{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:57:53Z","timestamp":1788245873520,"version":"build-2803163510"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Loaded foot marches (LFM) impose significant physical demands, altering gait and increasing the risk of musculoskeletal injuries in warfighters. Instrumented insoles offer a promising solution for rapidly screening and monitoring LFM gait changes in the field. The purpose of this study was to use instrumented insoles to examine acute and gait adaptation responses to a LFM and to assess the influence of physical fitness on gait responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Fourteen participants (m\u2009=\u20099, age\u2009=\u200931.2\u2009\u00b1\u20097.3\u2009years) with LFM experience completed the study. Physical fitness (PF) measures, including body composition, aerobic fitness, strength, and lower body power, were collected during a familiarization session. Instrumented insoles with inertial measurement units were worn during a 5-min unloaded walk followed by a 2-h LFM (20\u2009kg ruck) at 1.34\u2009m\/s on a treadmill. Gait measures collected included cadence, ground contact time (GCT), double support time (DST), swing time variability, and asymmetry measures. Changes in gait measures were analyzed using paired t-tests and repeated measures ANOVAs. Bivariate correlations between PF and changes in gait measures were computed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cadence (P\u2009=\u2009.048, d\u2009=\u20090.58), GCT (P\u2009&amp;lt;\u2009.001, d\u2009=\u20091.3), and DST (P\u2009&amp;lt;\u2009.001, d\u2009=\u20093.2) increased for the unloaded compared to LFM. Gait changes from unloaded to LFM showed cadence was correlated with absolute VO2max (r\u2009=\u20090.63, P\u2009=\u2009.022) and body mass (r\u2009=\u20090.56, P\u2009=\u2009.046); while GCT was correlated with absolute VO2max (r\u2009=\u2009\u22120.58, P\u2009=\u2009.038), body mass (r\u2009=\u2009\u22120.66, P\u2009=\u2009.015), and fat-free mass (r\u2009=\u2009\u22120.57, P\u2009=\u2009.040). During the 2-h LFM, cadence significantly decreased (P\u2009&amp;lt;\u2009.001, \u03b7p2\u2009=\u20090.608), while GCT (P\u2009&amp;lt;\u2009.001, \u03b7p2\u2009=\u20090.709) and DST (P\u2009=\u2009.003, \u03b7p2\u2009=\u20090.415) increased during the first hour, with no further changes observed in the second hour. Gait changes during the 2-h LFM were significantly associated with several PF measures, including body composition, lower-body strength, and power.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest participants exhibited consistent direction but variable magnitudes of gait changes during LFM, and changes were correlated with individual physical fitness and body composition. Instrumented insoles show potential for real-time screening and monitoring during LFMs, offering valuable insights into individual-level gait responses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf111","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T18:34:49Z","timestamp":1742409289000},"page":"125-133","source":"Crossref","is-referenced-by-count":1,"title":["Examining Gait Adaptations in Loaded Foot Marches Using Instrumented Insoles"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8579-0480","authenticated-orcid":false,"given":"Joel","family":"Martin","sequence":"first","affiliation":[{"name":"Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University , VA 20110,","place":["United States"]},{"name":"Center for the Advancement of Well-Being, George Mason University , Fairfax, VA 22030,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan Sax","family":"van der Weyden","sequence":"additional","affiliation":[{"name":"Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University , VA 20110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcie","family":"Fyock-Martin","sequence":"additional","affiliation":[{"name":"Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University , VA 20110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Barringer","sequence":"additional","affiliation":[{"name":"Lionel University , Carpinteria, CA 93013,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayleigh","family":"Newman","sequence":"additional","affiliation":[{"name":"Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University , VA 20110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Fridman","sequence":"additional","affiliation":[{"name":"Plantiga , Vancouver, BC V6A 3B1,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Caswell","sequence":"additional","affiliation":[{"name":"Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University , VA 20110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"issue":"5","key":"2026050205462307400_R1","first-page":"2","article-title":"Absolute and relative morbidity burdens attributable to various illnesses and injuries, active component, U.S. Armed Forces, 2018","volume":"26","year":"2019","journal-title":"MSMR"},{"issue":"3\u20134","key":"2026050205462307400_R2","doi-asserted-by":"publisher","first-page":"e480","DOI":"10.1093\/milmed\/usz328","article-title":"Epidemiology and financial burden of musculoskeletal injuries as the leading health problem in the military","volume":"185","author":"Dijksma","year":"2020","journal-title":"Mil Med"},{"issue":"1","key":"2026050205462307400_R3","article-title":"Risk factors for musculoskeletal injuries in the military: a qualitative systematic review of the literature from the past two decades and a new prioritizing injury model","volume":"8","author":"Sammito","year":"2021","journal-title":"Mil Med Res"},{"issue":"1","key":"2026050205462307400_R4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.7205\/MILMED.169.1.45","article-title":"Soldier load carriage: historical, physiological, biomechanical, and medical aspects","volume":"169","author":"Knapik","year":"2004","journal-title":"Mil Med"},{"issue":"2","key":"2026050205462307400_R5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1080\/17457300.2015.1132731","article-title":"Self-reported load carriage injuries of military soldiers","volume":"24","author":"Orr","year":"2017","journal-title":"Int J Inj Contr Saf Promot"},{"issue":"5","key":"2026050205462307400_R6","doi-asserted-by":"publisher","first-page":"500","DOI":"10.7205\/MILMED-D-12-00507","article-title":"Activities associated with injuries in initial entry training","volume":"178","author":"Knapik","year":"2013","journal-title":"Mil Med"},{"issue":"Suppl 4","key":"2026050205462307400_R7","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.1016\/j.jsams.2017.07.027","article-title":"Risk factors for injury associated with low, moderate, and high mileage road marching in a U.S. Army infantry brigade","volume":"20","author":"Schuh-Renner","year":"2017","journal-title":"J Sci Med Sport"},{"issue":"8","key":"2026050205462307400_R8","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18084010","article-title":"Soldier load carriage, injuries, rehabilitation and physical conditioning: an international approach","volume":"18","author":"Orr","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"6","key":"2026050205462307400_R9","first-page":"614","article-title":"The effect of backpack carriage on the biomechanics of walking: a systematic review and preliminary meta-analysis","volume":"32","author":"Liew","year":"2016","journal-title":"J Appl Biomech"},{"key":"2026050205462307400_R10","doi-asserted-by":"publisher","DOI":"10.1016\/j.apergo.2022.103893","article-title":"Effects of load carriage on measures of postural sway in healthy, young adults: a systematic review and meta-analysis","volume":"106","author":"Martin","year":"2023","journal-title":"Appl Ergon"},{"key":"2026050205462307400_R11","doi-asserted-by":"crossref","DOI":"10.1016\/j.apergo.2021.103376","article-title":"Military load carriage effects on the gait of military personnel: a systematic review","volume":"93","author":"Walsh","year":"2021","journal-title":"Appl Ergon"},{"issue":"1\u20132","key":"2026050205462307400_R12","doi-asserted-by":"publisher","first-page":"e83","DOI":"10.1093\/milmed\/usy218","article-title":"The physiology and biomechanics of load carriage performance","volume":"184","author":"Boffey","year":"2019","journal-title":"Mil Med"},{"issue":"1480","key":"2026050205462307400_R13","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1098\/rspb.2001.1761","article-title":"Mechanical and metabolic determinants of the preferred step width in human walking","volume":"268","author":"Donelan","year":"2001","journal-title":"Proc Biol Sci"},{"issue":"7","key":"2026050205462307400_R14","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1080\/00140139.2013.791377","article-title":"Impact of ballistic body armour and load carriage on walking patterns and perceived comfort","volume":"56","author":"Park","year":"2013","journal-title":"Ergonomics"},{"issue":"6","key":"2026050205462307400_R15","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1080\/00140131003672015","article-title":"Effects of military load carriage on kinematics of gait","volume":"53","author":"Majumdar","year":"2010","journal-title":"Ergonomics"},{"issue":"2","key":"2026050205462307400_R16","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1080\/00140139.2019.1690710","article-title":"Effect of a load distribution system on mobility and performance during simulated and field hiking while under load","volume":"63","author":"Sessoms","year":"2020","journal-title":"Ergonomics"},{"issue":"1","key":"2026050205462307400_R17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.apergo.2004.09.004","article-title":"Biomechanical and physiological comparison of conventional webbing and the M83 assault vest","volume":"36","author":"Coombes","year":"2005","journal-title":"Appl Ergon"},{"issue":"4","key":"2026050205462307400_R18","first-page":"45","article-title":"Influence of footwear and equipment on stride length and range of motion of ankle, knee and hip joint","volume":"16","author":"Schulze","year":"2014","journal-title":"Acta Bioeng Biomech"},{"issue":"1","key":"2026050205462307400_R19","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-22881-y","article-title":"Task demand and load carriage experience affect gait variability among military cadets","volume":"12","author":"Ulman","year":"2022","journal-title":"Sci Rep"},{"issue":"7","key":"2026050205462307400_R20","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1016\/j.jbiomech.2011.02.016","article-title":"Effects of load carriage and fatigue on gait characteristics","volume":"44","author":"Qu","year":"2011","journal-title":"J Biomech"},{"issue":"14","key":"2026050205462307400_R21","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1080\/00140130600757237","article-title":"Influence of carrying heavy loads on soldiers\u2019 posture, movements and gait","volume":"49","author":"Attwells","year":"2006","journal-title":"Ergonomics"},{"issue":"1\u20132","key":"2026050205462307400_R22","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1093\/milmed\/usad086","article-title":"Effect of fatigue on movement patterns during a loaded Ruck March","volume":"189","author":"Bloch","year":"2024","journal-title":"Mil Med"},{"issue":"6 (Suppl. 2)","key":"2026050205462307400_R23","doi-asserted-by":"publisher","first-page":"S131","DOI":"10.1139\/apnm-2015-0486","article-title":"Load carriage, human performance, and employment standards","volume":"41","author":"Taylor","year":"2016","journal-title":"Appl Physiol Nutr Metab"},{"issue":"5","key":"2026050205462307400_R24","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1093\/occmed\/kqi087","article-title":"Influences of body composition upon the relative metabolic and cardiovascular demands of load-carriage","volume":"55","author":"Lyons","year":"2005","journal-title":"Occup Med"},{"issue":"6","key":"2026050205462307400_R25","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s00421-007-0654-x","article-title":"Allometric scaling of strength measurements to body size","volume":"102","author":"Folland","year":"2008","journal-title":"Eur J Appl Physiol"},{"issue":"6","key":"2026050205462307400_R26","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.70252\/OVVG8388","article-title":"The relationship between lower-body strength and power, and load carriage tasks: a critical review","volume":"12","author":"Orr","year":"2019","journal-title":"Int J Exerc Sci"},{"issue":"2","key":"2026050205462307400_R27","doi-asserted-by":"publisher","DOI":"10.3390\/s23020609","article-title":"Effects of load carriage on postural control and spatiotemporal gait parameters during level and uphill walking","volume":"23","author":"Mexi","year":"2023","journal-title":"Sensors"},{"key":"2026050205462307400_R28","doi-asserted-by":"crossref","DOI":"10.1016\/j.apergo.2023.103991","article-title":"Use of accelerometers and inertial measurement units to quantify movement of tactical athletes: A systematic review","volume":"109","author":"Edwards","year":"2023","journal-title":"Appl Ergon"},{"issue":"4","key":"2026050205462307400_R29","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2022.802019","article-title":"Differences in peak impact accelerations among foot strike patterns in recreational runners","volume":"4","author":"Napier","year":"2022","journal-title":"Front Sports Act Living"},{"issue":"3","key":"2026050205462307400_R30","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1093\/ajcn\/75.3.453","article-title":"Body-composition assessment via air-displacement plethysmography in adults and children: a review","volume":"75","author":"Fields","year":"2002","journal-title":"Am J Clin Nutr"},{"issue":"4","key":"2026050205462307400_R31","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1097\/00005768-199904000-00013","article-title":"Cross-validation of three jump power equations","volume":"31","author":"Sayers","year":"1999","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"2026050205462307400_R32","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1519\/SSC.0000000000000433","article-title":"Standardization and Methodological Considerations for the Isometric Midthigh Pull","volume":"41","author":"Comfort","year":"2019","journal-title":"Strength Condit J"},{"issue":"1","key":"2026050205462307400_R33","doi-asserted-by":"crossref","DOI":"10.3390\/sports9010004","article-title":"Identifying reliable and relatable force\u2013time metrics in athletes\u2014considerations for the isometric mid-thigh pull and countermovement jump","volume":"9","author":"Merrigan","year":"2021","journal-title":"Sports"},{"issue":"2","key":"2026050205462307400_R34","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1093\/occmed\/kqu189","article-title":"Validation of the firefighter WFI treadmill protocol for predicting VO2 max","volume":"65","author":"Dolezal","year":"2015","journal-title":"Occup Med"},{"key":"2026050205462307400_R35","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2018.00257","article-title":"Indirect calorimetry: history, technology, and application","volume":"6","author":"Mtaweh","year":"2018","journal-title":"Front Pediatr"},{"issue":"3","key":"2026050205462307400_R36","doi-asserted-by":"publisher","first-page":"461","DOI":"10.2522\/ptj.20140253","article-title":"Role of body-worn movement monitor technology for balance and gait rehabilitation","volume":"95","author":"Horak","year":"2015","journal-title":"Phys Ther"},{"key":"2026050205462307400_R37","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1988"},{"key":"2026050205462307400_R38","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.646042","article-title":"Biomechanical response of the lower extremity to running-induced acute fatigue: a systematic review","volume":"12","author":"Apte","year":"2021","journal-title":"Front Physiol"},{"key":"2026050205462307400_R39","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2022.814172","article-title":"Concurrent evolution of biomechanical and physiological parameters with running-induced acute fatigue","volume":"13","author":"Prigent","year":"2022","journal-title":"Front Physiol"},{"issue":"4","key":"2026050205462307400_R40","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1080\/17457300.2013.833944","article-title":"Soldier occupational load carriage: a narrative review of associated injuries","volume":"21","author":"Orr","year":"2014","journal-title":"Int J Inj Contr Saf Promot"},{"issue":"4","key":"2026050205462307400_R41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0095797","article-title":"The influence of increased body fat or lean body mass on aerobic performance","volume":"9","author":"Maciejczyk","year":"2014","journal-title":"PLoS ONE"},{"issue":"4","key":"2026050205462307400_R42","article-title":"The relationship between physical characteristics and maximal strength in men practicing the back squat, the bench press and the deadlift","volume":"13","author":"Ferland","year":"2020","journal-title":"Int J Exerc Sci"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/Supplement_2\/125\/64287915\/usaf111.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/Supplement_2\/125\/64287915\/usaf111.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T09:46:29Z","timestamp":1777715189000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/Supplement_2\/125\/8256254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":42,"journal-issue":{"issue":"Supplement_2","published-online":{"date-parts":[[2025,9,16]]},"published-print":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf111","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,9]]},"published":{"date-parts":[[2025,9,1]]}}}