The Effect of Extracorporeal Shock Wave Therapy on Clinical and Functional Outcomes of Individuals with Medial Tibial Stress Syndrome: A Systematic Review

Background and Aim: Medial Tibial Stress Syndrome (MTSS) is one of the most common sports-related overuse injuries among runners and military personnel. Extracorporeal shock wave therapy (ESWT) is an emerging treatment modality that used for individuals with MTSS. However, there was no found a systematic review that specifically assess the clinical and functional efficacy of ESWT in individuals with MTSS. Therefore, the purpose of this systematic review was to investigate the effect of ESWT on the clinical and functional outcomes of individuals with MTSS. Methods: For this study, Embase, Scopus, Medline, Web of Science, PubMed, and Biomed Central databases were searched using selected keywords from inception to 1 June 2021. PRISMA instructions were followed for this study. Based on search strategies, 978 articles from six databases were identified. Following the removal of duplicate and irrelevant articles, the full text of 11 articles was received from the databases. After reviewing the full text of these articles, information related to four articles that examined the effects of ESWT on individuals with MTSS was extracted. Results: A total of 202 individuals with an age of 33.2 ± 8.9 years and MTSS history >3 weeks have participated in the studies. Three studies included athletes and one study included military personnel as a participant. Three studies found that ESWT had a significant treatment effect on the MTSS, while one study found that ESWT had no significant treatment effect on the MTSS. Conclusion: Given that most previous studies have reported that ESWT has a positive effect on individuals with MTSS, this treatment modality can be recommended for those individuals. However, due to the limited number of studies and the contradictory results and methodological weakness of some studies, more detailed studies are necessary for it to become viewed as an acceptable modality for the treatment of MTSS.