................................................................................. 3
1.1 Study Background ............................................................................................................................ 3
1.2 Problem Statement............................................................................................................................ 5
1.3 Research Questions ........................................................................................................................... 5
1.4 Research Objectives .......................................................................................................................... 5
1.5 Research Hypotheses ........................................................................................................................ 5
1.6 Research Significance and Benefits ................................................................................................. 6
CHAPTER 2: LITERATURE REVIEW .................................................................................................. 7
2.1 Introduction to Literature Review .................................................................................................. 7
2.2 Summary of Literature Review (gap in knowledge) .................................................................... 14
CHAPTER 3: METHODS ....................................................................................................................... 15
3.1 Research Design .............................................................................................................................. 15
3.2 Participants...................................................................................................................................... 15
3.3 Materials/Measured Variables....................................................................................................... 16
3.4 Protocols/Procedure ........................................................................................................................ 16
3.5 Statical Analysis .............................................................................................................................. 18
References .................................................................................................................................................. 19
Appendix .................................................................................................................................................... 22
Appendix A: The Physical Activity Readiness Questionnaire (PAR-Q) ................................................ 22
CHAPTER 1: INTRODUCTION
1.1 Study Background
Visual impairment is a condition that affects millions of people around the world, and it
can have a significant impact on their daily lives. According to the World Health Organization
(2020), around 2.2 billion people have near or distance vision impairments globally. Visual
impairment refers to any condition that causes a loss of vision, and it can range from mild to severe
classified by the visual system such as B1, B2 and B3 (International Sport Organization, 1976).
Some people are born with visual impairments, while others develop them later in life due to
various factors such as injury, illness, or ageing (Köberlein et al., 2013). One of the most
significant challenges faced by individuals with visual impairments is navigating their
environment. Without visual cues, it can be difficult to navigate new places, find objects, or even
perform simple tasks such as crossing the street. As a result, many individuals with visual
impairments rely on assistive devices such as canes or guide dogs (L. E. Ball et al., 2022) to help
them navigate their surroundings safely. Visual impairment can also impact an individual's ability
to participate in physical activities such as sports and exercise due to the facility are not userfriendly for them. They may face obstacles when it comes to finding suitable gym facilities as
inaccessible facilities and lack appropriate assistive equipment provided for them (Shields et al.,
2012). Not just that, they may also face social and emotional challenges. Feeling isolated or
misunderstood can be a common experience for individuals with visual impairments and can make
everyday activities more challenging. Regardless of the cause, it can lead to fall, feelings of
isolation and depression (Rosenberg & Sperazza, 2008).
According to Lindsay E. Ball et al. (2022); Haegele et al. (2018), adults with visual
impairment have sedentary behavior and lifestyle due to some limitations such as lack of access to
the facility. Visual impairment can limit an individual's ability to participate in physical activity,
leading to a more sedentary lifestyle. This sedentary lifestyle, combined with poor dietary choices,
can contribute to weight gain and obesity. Additionally, individuals with visual impairment may
face challenges in accessing physical activity programs, such as gyms, that are not designed to
accommodate their needs. They were not just a lack of accessibility toward the facility, lack of
confidence and interest in themselves or even from their family (Columna et al., 2019; Haegele et
al., 2021), social interaction barriers (Alcaraz-Rodríguez et al., 2022; Augestad & Jiang, 2015;
Haegele et al., 2018) and less education of motor skill from childhood (Alcaraz-Rodríguez et al.,
2022; Augestad & Jiang, 2015). Unfortunately, because of all these limitations, most people with
visual impaired had lower participation in physical activity (Capella-McDonnall, 2007; Haegele
et al., 2018; Haegele et al., 2021) and have a higher rate of being overweight and obese (Augestad
& Jiang, 2015; Capella-McDonnall, 2007; Haegele et al., 2021). Obesity is a medical condition
characterized by excessive body fat accumulation that can lead to various health problems,
including heart disease, type 2 diabetes, and stroke. In a study from Capella-McDonnall (2007),
the rate of overweight increases significantly with year in worldwide and has been considered as
most important public health problem. Not just that, it has evidence that people with disability are
higher in being obese compared to general population (Augestad & Jiang, 2015; CapellaMcDonnall, 2007).
One way to make them be active is by asking them to participate in physical activity such
as running. Running is one of the most popular forms of exercise (Higginson, 2009; Moening et
al., 1993; Pedisic et al., 2020), enjoyed by millions of people around the world (Moening et al.,
1993; Pedisic et al., 2020). According to Pedisic et al. (2020), around 3.7 million each month which
is equal to 8.5% of English adults participate in running either as a sport or recreational activity.
Running is a simple and accessible form of physical activity that can be done anywhere, anytime
and has been modified such as running on the treadmill. The treadmill became the most suitable
to fulfil all the needs of the visually impaired runner to reduce the risk of falling in the pathway
and to run independently without the guide runner. Running on the treadmill is one of the safest
alternatives and options for those visually impaired people as they prefer to not being exposed to
unstable paths and obstacles (Nakamura (1997). Meanwhile, according to L. E. Ball et al. (2022),
visually impaired runners reported difficulty in finding guided runners who have the same time of
day, pace and goals. Thus, running on a treadmill offers a controlled and consistent environment
that can be helpful for individuals who need to monitor their exercise intensity more closely.
Treadmill running allows users to adjust the speed, incline, and other variables to create a
customized workout that suits their needs and goals. The treadmill also had safety clips for
emergency stops and surfaces that are smooth without obstacles which perfectly suited to the
visually impairer’s needs. To our knowledge, there is still a lack of studies comparing the running
gait between the sighted and the visually impaired. Most studies only covered comparing running
overground compared to the treadmill, differences in the walking gait of sighted and visually
impaired or differences in treadmill running gait among females and males. Therefore, the aim of
this study was to compare the differences of running kinematics on the treadmill between the
sighted and the visually impaired person.
1.2 Problem Statement
Previous studies have mainly concentrated on gait kinematics in visually impaired
individuals during walking, but there has been less emphasis on the kinematic and variability when
running, specifically on treadmills.
1.3 Research Questions
What is the difference in running kinematics between the sighted and visually impaired
runner on a treadmill?
1.4 Research Objectives
To determine the differences in running kinematics on the treadmill between the sighted
and visually impaired runner.
1.5 Research Hypotheses
Clear vision might influence the gait kinematics of running compared to the sight problem.
Visually impaired people might have differences compared to the sighted in terms of joint angles
(hip angle, knee angle, ankle angle), the stride length and stride rate which are measured in three
different phases such as foot-contact phase, mid-stance phase and toe-off phase during running.
We hypothesized that the kinematics running gait among the sighted might differ from the visually
impaired person. Thus, there were significant differences in kinematics between the sighted and
the visually impaired person running on the treadmill.
1.6 Research Significance and Benefits
The study can possibly provide more understanding and experiences to visually impaired
people, adaptation to new forms of exercise for people with disabilities and development to new
technologies in future. Next, it will provide people with disabilities with several choices of
exercising as to make exercise more accessible for people with disabilities. It also helps coaches
to identify factors that may improve performance and reduce the risk of injury.
CHAPTER 2: LITERATURE REVIEW
2.1 Introduction to Literature Review
Many studies have focused on differences in variability during walking for the visually
impaired and sighted person (Bennett et al., 2019; Bennett et al., 2022; Mason et al., 2005;
Nakamura, 1997). Two previous studies by Bennett et al. (2019); Nakamura (1997) shows the
differences in variability of walking, for example, late blind and congenitally blind people walked
much slower, took shorter strides, and spent more time in the stance phase of gait than those
sighted. Besides, the gait of visually impaired people shows an effort to adjust to diverse
environmental situations to maintain a more stable posture and to achieve safe walking. Contrary
to the previous study, Bennett et al. (2022); Mason et al. (2005) reported zero changes in variability
among sighted and visual impairment persons, especially in walking. The results indicate no
significant distinction in lower extremity coordination patterns for both groups when walking at
matched speeds and no significant differences in both groups in the length or frequency of steps.
This is because a visually impaired person tends to have short, low strides, low range of motion,
and environmental factors during walking (Bennett et al., 2022; Mason et al., 2005).
In light of this, researchers have become aware of the differences in walking gaits among
sighted and visually impaired people and started to divert interest in running kinematics, mainly
on the overground. The findings by Ferro et al. (2002) show visually impaired runners present a
stride rate better than the other groups, but stride length is lessened when the increment of velocity
happens. In addition, lower limb kinematics such as ankle, knee, and hip also reported significant
differences. Meanwhile, the knee flexion angle, ankle dorsi/plantar flexion angle, and sagittal
plane hip rotation were substantially different for the sighted group (Estep et al., 2018; Sinclair et
al., 2013).
A total of seven articles (refer table 1 and table 2) were analyzed about the differences in
kinematics in walking and running for sighted and visually impaired runners. Much evidence from
previous literature covered walking kinematics and narrowly covered research on running on a
treadmill. Thus, this literature review aims to determine the differences in running kinematics on
the treadmill between sighted and visually impaired runners.
Table 1: Difference in sighted and visually impaired persons on walking.
Author/title
1. Bennett et al. (2019)
Walking biomechanics
and energetics of
individuals with a visual
impairment: a
preliminary report
2. Bennett et al. (2022)
Lower extremity
coordination during
walking in persons who
are blind and sighted
controls: A preliminary
report.
Sample
N: 3 (VI, 2 female and
on 1 male) and N: 20
sighted with 7 males
and 13 females.
N: 5 (VI) and N: 5
(sighted) with the same
age, sex and body mass
index matched.
Objectives
Examine the kinematics,
kinetics, and mechanical
work involved in the
two types of walking
that people with a VI
typically use—
independent walking
and assisted walking—
and compare the gait
biomechanics of
participants with VIs
with sighted controls.
This study aimed to
compare the lower
extremity coordination
patterns of blind
participants with those
of sighted controls who
Interventions
Independent and guided
walking at self-selected
speeds were performed
using three-dimensional
motion capture and
force platforms. Then,
compared joint angles,
moments, external
work, and recovery.
Main findings
Compared to guided
walking and sighted
controls, the VI group's
independent walking
was slower and had
shorter strides.
When compared to
guided walking and
controls, the VI group's
independent walking
reduced hip range of
motion and peak joint
moments.
In the VI group,
individual walking
produced 14%, 32%,
and 16% more work
than guided walking.
Guided walking
improved recovery by
11% compared to
unassisted walking.
The blind person will go No significant
through level walking
differences in lower
independently (cane)
extremity coordination
and human guide
patterns were recorded
meanwhile sighted
for both groups when
participants will walk at walking at matched
speeds.
were age, sex, and body
mass index matched.
matched speeds for both
conditions.
Angle-angle plots
- inter-limb: left or right
thigh)
- intra-limb: ankle-hip,
ankle-knee, and anklehip
3. Mason et al. (2005)
Variability in the length
and frequency of steps
of sighted and visually
impaired walkers.
N: 18 (6 typical vision,
Snellen acuity 20/30 or
better, N:12 VI, younger
group, and older group)
with mean age, 27.3
years, and 56.6 years.
Experiment 1: The
differences between
participant groups in
step length and
frequency.
Experiment 2: The
initial stage was to
Experiment 1: 8 trials
on each three paces
(slow, preferred, and
fast). Then do the 8
trials again wearing a
computer-readable
pedometer.
The blind group shows
↓ in stride length and
joints ROM compared
to the sighted.
Compared to walking
with a seeing human
guide, blind people took
shorter steps and had a
smaller range of motion
while
walking
independently.
Although the visual
feedback system does
give us important data
regarding the
surroundings we walk
in, central pattern
generators' control over
lower extremity
coordination patterns
still seems reliable
without visual feedback.
Experiment 1: There
are no significant
differences in either
group in the length or
frequency of steps.
Nevertheless,
comparing the mean,
male participants and
4 used dog guides, 4
used canes, and 4 no
mobility devices.
ascertain each
participant's mean step
length's reproducibility,
particularly at the
desired pace, which is
the pace at which a
pedometer would be
calibrated. The second
was to assess the
precision of two
approaches to
measuring the distance
travelled.
Experiment 2: 2 months
later with 4 participants
from the previous
experiment. They still
need to do the three
paces but on different
walkways (20,40 and 80
feet long).
longer step lengths at
fast pace (M = 2.86
feet) than females (M =
2.44 feet, t [16] = 3.402,
p < .005).
By averaging 18
subjects, we discovered
that there was little
variation in the number
and length of steps.
The preferred pace had
the lowest step length
variability (M = 1.94%,
SE = 0.13%), while the
slow pace had the
lowest step frequency
variability (M = 1.96%,
SE = 0.17%).
Experiment 2: The
percentage of variability
over distance did not
alter consistently.
The percentage change
was relatively high at a
slow pace (step length:
8.5%, frequency:
23.3%). The percentage
changes were smaller at
the preferred and fast
paces: preferred pace
(5.4% for length and
5.2% for frequency) and
fast pace (5.5% for
length and 6.7% for
frequency).
4. Nakamura (1997)
Quantitative analysis of
gait in the visually
impaired
Male, N: 15 late blind,
N:15 congenitally blind
and N:15 sighted
persons. Age ranges
from 36 to 54 years old,
39 to 48 years old and
40 to 50 years old,
respectively.
examine the differences
between sighted and
visually impaired
people's gaits using a
motion analysis system.
Each participant needs
to walk a 10-m walkway
at their own preferred
pace.
Late blind and
congenitally blind
people walked much
slower, took shorter
strides, and spent more
time in the stance phase
of gait than those who
were sighted.
In the late-onset and
congenitally blind
groups, the correlations
between gait parameters
were preserved, much
like in the sighted
group.
With the active use of
non-visual sensory
input, the gait of
visually impaired people
shows an effort to adjust
to diverse
environmental situations
to maintain a more
stable posture and to
achieve safe walking.
VI: visual impaired; ROM: range of motion; M: mean; SE: standard errors
Table 2: Different patterns of running kinematics on a treadmill.
1. Estep et al. (2018)
Differences in the
pattern of variability for
lower extremity
kinematics between
walking and running
2. Sinclair et al. (2013)
3-D kinematic
comparison of treadmill
and overground running
N: 17 (5 females and 12
males) within the age of
20 and 58 years old.
(Age: 38 ± 11.6 years,
height: 176.7 ± 9.3 cm
and mass:
82.5 ± 23.7 kg)
N: 12 (1 female and 11
males), with age, height,
and body mass mean of
22.5 ^ 4.2 years, 1.71 ^
To evaluate the
distribution of kinematic
variability for a group of
people utilizing a
battery of common
variability measures
(such as SD and CV)
and nonlinear signal
regularity measures
To determine how
similar the 3D
kinematics from the
stance phase of
In the walking task,
participants were told to
walk for around 5
minutes at a selfselected, comfortable
pace between 1.12 m/s
and 1.56 m/s. After five
minutes, walking
kinematic data was
gathered. After then,
participants were told to
run for about five
minutes at a
comfortable speed they
chose for themselves,
between 2.24 and 2.91
m/s. Running kinematic
data was gathered at the
conclusion of the five
minutes.
Participants need to run
on a treadmill which
minimally covered
25km 3 times per week.
SD for knee flexion
angle and ankle
dorsi/plantar flexion
angle were substantially
different between
treatments (F1,32 =
6.563, p =0.015 and
23.453, p > 0.001,
respectively).
There were no
appreciable variations in
the levels of variability
between walking and
running for any other
variables (p > 0.05).
There were significant
differences in sagittal
plane hip rotation
between overground and
treadmill running.
3. Ferro et al. (2002)
Kinematic and Kinetic
Study of Running
Technique at Different
High Speeds in Blind
Paralympics Athlete
0.06 m, and 75.4 ^ 8.4
kg, respectively
overground and
treadmill running are.
N: 5 paralympic
sprinters (B1) and 4
national sprinters (C)
The current study's goal
is to examine the
running form of
category B1 blind
runners to advance our
understanding of these
forms and raise the
athletes' performance in
collaboration with
coaches.
Both groups need to run
for two full strides at
four different speeds
(40, 60, 80, and 100%
of maximum velocity)
were examined.
Treadmill running was
found to be associated
with significantly
greater peak ankle
eversion.
The kinematic
examination of running
at increasing velocities
revealed the association
between biomechanical
factors and velocity as
well as significant
variations between B1
and C athletes.
The stride length
reduced during a sprint,
stride rate was higher in
B1 (p=0.006) and
increased with
increasing velocity
(p0.001).
With increases in
velocity in both groups,
there were noticeable
differences in the knee,
thigh, and ankle angles.
SD: standard deviation; CV: coefficient of variation
2.2 Summary of Literature Review (gap in knowledge)
Walking among the visually impaired (VI) has been widely discussed by researchers,
particularly in assisted walking, walking gaits, joint angles, and more (Bennett et al., 2019; Bennett
et al., 2022; Mason et al., 2005; Nakamura, 1997). Nonetheless, the extent of research has not
caught up with the running kinematics of visually impaired runners on a treadmill. Running on a
treadmill is the safest option for visually impaired runners because as Nakamura (1997) stated
some visually impaired persons are willing to do indoor running instead of outdoors because they
mentioned getting disclosed to insecure paths and obstacles. Meanwhile, according to L. E. Ball
et al. (2022), visually impaired runners reported difficulty searching for guided runners who own
the same time of day, pace, and goals. To our knowledge, this is the first study that emerged on
the running kinematics between sighted and visually impaired runners on a treadmill. Therefore,
the purpose of this study is to see the difference in running kinematics among the sighted and
visually impaired runners on a treadmill. Obtaining this information can assist in training programs
for those with visual impairments and offer insightful information about the biomechanics of
running stride for future use.
CHAPTER 3: METHODS
3.1 Research Design
This study aims to compare between the sighted and the visually impaired person related
to their running kinematics on the treadmill. Thus, this study will use the research design of crosssectional design. This design would involve comparing the variability and running patterns
between two groups of participants: one group consisting of sighted individuals and the other
group consisting of visually impaired individuals. The independent variable would be the visual
ability of the participants, while the dependent variable would be the variability and running
patterns. The study could be conducted in a laboratory setting, with participants running on a
treadmill while their running patterns are monitored and recorded using motion capture
technology. Statistical analysis would be used to compare the variability and running patterns
between the two groups of participants.
3.2 Participants
A total of fifteen visually impaired male runners will be recruited. The characteristic of
participants must be active and has experienced participating in physical activity or sports and be
free from any injury. For the visually impaired person, the level of visual impairment is selected
among B1 and B2 categories only. The difference between these categories is B1; those have the
most severe level of visual impairment, classified as totally or almost totally blind, able to
recognize the shape of a hand or distinguish between light and dark but have no functional vision
or very limited vision while B2; have a higher level of visual acuity than those in B1, but still have
a severe level of visual impairment, able to recognize some shapes and forms and have a limited
ability to see objects at close range (International Blind Sports Federation, 2008).
Another fifteen sighted male runners will be recruited, and all participants must be free
from any injury during the data collection phase. They will need to complete a PAR-Q (Physical
Activity Readiness Questionnaire) survey before participating in this study (Appendix). Regarding
the willingness to participate in this study, the sighted people will fill out the consent form while
the consent of the impaired person we will get from them in writing accompanied and guided by
their guidance. Safety precautions are taken seriously which research assistant will assist the
visually impaired person.
3.3 Materials/Measured Variables
Three timing gates (SWIFT Speedlight) will be used to determine the subject’s maximum speed.
A treadmill will be used to measure the running kinematics among the participants. To collect the
3D kinematics during testing, a 9-Camera 3D Motion Capture System (200 Hz) will be used to
capture all the movement. The motions that will be measured in this study are joint angles (hip
angle, knee angle, ankle angle), the stride length and stride rate. Spherical retro-reflective markers
were placed at joints for tracking movement in the systems. All these variables will be analyzed in
three different phases such as foot-contact phase, mid-stance phase and toe-off phase.
3.4 Protocols/Procedure
Firstly, all 30 participants are required to sprint on the track for 30 meters at their maximum
speed which will be measured using the timing gate. Three timing gates were set along the track,
the first timing gate acts as a starter to the running time and the other timing gate is the end of the
run time. Participants will start running 10 meters before the first timing gate to ensure all
participant can reach their top speed before reaching and crossing the first timing gate. During the
VI runner’s warm-up and sprint, a running guide was provided to assist them. Ten minutes of
warm-up time for VI runners included adapting them to the new guide runner. Three sprint trails
were given for familiarization to let all the participants recognize the beep sound from the timing
gate and the 30 meters length of the track. All participants are required to do three sprint trials with
a three-minutes interval of rest between each sprint trial.
Next, all of them will be running on the treadmill individually for one session only. The data
collection will be run in the motion capture lab with the treadmill set to 40% and 60% of their
maximum velocity. To record the treadmill running, the motion capture system of Qualisys will
be used. In measuring hip angle, knee angle and ankle angle, spherical retro-reflective markers
were placed at the specific joints of the participants as illustrated in Figure 1 with maker placement
details attached in Table 1.
Figure 1: Marker placement of Running Performance provided by Qualisys Track Manager. The acronym
is specified in the table below.
Table 1: Marker placement for Running Performance by Qualisys Track Manager
Name
L_HEAD, R_HEAD
SGL
SME
TV2
TV12
SACR
L_SAE, R_SAE
L_HLE, R_HLE
L_HME, R_HME
L_RSP, R_RSP
L_USP, R_USP
L_HM2, R_HM2
L_IAS, R_IAS
L_PAS, R_PAS
L_FLE, R_FLE
Location
Above the ear
Forehead
Sternum
Spine, 2nd Thoracic Vertebra
Spine, 12th Thoracic Vertebra
Sacrum
Shoulder
Elbow (lateral/outside)
Elbow (medial/inside)
Radial wrist (thumb side)
Ulna wrist (pinkie side)
Hand (basis of Forefinger)
Pelvic (Illiac crest)
Patella (above the knee)
Lateral knee
L_TTC, R_TTC
L_FAL, R_FAL
L_FCC, R_FCC
L_FM2, R_FM2
L_FM5, R_FM5
Shin
Ankle
Heel
2nd Toe
5th Toe
After placing all the markers, participants start running on the treadmill at a slow speed of
6km/h for familiarization. Before the running trial, a standing anatomical 3D static calibration of
the runner was taken. All participants will get a reminder about their running speed (40% and 60%
of their maximum track speed) and the changes in running speed stages would be continuous
without stopping them from running. The running speed will be assisted by the research assistant
with verbal instruction and feedback on the speed particularly for the visually impaired participants
to ensure their focus on running only. To ensure the data was accurate, all participants are required
to maintain their speed for one minute to capture the data. The variables that will be investigated
are joint angles (hip angle, knee angle, ankle angle), the stride length and stride rate of the
participants while running on a treadmill.
3.5 Statical Analysis
All variables will be measured and compared between the two groups. A normality test
will be conducted with (p>0.05) based on the Shapiro-Wilk and Kolmogorov Smirnov. Then, a Ttest will be used to analyze the data for two different groups using the SPSS software (29.0, IBM
SPSS, Chicago, IL). As to analyze the correlation between the variables, the Person’s coefficient
is set to -1<r<+1. The significant difference is accepted when the value is P<0.05.
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Appendix
Appendix A: The Physical Activity Readiness Questionnaire (PAR-Q)