Shockwave treatment for medial tibial stress syndrome in military cadets: A single-blind randomized controlled trial.

Author: Gomez Garcia S1, Ramon Rona S2, Gomez Tinoco MC3, Benet Rodriguez M4, Chaustre Ruiz DM5, Cardenas Letrado FP6, Lopez-Illescas Ruiz Á7, Alarcon Garcia JM8
Affiliation:
1Orthopaedic Surgeon and Sports Medicine Physician, Military School of Cadets of the Colombian Army, Calle 80 No. 38-00, Bogotá, Colombia. Electronic address: sancubacfg@yahoo.es.
2Director of Physical Medicine and Rehabilitation Department, Hospital Quirón, Garcia Cugat Foundation CEU-UCH Chair of Medicine and Regenerative, International University of Catalonia, Plaça d'Alfonso Comín, 5-7, 08023, Barcelona, Spain. Electronic address: sramon@comb.cat.
3Psychology Unit of the Academic Vice-Rectory, Military School of Cadets of the Colombian Army, Calle 80 No. 38-00, Bogotá, Colombia. Electronic address: nanygomezt@hotmail.com.
4Research Director of the CAFAM University Foundation, Cra. 68 No. 90-88, Bogotá, Colombia. Electronic address: benetmikhail@gmail.com.
5Department of Physical Medicine and Rehabilitation, Central Military Hospital, Transversal 3 No.49-00, Bogotá, Colombia. Electronic address: diegomchaustrer68@yahoo.com.co.
6Physiotherapy Unit, Military School of Cadets of the Colombian Army, Calle 80 No. 38-00, Bogotá, Colombia. Electronic address: frapcl@hotmail.com.
7Director of Physical Rehabilitation Unit, National Sports Medicine Center, Higher Sports Council, C/ Pintor El Greco S/N, 28040, Madrid, Spain. Electronic address: lopezillescas@gmail.com.
8Director of Shockwave Service, Vithas Nuestra Señora de América Hospital, Madrid, Spain. Electronic address: ondasdechoquealarcon@icloud.com.
Conference/Journal: Int J Surg.
Date published: 2017 Oct
Other: Volume ID: 46 , Pages: 102-109 , Special Notes: doi: 10.1016/j.ijsu.2017.08.584. Epub 2017 Sep 5. , Word Count: 278

Medial tibial stress syndrome (MTSS) is a common injury in athletes and soldiers. Several studies have demonstrated the effectiveness of extracorporeal shockwave treatment (ESWT) in athletes with MTSS.

OBJECTIVE: To assess whether one session of focused ESWT is effective in the treatment of military cadets with MTSS.

DESIGN: A randomized, prospective, controlled, single-blind, parallel-group clinical study.

LEVEL OF EVIDENCE: Ib.

SETTING: Military School of Cadets of the Colombian Army.

METHODS: Forty-two military cadets with unilateral chronic MTSS were randomly assigned to either one session of focused electromagnetic ESWT (1500 pulses at 0.20 mJ/mm2) plus a specific exercise programme (muscle stretching and strengthening exercises) or the exercise programme alone. The primary endpoint was change in asymptomatic running test (RT) duration at four weeks from baseline. Secondary endpoints were changes in the visual analogue scale (VAS) after running and modified Roles and Maudsley (RM) score also at four weeks from baseline.

RESULTS: ESWT patients were able to run longer. Mean RT after four weeks was 17 min 33 s (SE: 2.36) compared to 4 min 48 s (SE: 1.03) in the exercise-only group (p = 0.000). Mean VAS after running was 2.17 (SE: 0.44) in the ESWT group versus 4.26 (SE: 0.36) in the exercise-only group (p = 0.001). The ESWT group had a significantly higher RM score, with excellent or good results for 82.6% of patients vs. 36.8% in the exercise-only group (p = 0.002). No significant adverse effects of ESWT were observed.

CONCLUSION: A single application of focused shockwave treatment in combination with a specific exercise programme accelerates clinical and functional recovery in military cadets with MTSS.

Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

KEYWORDS: Medial tibial stress syndrome; Military injuries; Regenerative therapy; Shin splints; Shockwave; Shockwave treatment

PMID: 28882773 DOI: 10.1016/j.ijsu.2017.08.584

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