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SportsMedUpdate
  1. Martin P Schwellnus
  1. University of Cape Town, South Africa

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In a non-randomised controlled study, radial extracorporeal shock wave therapy was effective in reducing pain and improving function in patients with chronic medial tibial stress syndrome

Background

Extracorporeal shock wave therapy (SWT) is used in the treatment of insertional tendinopathy—medial tibial stress syndrome (MTSS) is typically painful at the insertion of the tibialis posterior or soleus muscles.

Research question/s

Does extracorporeal SWT reduce pain and improve function in chronic MTSS?

Methodology

Subjects 94 patients with chronic recalcitrant MTSS (<6 months)

Experimental procedure In a non-randomised fashion, subjects were treated with either a 12-week standardised home training programme (stretches, resistance exercises) only (CON=47, female=26) or home training and repetitive low-energy radial shock wave therapy (SWT=47, female=28, 3 weekly sessions, 2000 shocks per session; 2.5 bars equal to 0.1 mJ/mm2; total energy flux density, 200 mJ/mm2; no local anaesthesia). Outcomes were measured at 0, 1, 4 and 15 months.

Measures of outcome Recovery 6-point Likert scale—success=rating of 1 (completely recovered) or 2 (much improved); pain in past week (numeric rating 0–10).

Main finding/s

Return to sport at 15 months: Ability to return to their preferred sport at their preinjury level at 15 months: SWT group=40/47 subjects, CON group=22/47 subjects.

Conclusion/s

In a non-randomised controlled study, radial extracorporeal shock wave therapy was effective in reducing pain and improving function in patients with chronic medial tibial stress syndrome.

Evidence-based rating: 7.5/10

Clinical interest …

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