Risk factors and prognostic indicators for medial tibial stress syndrome

Moen, Maarten H.; Bongers, T.N.; Bakker, Eric W. P.; Zimmermann, W; Weir, Adam; Tol, Johannes L.; Backx, Frank

doi:10.1111/j.1600-0838.2010.01144.x

Cited by 98 publications

(119 citation statements)

References 24 publications

(44 reference statements)

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“…The 21 included studies consisted of three cross-sectional,10 21 30 nine case–control7 8 11–15 20 31 and nine prospective cohort studies 2–4 9 16–19 22. In seven of the 21 studies, the participants were recreational athletes/physically active 7 10 11 14 15 20 30.…”

Section: Resultsmentioning

confidence: 99%

“…Risk factors for MTSS have been studied in numerous individual studies. Researchers have examined many variables as potential risk factors for MTSS such as body mass index (BMI),4 7–9 bone geometry,10 gait kinematics,[11–14 leg length differences,12 navicular drop,9 15–20 range of motion (ROM),4 8 9 11 12 14 16 18 21 training history4 18 19 22 and others. Although the results of these individual studies can inform clinical practice, the reported findings are often based on small sample sizes with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis

2014

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Medial tibial stress syndrome (MTSS) is a common injury in runners and military personnel. There is a lack of agreement on the aetiological factors contributing to MTSS, making treatment challenging and highlighting the importance of preventive efforts. Understanding the risk factors for MTSS is critical for developing preventive measures. The purpose of this systematic review and meta-analysis was to assess what factors put physically active individuals at risk to develop MTSS. Selected electronic databases were searched. Studies were included if they contained original research that investigated risk factors associated with MTSS, compared physically active individuals with MTSS and physically active individuals without MTSS, were in the English language and were full papers in peer-reviewed journals. Data on research design, study duration, participant selection, population, groups, MTSS diagnosis, investigated risk factors and risk factor definitions were extracted. The methodological quality of the studies was assessed. When the means and SDs of a particular risk factor were reported three or more times, that risk factor was included in the meta-analysis. There were 21 studies included in the systematic review and nine risk factors qualified for inclusion in the meta-analysis. Increased BMI (weighted mean difference (MD)=0.79, 95% CI 0.38 to 1.20, p<0.001), navicular drop (MD=1.19 mm, 95% CI 0.54 to 1.84, p<0.001), ankle plantarflexion range of motion (ROM; MD=5.94°, 95% CI 3.65 to 8.24, p<0.001) and hip external rotation ROM (MD=3.95°, 95% CI 1.78 to 6.13, p<0.001) were risk factors for MTSS. Dorsiflexion and quadriceps-angle were clearly not risk factors for MTSS. There is a need for high-quality, prospective studies using consistent methodology evaluating MTSS risk factors. Our findings suggest that interventions focused on addressing increased BMI, navicular drop, ankle plantarflexion ROM and hip external rotation ROM may be a good starting point for preventing and treating MTSS in physically active individuals such as runners and military personnel.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis

2014

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“…7 The lower extremity injuries military recruits sustain have negative effects on morbidity, training time, financial resources, and staffing. 2,8,9 Based on research findings and practitioners' beliefs, experiences, biases, and paradigms, multiple risk factors are theorized for MTSS. 2 In the 21 studies the authors reviewed, more than 100 risk factors were proposed, yet only 9 risk factors were supported by moderate to strong evidence in clinical practice 5 : body mass index (BMI), navicular drop, ankle plantar-flexion range of motion (ROM), ankle-dorsiflexion ROM, ankle-eversion ROM, ankle-inversion ROM, quadriceps angle, hip internalrotation ROM, and hip external-rotation ROM.…”

Section: Commentarymentioning

confidence: 99%

Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review

Winkelmann

Anderson

Games

et al. 2016

Journal of Athletic Training

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Reference/Citation: Hamstra-Wright KL, Bliven KC, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med. 2015;49(6):362-369.Clinical Question: What factors put physically active individuals at risk to develop medial tibial stress syndrome (MTSS)?Data Sources: The authors performed a literature search of CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from each database's inception to July 2013. The following key words were used together or in combination: armed forces, athlete, conditioning, disorder predictor, exercise, medial tibial stress syndrome, militaries, MTSS, military, military personnel, physically active, predictor, recruit, risk, risk characteristic, risk factor, run, shin pain, shin splints, and vulnerability factor.Study Selection: Studies were included in this systematic review based on the following criteria: original research that (1) investigated risk factors associated with MTSS, (2) compared physically active individuals with and without MTSS, (3) was printed in English, and (4) was accessible in full text in peerreviewed journals.Data Extraction: Two authors independently screened titles or abstracts (or both) of studies to identify inclusion criteria and quality. If the article met the inclusion criteria, the authors extracted demographic information, study design and duration, participant selection, MTSS diagnosis, investigated risk factors, mean difference, clinical importance, effect size, odds ratio, and any other data deemed relevant. After the data extraction was complete, the authors compared findings for accuracy and completeness. When the mean and standard deviation of a particular risk factor were reported 3 or more times, that risk factor was included in the meta-analysis. In addition, the methodologic quality was assessed with an adapted checklist developed by previous researchers. The checklist contained 5 categories: study objective, study population, outcome measurements, assessment of the outcome, and analysis and data presentation. Any disagreement between the authors was discussed and resolved by consensus.Main Results: A total of 165 papers were initially identified, and 21 original research studies were included in this systematic review. More than 100 risk factors were identified in the 21 studies. Continuous data were reported 3 or more times for risk factors of body mass index (BMI), navicular drop, ankle plantarflexion range of motion (ROM), ankle-dorsiflexion ROM, ankleeversion ROM, ankle-inversion ROM, quadriceps angle, hip internal-rotation ROM, and hip external-rotation ROM. As compared with the control group, significant risk factors for developing MTSS identified in the literature were (1) Conclusions: The primary factors that appeared to put a physically active individual at risk for MTSS were increased BMI, increased navicular drop, greater ankle plantar-flexion ROM, and greater hip external-rotation...

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“…This ailment has been associated with the presence of several risk factors such as training errors, decreased hip internal range of motion, increased ankle plantar flexion, positive navicular drop, female gender, increased body mass and foot hyperpronation [6][7][8][9][10][11][12][13].…”

mentioning

confidence: 99%

Medial Tibial Stress Syndrome in Athletes: Diagnostic and Therapeutic Approach

Angoules¹

2015

J Nov Physiother

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Risk factors and prognostic indicators for medial tibial stress syndrome

Cited by 98 publications

References 24 publications

Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis

Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis

Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review

Medial Tibial Stress Syndrome in Athletes: Diagnostic and Therapeutic Approach

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