Conservative Interventions for Medial Tibial Stress Syndrome in Long distance runners and military personnel: a systematic review
Keidel - Morgan, Brett
Cardiff Metropolitan University
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Background. Medial tibial stress syndrome (MTSS) is a common overuse injury that accounts for between 13.2% and 17.3% of all reporting running related injuries. Despite the high incidence rates in military and athletic populations there is still no defined optimal treatment option. Aim. To assess the effectiveness of conservative (non-surgical) interventions available for the treatment of MTSS. Method. A systematic search of the literature was undertaken which included: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, NCBI, MEDLINE, EMBASE databases and Index to thesis, current contents and dissertation abstracts. Selection criteria: Randomised control, quasi-randomised or controlled clinical trial with a clinical diagnosis of MTSS. Data collection and analysis: The search results were screened to identify those that meet the inclusion criteria and quality assessed those using the Cochrane Assessment of Risk of Bias tool. This tool focused on five key areas of bias – Selection, performance, detection, attrition and reporting bias. Results. Six trials, involving 1,733 subjects, met the inclusion criteria for this review. All of the studies were subject to at least one area of bias, each of the trials showed a high or unclear risk of performance bias. The results of one study found substantially reduced instantaneous relative risk of MTSS versus control through a gait retraining programme (Sharma et al 2014). One study (Larsen et al 2002) found that results were significantly better in an actual-use analysis in the intervention group for total number of subjects with lower extremity problems and a significant difference was found for subjects with MTSS. Another study (Newman et al 2016) showed that pain (palpation) was reduced in the experimental group while the other three studies showed no significant differences. Despite these findings, since each study was at risk of bias no definitive conclusions could be drawn.
BSc Biomedical Sciences (Health, Excercise & Nutrition)
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