Gauri Desai

All Publications

• Age and running experience influence shock attenuation during human running. Journal of science and medicine in sport Desai, G. A., Rosenberg, M., Gruber, A. H. 2025

  Abstract

  This study examined the associations of age and running experience with shock attenuation during running, as age and experience may influence passive (body composition) and active (gait) shock attenuation mechanisms.Cross-sectional study.Participants included healthy middle-aged-experienced runners (n = 20, age: 52.95 ± 5.83 years, >1 year of experience, 9-30 mi·week-1), young-experienced runners (n = 24, age: 22.37 ± 4.09 years, >1 year of experience, 9-30 mi·week-1), and young-novice runners (n = 14, age: 22.50 ± 3.52 years, <1 year of experience, 3-13 mi·week-1). Participants ran overground at 3.35 m·s-1 while triaxial accelerometers measured tibial and low-back impact shock. Frequency-domain axial and resultant shock attenuation was calculated using a transfer function within 3-8 Hz (FB1), 9-20 Hz (FB2), 21-35 Hz (FB3), and 36-50 Hz (FB4) bins. Linear regression tested associations of age among experienced runners and experience among young runners with each dependent variable (α > 0.05).Middle-aged-experienced runners attenuated less resultant shock within FB1 (p = 0.02, 95 % confidence interval: 1.27-18.71, β = 9.99) and axial shock within FB2 (p = 0.04, confidence interval: 0.40-37.37, β = 28.89) and FB3 (p = 0.005, confidence interval: 17.02-91.71, β = 54.37) than young-experienced runners. Young-novice attenuated less axial shock within FB3 than young-experienced runners (p = 0.02, confidence interval: 6.72-92.13, β = 49.43).Age and running experience independently influence shock attenuation, suggesting different shock attenuation responses between runner sub-populations.

  View details for DOI 10.1016/j.jsams.2025.10.010

  View details for PubMedID 41193283

• Impaired neuromusculoskeletal response to training stimuli associated with low energy availability: a systematic review. British journal of sports medicine DeJong Lempke, A. F., Smulligan, K. L., Desai, G. A., Hagan, K. E., Oldham, J. R., Islam, L. Z., Whitney, K. E. 2025

  Abstract

  Low energy availability (LEA) impairs musculoskeletal health, with emerging evidence of impaired neuromusculoskeletal adaptations to training. We aimed to synthesise the existing evidence examining neuromusculoskeletal responses to training stimuli among individuals with LEA.Systematic review (PROSPERO 603258).Six databases were searched on 4 November 2024 (total n=6399; duplicates n=2811; articles to screen n=3388). Search terms included the population and training-related exposures. Two blinded, independent reviewers screened articles using the Covidence web-based tool.Original articles written in English with any form of neuromusculoskeletal responses to training stimuli (premeasures and postmeasures) assessed among individuals aged ≥10 years with LEA were included. Study details, methodological quality (Physiotherapy Evidence Database, PEDro scale) and descriptive summaries with change percentages by time point and LEA status were extracted.21 studies met inclusion criteria (total participants: 536; 44% males, 56% females; PEDro: 5±2). Inconsistencies in LEA thresholds and criteria, exercise exposures and follow-up time frames precluded pooled analyses. All studies examined changes in lean muscle or fat-free mass (FFM), with seven also examining functional or activity-specific performance, and fewer concurrently examining strength, limb circumference, cellular-level or subjective neuromusculoskeletal measures. 10 studies identified that those with LEA had impaired lean mass/FFM responses (-1% to -5%), and 10 found no substantial changes over time (<1%). Six studies identified functional/sport-specific impairments over time among those with LEA (-4% to -10%). All remaining primary adaptations (strength, limb circumference, cellular-level and subjective measures) were impaired with LEA. These findings are clinically meaningful to consider, particularly for LEA-related impaired responses to rehabilitation targeting muscle hypertrophy and strength.Coaches, athletes and clinicians should be aware of the evidence suggesting LEA impairs neuromusculoskeletal training responses.

  View details for DOI 10.1136/bjsports-2025-110096

  View details for PubMedID 41087038

• Greater external negative mechanical work is accompanied by a greater metabolic cost of walking for socket-suspended versus bone-anchored prosthesis users with transfemoral limb loss. Clinical biomechanics (Bristol, Avon) Desai, G. A., Pope, J. R., Ezeajughi, C., Shim, J. K., Miller, R. H. 2025; 127: 106598

  Abstract

  BACKGROUND: Bone-anchored prostheses may address the high metabolic cost of walking in transfemoral (i.e., above-knee) amputees if they mitigate the mechanical energy dissipated due to socket use, reflecting a lower metabolic cost of walking than socket-suspended prosthesis users. Therefore, we compared external mechanical work between socket-suspended and bone-anchored transfemoral prosthesis users during walking and identified if these differences are accompanied by those in their metabolic costs of walking. We hypothesized that socket users would perform more net and negative external mechanical work in their prosthetic limb over the gait cycle and exhibit a higher metabolic cost of walking than bone-anchored prosthesis users.METHODS: High-functioning (Medicare K-level≥3, no dysvascular limb loss) transfemoral amputees with a socket-suspended or bone-anchored prosthesis were recruited (N=12 per group). Participants walked at 1.0m/s on a treadmill as pulmonary gases were measured for metabolic cost estimates and overground as ground reaction forces were measured to calculate net and negative external mechanical work across the gait cycle. Metabolic cost and prosthetic-limb external mechanical work outcomes were compared between groups using independent samples t-tests (alpha<0.05) corrected for multiple comparisons.FINDINGS: Net mechanical work done by the prosthetic limb was not significantly different between groups (p=0.93, g=0.64). However, socket users showed greater external negative mechanical work (p=0.005, g=1.17), which was accompanied by a 10.13% greater metabolic cost of walking than bone-anchored prosthesis users (p=0.03, g=0.54).INTERPRETATION: Bone-anchored prostheses may address the high metabolic costs of transfemoral amputee walking by mitigating socket-related energy loss.

  View details for DOI 10.1016/j.clinbiomech.2025.106598

  View details for PubMedID 40570752

• Inconsistent Effects of Experience on Running Biomechanics May be Influenced by Study Heterogeneity and Classification Criteria: a Systematic Review and Proposal of a Revised Taxonomy SPORTS MEDICINE-OPEN Rabello, R., Desai, G. A., Gruber, A. H. 2025; 11 (1): 69

  Abstract

  Less-experienced runners are proposed to sustain more running related injuries (RRIs) than more-experienced runners because of differences in their gait biomechanics. However, the effects of running experience on biomechanics remain inconclusive. The objective of this systematic review was to examine the evidence concerning the influence of experience on running biomechanics and summarize the criteria used to classify running experience. A classification procedure for running experience was proposed based on the results.Five common databases were searched for relevant articles following PRISMA guidelines (PROSPERO_ID CRD42022296734) and the PICO framework. Peer-reviewed research reporting a statistical effect of running experience on running gait biomechanics in adults (18-65 years) were included. Exclusion criteria were: subjects with current pathologies or symptomatic injuries; reporting running only barefoot, in minimalist shoes, during sprinting, or incline/decline running; classified experience only through performance-related measures; or did not specify running experience group definition. Risk of bias was assessed with the Downs and Black checklist. Extracted data were organized in tables and synthesized descriptively due to study heterogeneity.Twenty-eight studies with 916 total subjects were included. Although most studies found significance in their comparisons, no studies comparing similar gait variables found the same statistical result. Some variables compared between experience levels were examined in only one study. Experience classification criteria were inconsistent between studies; cut-offs for more-experienced ranged between 2 and 10 years and/or 15-50 km/week and cut-offs for less-experienced ranged between 0.5 and 3 years and/or 0-20 km/week. Meta-analysis was not possible due to heterogeneity among the included studies.Effects of experience on running mechanics were inconsistent in the current literature. The lack of consistent findings may be due to the heterogeneous criteria used to classify runners into experience groups and the inconsistency of the variables investigated. Replication studies, heterogeneous study design, and longitudinal studies are needed to determine if or how running biomechanics change as runners gain experience. Heterogeneous study designs must begin with standard experience classification criteria for the effect of experience on running biomechanics to be identified. We propose an updated taxonomy to classify runners into groups considering three facets: exposure, performance, and intention.PROSPERO ID CRD42022296734. Registered 28 September 2022-Retrospectively registered, https://www.chictr.org.cn/bin/project/edit?pid=149714 .

  View details for DOI 10.1186/s40798-025-00870-5

  View details for Web of Science ID 001504522700004

  View details for PubMedID 40483619

  View details for PubMedCentralID PMC12146231

• Running stiffness and spatiotemporal parameters are similar between non-runners and runners with different experience levels. Sports biomechanics Rabello, R., Desai, G. A., Sforza, C., Gruber, A. H. 2025: 1-15

  Abstract

  Spatiotemporal parameters and leg and joint stiffness are variables that represent the fundamental dynamics of running. Therefore, these variables may effectively differentiate between less-experienced and more-experienced runners' gait, possibly addressing differing injury rates between populations. We compared stiffness and spatiotemporal parameters between runners with different experience levels, including a group with no previous running experience. Healthy physically active participants (22.1 ± 3.6y) were divided into three groups, according to experience: experienced (running >1-year, 14-48 km/week; n = 23, 9F), novice (running <1-year, 5-21 km/week; n = 15, 4F) and non-runners (no running for the past 5 years; n = 17, 7F). Three-dimensional motion capture and force plates measured gait mechanics during overground running at 3.35 m·s-1. Knee, ankle and three-dimensional leg stiffness, contact time, flight time and step length were compared between groups using independent-measures ANCOVA (covariate = sex). No biomechanical variable was significantly different between the groups (leg: p = 0.652, Hedges' g = 0.09-0.17; ankle: p = 0.439, g = 0.07-0.19; knee: p = 0.153, g = 0.13-0.29; contact time: p = 0.592, g = 0.06-0.24; flight time: p = 0.513, g = 0.03-0.40; step length: p = 0.107, g = 0.26-0.61). Stiffness and spatiotemporal parameters were not different between runners with greater than 1-year of experience when compared to runners with less than 1-year experience and non-runners. Therefore, running gait may not differentially affect injury rates between experience levels.

  View details for DOI 10.1080/14763141.2025.2480094

  View details for PubMedID 40126086

• Joint Biomechanics In Transfemoral Amputees With A Socket-based Versus Osseointegrated Prosthesis: A Pilot Study Desai, G. A., Pope, J. R., Shim, J. K., Miller, R. H. LIPPINCOTT WILLIAMS & WILKINS. 2024: 573-574

  View details for Web of Science ID 001315123202398

• Gender Differences In Cumulative Knee Loading During Walking And Running Snyder, S. J., Fakhar, M., Desai, G. A., Shim, J., Miller, R. H. LIPPINCOTT WILLIAMS & WILKINS. 2024: 245

  View details for Web of Science ID 001315123201118

• Sex differences in body composition and shock attenuation during running. Journal of biomechanics Desai, G. A., DeJong Lempke, A. F., Harezlak, J., Gruber, A. H. 2024; 173: 112245

  Abstract

  Running-related impact shock is absorbed via biological tissue deformation. Given known sex differences in body composition, shock attenuation may also differ between sexes thereby influencing sex-specific running-related injury risk. This study examined sex differences in body composition and shock attenuation during running. Seventeen female (mean ± 1SD age: 34.7 ± 16.1) and twenty-one male runners (age: 29.0 ± 13.8) ran overground as inertial measurement units with triaxial accelerometers measured impact shock at the distal tibia and low-back. Frequency-domain axial and resultant shock attenuation were calculated between the low-back relative to the tibia using a transfer function of the power spectral density within 9-20, 21-35, and 36-50 Hz. Bone mineral density and content, fat and lean mass were measured in the lower extremity and pelvis/gynoid regions using dual x-ray absorptiometry. The association between sex and shock attenuation was tested using age-adjusted linear regression models, adjusted and unadjusted for body composition as a post-hoc analysis (α = 0.05). Body composition variables normalized to body mass were compared between sexes using independent samples t-tests (α = 0.05). Body composition differed between sexes (p-range: <0.001-0.01, Cohen's d range: 0.17-2.41). Before adjusting for body composition, sex was not significantly associated with axial or resultant shock attenuation (p > 0.05), but adjusting for select body composition variables like lower extremity lean and bone mass revealed greater attenuation in females than males (β-range: -124.76 to -46.42, negative indicates greater attenuation; p-range = 0.004-0.04). Sex may not influence shock attenuation during running, but body composition must be accounted for to better understand this association and consequently sex-specific tissue capacities relative to applied loads.

  View details for DOI 10.1016/j.jbiomech.2024.112245

  View details for PubMedID 39084062

• Shock Attenuation May Be Influenced By Body Composition In Human Running Desai, G. A., Gruber, A. H., Rosenberg, M. LIPPINCOTT WILLIAMS & WILKINS. 2023: 826-827

  View details for Web of Science ID 001158156602545

• Weekly Moderate-to-vigorous Physical Activity And Biomechanical Plasticity Among Active Adults: A Prospective Study Desai, G. A., Gruber, A. H. LIPPINCOTT WILLIAMS & WILKINS. 2022: 186

  View details for Web of Science ID 000888056600549

• Bilateral differences in coordination variability among injured and uninjured runners: A prospective study. Journal of biomechanics Desai, G. A., Gruber, A. H. 2022; 132: 110938

  Abstract

  This prospective cohort study aimed to identify bilateral differences in coordination variability (CAV) to determine if limb-specific CAV or CAV asymmetry is associated with running-related overuse injury (RRI) development in recreational runners. Lower limb kinematics were collected at enrollment. Runners were classified as injured (n = 14) or controls (n = 17) based on RRI incidence during a ≥ 6-month follow-up. Pelvis-thigh, knee-shank, knee-ankle, and shank-ankle CAV was quantified bilaterally within thirds of stance using modified vector coding. Wilcoxon Signed-Rank tests compared CAV between limbs within each group, and Wilcoxon Rank-Sum tests compared CAV asymmetry between groups (α ≤ 0.05). Injured runners displayed elevated injured versus uninjured limb CAV during initial-stance for all couplings (p < 0.010,d(effect size) = 0.51-1.31) except pelvis-thigh (p = 0.060,d = 0.36). During mid-stance, the injured limb exhibited restricted knee-ankle CAV (p < 0.010,d = 0.413) and elevated pelvis-thigh CAV (p < 0.010,d = 0.23). Controls also displayed bilateral differences specifically in pelvis-thigh CAV across stance, shank-ankle CAV during initial-stance, in all couplings during mid-stance, and shank-ankle CAV during late-stance (p < 0.010-0.025,d = 0.09-0.63). Comparing CAV asymmetry between groups revealed lower asymmetry among injured runners compared with controls for knee-ankle coupling in mid-stance and all couplings except pelvis-thigh during late-stance (p < 0.010,d = 0.85-1.87). Injured runners also displayed greater knee-shank CAV asymmetry in mid-stance versus controls (p < 0.010,d = 0.85). Logistic regression (α ≤ 0.05) revealed that between-limb CAV asymmetry did not predict RRI (p = 0.161), however, the odds of RRI were > 20% in the limb with either elevated shank-ankle CAV in initial-stance (p = 0.020) or elevated knee-ankle CAV in mid-stance (p = 0.043) than the contralateral limb. Therefore, limb-specific CAV rather than degree of CAV asymmetry may influence risk of RRI.

  View details for DOI 10.1016/j.jbiomech.2021.110938

  View details for PubMedID 34998179

• Segment coordination and variability among prospectively injured and uninjured runners. Journal of sports sciences Desai, G. A., Gruber, A. H. 2021; 39 (1): 38-47

  Abstract

  Coordinative variability (CAV) and underlying coordinative patterns are potential running-related overuse injury (RROI) mechanisms, but prospective analyses are needed. This study compared lower limb CAV and coordinative patterns between prospectively injured and uninjured runners. Knee, shank, and ankle kinematics were collected for 39 recreational runners at the beginning of a 6-month follow-up period. Subjects were classified as injured (n=21) or controls (n=18) based on RROI incidence during follow-up. CAV was quantified using modified vector coding. Time spent in each coordinative pattern category was quantified using binning frequency analysis. Coordinative patterns were classified as mechanically unsound if underlying joint/segment motions opposed anatomically allowable running motion. Wilcoxon Rank-Sum tests compared CAV and binning frequencies between groups within different stance portions for knee-shank, shank-ankle, and knee-ankle couplings (α≤0.05). During initial-stance, the injured group displayed significantly greater knee-ankle CAV (effect size (ES)=1.1), knee-shank CAV (ES=0.97), and greater frequency of mechanically unsound knee-shank (ES=0.72) and shank-ankle (ES=0.63) motion. During mid-stance, the injured group displayed lower frequency of mechanically sound knee-ankle motion (ES=0.31). In late-stance, the injured group displayed greater shank-ankle CAV (ES=0.11). Mechanically unsound coordinative patterns along with greater knee-ankle and shank-ankle CAV potentially lead to RROI.

  View details for DOI 10.1080/02640414.2020.1804519

  View details for PubMedID 32794430

• Assessing Between-limb Differences In Prospectively Injured And Uninjured Runners Using Dynamical Measures Of Gait Desai, G. A., Gruber, A. H. LIPPINCOTT WILLIAMS & WILKINS. 2020: 718

  View details for Web of Science ID 000590026303014