Open Access Open Badges Study protocol

The NLstart2run study: health effects of a running promotion program in novice runners, design of a prospective cohort study

Bas Kluitenberg1*, Marienke van Middelkoop2, Ron L Diercks1, Fred Hartgens3, Evert Verhagen4, Dirk-Wouter Smits5, Ida Buist1 and Henk van der Worp1

Author Affiliations

1 Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands

2 Department of General Practice, Erasmus MC Medical University, Rotterdam, The Netherlands

3 Departments of Epidemiology and Surgery, Research School CAPHRI, Maastricht University Medical Centre+, and Sports Medicine Centre Maastricht, Maastricht, The Netherlands

4 Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research VU University Medical Center, Amsterdam, The Netherlands

5 Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands

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BMC Public Health 2013, 13:685  doi:10.1186/1471-2458-13-685

Published: 26 July 2013



Running is associated with desirable lifestyle changes. Therefore several initiatives have been undertaken to promote running. Exact data on the health effects as a result of participating in a short-term running promotion program, however, is scarce. One important reason for dropout from a running program is a running-related injury (RRI). The incidence of RRIs is high, especially in novice runners. Several studies examined potential risk factors for RRIs, however, due to the often underpowered studies it is not possible to reveal the complex mechanism leading to an RRI yet.

The primary objectives are to determine short- and long-term health effects of a nationwide “Start to Run” program and to identify determinants for RRIs in novice runners. Secondary objectives include examining reasons and determinants for dropout, medical consumption and economical consequences of RRIs as a result of a running promotion program.


The NLstart2run study is a multi-center prospective cohort study with a follow-up at 6, 12, 24 and 52 weeks. All participants that sign up for the Start to Run program in 2013, which is offered by the Dutch Athletics Federation, will be asked to participate in the study.

During the running program a digital running log will be completed by the participants every week to administer exposure and running related pain. After the running program the log will be completed every second week. An RRI is defined as any musculoskeletal ailment of the lower extremity or back that the participant attributed to running and hampers running ability for at least one week.


The NLstart2run study will provide insight into the short- and long-term health effects as a result of a short-term running promotion program. Reasons and determinants for dropout from a running promotion program will be examined as well. The study will result in several leads for future RRI prevention and as a result minimize dropout due to injury. This information may increase the effectiveness of future running promotion programs and will thereby contribute positively to public health.

Trial registration

The Netherlands National Trial Register NTR3676. The NTR is part of the WHO Primary Registries.