The Effect of Wearable-Based Real-Time Feedback on Running Injuries and Running Performance: A Randomized Controlled Trial.

Researchers gave 220 recreational runners pressure-sensitive insoles that could detect how they were loading their feet and legs while running. Half the runners got real-time feedback through these insoles about their running technique and speed, aimed at reducing stress on overloaded joints. The other half wore the same insoles but without any feedback.

When the team looked at injury rates using intention-to-treat analysis (the standard scientific approach), they found no meaningful difference between the groups. However, when they looked only at runners who actually used the insoles correctly and received the feedback as intended, those runners had about half the injury rate of the control group, and their injuries tended to be less severe. The feedback did not appear to make runners faster or more motivated to exercise.

Researchers tested whether special shoe insoles that give runners real-time feedback about their running technique could help prevent injuries. The insoles were designed to alert runners when they were putting too much stress on certain parts of their legs or feet.

In the group that received this feedback and used it properly, runners did have fewer injuries and the injuries they did get were milder compared to runners who wore the same insoles but got no feedback. That said, the feedback did not make runners faster or help them enjoy running more.

About six out of ten runners who completed the study said they would want to keep using the insoles after the research ended. The findings suggest the technology may have some benefit, though there is still uncertainty about how well it would work in real life outside a research study.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This RCT examined whether real-time spatiotemporal feedback from instrumented insoles could reduce injury incidence in recreational runners. The intention-to-treat analysis yielded a null primary outcome, but a significant protocol violation occurred: about a third of participants used incorrect wearable settings, diluting any intervention effect.

The as-treated analysis showed a meaningful reduction in injury rate (HR 0.53) and lower first-time injury severity among those who received feedback correctly. The per-protocol analysis showed a trend favoring the intervention but did not reach statistical significance.

Running performance and exercise motivation were unaffected across all analyses. The study highlights both the potential value of real-time biomechanical feedback and the practical implementation challenges that can obscure true treatment effects in wearable-based interventions.