{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:37:36Z","timestamp":1785490656916,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T00:00:00Z","timestamp":1524182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Runner\u2019s dystonia (RD) is a task-specific focal dystonia of the lower limbs that occurs when running. In this retrospective case series, we present surface electromyography (EMG) and joint kinematic data from thirteen patients with RD who underwent instrumented gait analysis (IGA) at the Functional and Biomechanics Laboratory at the National Institutes of Health. Four cases of RD are described in greater detail to demonstrate the potential utility of EMG with kinematic studies to identify dystonic muscle groups in RD. In these cases, the methodology for muscle selection for botulinum toxin therapy and the therapeutic response is discussed. Lateral heel whip, a proposed novel presentation of lower-limb dystonia, is also described.<\/jats:p>","DOI":"10.3390\/toxins10040166","type":"journal-article","created":{"date-parts":[[2018,4,23]],"date-time":"2018-04-23T04:29:17Z","timestamp":1524457757000},"page":"166","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Electromyographic and Joint Kinematic Patterns in Runner\u2019s Dystonia"],"prefix":"10.3390","volume":"10","author":[{"given":"Omar F.","family":"Ahmad","sequence":"first","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pritha","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Neurology, George Washington University Medical Faculty Associates, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Stanley","sequence":"additional","affiliation":[{"name":"Functional and Applied Biomechanics Laboratory, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Karp","sequence":"additional","affiliation":[{"name":"Combined Neurosciences IRB, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hallett","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Codrin","family":"Lungu","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5405-2143","authenticated-orcid":false,"given":"Katharine","family":"Alter","sequence":"additional","affiliation":[{"name":"Functional and Applied Biomechanics Laboratory, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ramdhani, R.A., and Frucht, S.J. (2013). Adult-onset idiopathic focal lower extremity dystonia: A rare task-specific dystonia. Tremor Other Hyperkinet Mov. N. Y., 3.","DOI":"10.5334\/tohm.135"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jns.2006.09.003","article-title":"Runner\u2019s dystonia","volume":"251","author":"Wu","year":"2006","journal-title":"J. Neurol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/j.parkreldis.2013.07.013","article-title":"Focal task-specific lower extremity dystonia associated with intense repetitive exercise: A case series","volume":"19","author":"Katz","year":"2013","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1080\/00222895.1987.10735423","article-title":"Phase-dependent compensatory responses to perturbation applied during walking in humans","volume":"19","author":"Belanger","year":"1987","journal-title":"J. Mot. Behav."},{"key":"ref_5","first-page":"41","article-title":"Motor and sensory dysfunction in musician's dystonia","volume":"11","author":"Chang","year":"2013","journal-title":"Curr. Neuropharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1002\/jor.1100060503","article-title":"Emg profiles of knee joint musculature during walking: Changes induced by anterior cruciate ligament deficiency","volume":"6","author":"Limbird","year":"1988","journal-title":"J. Orthop. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00002060-200101000-00007","article-title":"Muscle power compensatory mechanisms in below-knee amputee gait","volume":"80","author":"Sadeghi","year":"2001","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.jvs.2015.09.045","article-title":"Altered joint kinematics and increased electromyographic muscle activity during walking in patients with intermittent claudication","volume":"63","author":"Gommans","year":"2016","journal-title":"J. Vasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1093\/brain\/121.7.1195","article-title":"The pathophysiology of primary dystonia","volume":"121","author":"Berardelli","year":"1998","journal-title":"Brain"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1196\/annals.1444.012","article-title":"Task-specific dystonias: A review","volume":"1142","author":"Perlmutter","year":"2008","journal-title":"Ann N. Y. Acad. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.parkreldis.2016.03.013","article-title":"Repetitive exercise dystonia: A difficult to treat hazard of runner and non-runner athletes","volume":"27","author":"Ahlskog","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.gaitpost.2017.08.003","article-title":"Siamoc position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an italian consensus conference","volume":"58","author":"Benedetti","year":"2017","journal-title":"Gait Posture"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1212\/WNL.38.7.1005","article-title":"Hand cramps: Clinical features and electromyographic patterns in a focal dystonia","volume":"38","author":"Cohen","year":"1988","journal-title":"Neurology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1093\/brain\/121.5.801","article-title":"Abnormal motor unit synchronization of antagonist muscles underlies pathological co-contraction in upper limb dystonia","volume":"121","author":"Farmer","year":"1998","journal-title":"Brain"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1136\/jnnp-2014-309040","article-title":"Using reaction time and co-contraction to differentiate acquired (secondary) from functional \u2018fixed\u2019 dystonia","volume":"86","author":"Macerollo","year":"2015","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1212\/01.WNL.0000162024.05514.03","article-title":"Abnormal co-contraction in yips-affected but not unaffected golfers: Evidence for focal dystonia","volume":"64","author":"Adler","year":"2005","journal-title":"Neurology"},{"key":"ref_17","first-page":"2410","article-title":"Compensatory gait mechanics in patients with unilateral knee arthritis","volume":"29","author":"McGibbon","year":"2002","journal-title":"J. Rheumatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"50","DOI":"10.3389\/fnhum.2017.00050","article-title":"Part 2: Adaptation of gait kinematics in unilateral cerebral palsy demonstrates preserved independent neural control of each limb","volume":"11","author":"Bulea","year":"2017","journal-title":"Front. Hum. Neurosci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2106\/00004623-198769030-00016","article-title":"Gait patterns in spastic hemiplegia in children and young adults","volume":"69","author":"Winters","year":"1987","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1468-1331.2005.01047.x","article-title":"Electromyographic evaluation of the sound and involved side during gait of spastic hemiplegic children with cerebral palsy","volume":"12","author":"Patikas","year":"2005","journal-title":"Eur. J. Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s11832-013-0508-5","article-title":"Biomechanics and muscle function during gait","volume":"7","author":"Brunner","year":"2013","journal-title":"J. Child Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.pmrj.2015.02.016","article-title":"Medial and lateral heel whips: Prevalence and characteristics in recreational runners","volume":"7","author":"Souza","year":"2015","journal-title":"PM&R"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1002\/mds.10597","article-title":"Paroxysmal exercise-induced dystonia as a presenting feature of young-onset parkinson's disease","volume":"18","author":"Bozi","year":"2003","journal-title":"Mov. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2280","DOI":"10.1212\/01.WNL.0000147298.05983.50","article-title":"Clinical evaluation of idiopathic paroxysmal kinesigenic dyskinesia: New diagnostic criteria","volume":"63","author":"Bruno","year":"2004","journal-title":"Neurology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S1474-4422(08)70117-0","article-title":"Phenotype, genotype, and worldwide genetic penetrance of lrrk2-associated parkinson's disease: A case-control study","volume":"7","author":"Healy","year":"2008","journal-title":"Lancet Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.1002\/ana.10630","article-title":"Autosomal dominant guanosine triphosphate cyclohydrolase i deficiency (segawa disease)","volume":"54","author":"Segawa","year":"2003","journal-title":"Ann. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2466","DOI":"10.1111\/j.1528-1167.2010.02726.x","article-title":"Mild adolescent\/adult onset epilepsy and paroxysmal exercise-induced dyskinesia due to glut1 deficiency","volume":"51","author":"Afawi","year":"2010","journal-title":"Epilepsia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.braindev.2009.02.008","article-title":"The expanding phenotype of glut1-deficiency syndrome","volume":"31","author":"Brockmann","year":"2009","journal-title":"Brain Dev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/1756285608095119","article-title":"Diagnosis and treatment of paroxysmal dyskinesias revisited","volume":"1","author":"Unterberger","year":"2008","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1007\/s00415-016-8373-z","article-title":"Focal task specific dystonia: A review and update","volume":"264","author":"Stahl","year":"2017","journal-title":"J. Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1136\/jnnp-2015-311298","article-title":"Task-specific dystonia: Pathophysiology and management","volume":"87","author":"Sadnicka","year":"2016","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.gaitpost.2010.11.013","article-title":"Comparison of elliptical training, stationary cycling, treadmill walking and overground walking. 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