To prospectively investigate gait-related risk factors associated with downslope walking concerning sport-related lower limb injuries.

The inclusion criteria comprised healthy college students, and the exclusion criteria were lower limb trauma or ligament injury in the last year, history of surgery, neuromuscular disorders, and conditions impairing athletic performance or quality of life. Demographics and anthropometric data of participants were collected, and a three-dimensional gait analysis system was employed to obtainsix degreeoffreedom (6 DOF) kinematic parameters of the knee during down-slope walking on a treadmill. Over 18 months, lower limb injuries were documented. Independent samples t tests and Wilcoxon Mann-Whitney tests were used to compare variable differences. Binary analysis identified risk factors, with variables showing P<0.05 included in multivariate logistic regression analysis.

A total of 518 subjects were recruited, of whom 399 were ultimately included, including 190 males and 209 females, average age were (20.3±3.7) years, resulting in a follow-up rate of 80.7%. A total of 36 injuries (9.0%) were reported. Multivariate logistic regression analysis indicated that subjects who sustained injuries exhibited significantly greater anterior tibia translation (ATT) during the loading response [odds ratio (OR) =2.563, 95% confidence interval (CI) (1.439, 4.565)]while walking down-slope. The uninjured subjects exhibited a greater maximum knee flexion angle (KFA) during down-slope walking[OR=0.969, 95%CI (0.953, 1.014)].

Greater ATT may serve as a gait-related risk factor for lower limb injuries, whereas greater KFA may act as a protective factor. Other gait-related factors assessed under downs-lope conditions, especially muscle mass, gender, and BMI, do not demonstrate significant etiological relevance among college students.