Investigating the Effect of Plantar Pressure Distribution Pattern on the Occurrence of Medial Tibial Stress Syndrome in Military Soldiers during Military Training

Introduction: Medial tibial stress syndrome is one of the most common musculoskeletal injuries among soldiers. However, there has not been a detailed report on the effect of risk-factors on its occurrence including the distribution of plantar pressure in military personnel and different communities. For this reason, the purpose of this study is to investigate the effect of plantar pressure distribution pattern on the incidence of medial tibial stress syndrome in military soldiers during military training. Methods and Materials: The statistical population of this research is male military soldiers at Imam Hossein University (AS) during the 6 months of military training with an average age of (19.68 ± 0.99 years), height of (174 ± 0.04 cm) and body mass index of (23.32 ± 1.76 kg/m2). 116 of them were selected as the statistical sample of this study. At the beginning of the training course, in addition to investigate the prevalence of medial tibial stress syndrome using the Yates and White criteria and plantar-foot pressure distribution data, vertical fluctuations and the symmetry of the subjects’ plantar pressure were collected by the PT-scan plantar pressure distribution device (made by Mashhad Technologists in Iran). Then, the subjects started to do the exercises related to military training. Moreover, at the end of the 6-month period, the possible prevalence of medial tibial stress syndrome was evaluated by using the Yates and White criteria again. The chi-square test was used to check the prevalence of injury and the logistic regression test was used to check the effect of the independent variable on the dependent variable. All hypothesis tests were performed at a significance level equal to or smaller than 0.05. Results: The results of chi-square test showed that the prevalence rate of medial tibial stress syndrome in military soldiers was 29.3٪ at the end of the period. Furthermore, the results of the logistic regression showed that the plantar pressure distribution variables were able to explain between 71.6٪ and 96.6٪ of the changes in the incidence of medial tibial stress syndrome. Among these, the symmetry index variable (96.6٪) was a statistically more accurate predictor of injury than other variables. (p≥0.05). In other findings, the results of logistic regression to investigate the predicting role of body posture fluctuations in the incidence of injury showed that the model was able to predict 100٪ of the incidence of medial tibial stress syndrome injury (p=0.001). Discussion and Conclusion: Since the prevalence of medial tibial stress syndrome in military soldiers is very high, specialists and medical staff of military soldiers in this field can be effective in identifying people prone to internal tibial pressure syndrome by considering the plantar pressure distribution pattern and foot movement patterns.