Table 6.
Summary of studies analyzing treatment methods and time to recovery.
| Study | Design Level of Evidence (NHMRC) |
Participants | Methodology | Results (p <0.05) |
|---|---|---|---|---|
| Loudon and Dolphino, 2010 [28] | Case series IV |
23 runners with MTSS (12♂/11♀)
|
Initial measurements: ▪ Alignment: ND test and talocrural dorsiflexion ROM ▪ Pain (NPRS) Treatment (3 weeks): ▪ Off-the-shelf BFO ▪ Home stretching program Follow-up: ▪ GRC questionnaire by email (Post 7 and 21 days) |
▪ ↓ Duration of the symptoms: 44% ♀and 83% ♂ ▪ ↓ Pain level in the successful group ▪ Improvement in GRC in the successful group (post 21 days) |
| Mulvad et al., 2018 [29] | Cohort III-2 |
112 injured runners (30♂/82♀)
|
▪ Clinical examinations | ▪ MTSS had the longest time to recovery (70 days) |
| Naderi et al., 2019 [26] | Case–control III-2 |
100 runners (100♂) ▪ 50 runners with MTSS
|
▪ Arch-support full-length footorthoses in the shoes ▪ Pain measurement (algometry, VAS) ▪ Foot postures (FPI-6) ▪ Dynamic pressure distribution during running (stance phase) |
After using arch-support foot- orthosesin MTSS runners: ▪ ↓ Total contact time ▪ ↓ Absolute impulse in the midfoot region and ↑peak pressure and absolute impulse underneath the M5 region ▪ Pressure distribution was laterally at FFF and HO ▪ Pressure displacement was shifted from lateral to medial during FFCP and from medial to lateral during FFPOP ▪ The X-component of the COP was more medially at FFF and was displaced to lateral side during FFPOP ▪ The X-component of the COP was laterally at FFF and the lateral COP displacement ↓during FFPOP |
| Newman et al., 2017 [23] | Randomized controlled trial II |
24 runners with MTSS ▪ Experimental group: 12 (5♂/7♀)
|
Treatment: ▪ Experimental group: standard dose shockwave therapy (total = 1450 mJ/mm2) ▪ Control group: sham dose shockwave therapy (total = 70 mJ/mm2)Measurements: ▪ Pain: pressure algometry and during running (NRS) ▪ Self GROC questionnaire Follow-up: 10 weeks |
▪ No significant differences between groups |
| Nielsen et al., 2014 [31] | Cohort III-2 |
254 injured runners ▪ 38 runners with MTSS (15%), (18♂/20♀) |
▪ Clinical examinations ▪ Prospective follow-up to determine time to recovery |
▪ Mean time to recovery of 72 days |
BFO: Basic Foot Orthotic; COP: Center of Pressure; FFCP: Forefoot Contact Phase; FFF: Forefoot Flat; FFPOP: Forefoot Push-Off Phase; FPI-6: Foot Posture Index; GRC: Global Rating of Change; GROC: Global Rating of Change; mJ: millijoules; NHMRC: National Health and Medical Research Council; NPRS: Numerical Pain Rating Scale; MTSS: Medial Tibial Stress Syndrome; M5: 5th metatarsal; ND: navicular drop; NRS: Numerical Rating Scale; ROM: Range of Motion; VAS: Visual Analog Scale. ♂: man; ♀: woman.