Extracorporeal Shockwave Therapy (ESWT) in the management of Medial Tibial Stress Syndrome (MTSS): A systematic review.

Abstract

Objectives: To gather and evaluate evidence for the effectiveness or ineffectiveness of extracorporeal shockwave therapy in the management of medial tibial stress Syndrome. Design: Systematic review following The PRISMA 2020 guidelines. Eligibility criteria: Randomized or controlled clinical studies assessing ESWT in active patients with MTSS. The risk of bias and the quality of studies for randomized controlled trials were evaluated using The PEDro scale of bias. While, non-randomized clinical trials were evaluated using The Newcastle-Ottawa Scale. Results: Four studies were identified that compared an intervention group with ESWT included and a control group with sham shock, exercise program and\or no intervention. Each group had approximately similar numbers of participants. Respectively. The mean age of participants in these studies for the ESWT group was 41.4 YO and for the control group 42.4 YO. Three of the studies used focused ESWT and one used radial ESWT. Each study looked at different outcome parameters, which led to a non-homogeneity of data. This systematic review investigates these Dissertation (ESWT effect on MTSS) May Alibrahim (720001213) Br J Sports Med studies to demonstrate ESWT's effectiveness in pain reduction, accelerated recovery time, and improved functional outcomes. Two studies had a low risk of bias and the other two had a moderate risk of bias assessment. Conclusion: Extracorporeal shockwaves lowered pain and recovery time while increasing patient satisfaction. There were no adverse effects recorded in any study. Based on the limited research available, ESWT could decrease pain and reduce recovery time in MTSS. More randomized clinical studies with sham control groups may confirm these findings in different patient populations. Keywords: Military personnel, Athletes, Runners, ESWT, Extracorporeal Shockwave Therapy, Randomized controlled trials, controlled trials.