Učinkovitost fizioterapevtskih postopkov pri zdravljenju oseb z medialnim tibialnim stres sindromom - pregled literature : diplomsko delo

Sotošek, Robin (author), Hlebš, Sonja (mentor), Ipavec, Matej (comentor), Vauhnik, Renata (reviewer)

Uvod: Medialni tibialni stres sindrom (MTSS) je preobremenitvena poškodba, ki najpogosteje nastane zaradi prekomerne obremenitve, predvsem pri športnikih oziroma atletih tekačih. Kaže se kot difuzna bolečina vzdolž zadnje notranje strani golenice z občasno prisotno oteklino na notranji strani goleni. Dejavniki tveganja so povečan kot navikularne kosti, povečan indeks telesne mase, povečana plantarna fleksija skočnega sklepa in povečana zunanja rotacija kolčnega sklepa. Za zdravljenje MTSS se uporabljajo različni fizioterapevtski postopki (FP). Namen: Namen diplomskega dela je bil na podlagi pregleda literature analizirati učinke FP pri osebah z medialnim tibialnim stres sindromom. Metode dela: Iskanje literature je potekalo v podatkovnih zbirkah PubMed in Pedro. Na podlagi vključitvenih in izključitvenih kriterijev smo izbrali raziskave za podrobnejšo analizo z uporabo naslednjih ključnih besed v angleškem jeziku: medial tibial stress syndrome, physiotherapy in stress syndrome, treatment of MTSS, shin pain, leg pain in athletes, MTSS causes. Rezultati: Na podlagi vključitvenih in izključitvenih kriterijev je bilo v pregled literature vključenih 5 raziskav. V štirih raziskavah so proučevali učinke udarnih globinskih valov (UGV) na zdravljenje oseb z MTSS, v eni pa učinke miofascialnega sproščanja (MS) na zmanjšanje bolečine pri osebah z MTSS, kjer so ugotovili statistično pomembno zmanjšanje bolečine po vizualni analogni lestvici (VAL) (iz 7 na 2.1) (p < 0.001). Pri uporabi radialnih UGV je po treh intervencijah 76 % oseb preiskovalne skupine popolnoma okrevalo oziroma izboljšalo funkcijo v primerjavi s primerjalno skupino, kjer je do enakih rezultatov prišlo 37 % oseb. Razprava in zaključek: Rezultati pregleda kažejo na pozitivne učinke UGV, telesne vadbe (TV) in MS na zmanjšanje bolečine, povrnitev funkcije, izboljšanje kakovosti življenja in hitrejše okrevanje za vrnitev k športu. Ker so v večini raziskav uporabili tudi program TV, to ovira vrednotenje učinkov preiskovanih FP. Zaradi uporabe subjektivnih merilnih orodij, razlik v programih intervencij in razlik v vzorcih obstaja pomanjkanje dokazov o učinkovitosti izbranih FP pri zdravljenju oseb z MTSS. Zaradi pomanjkanja raziskav ostajajo dolgoročni učinki izbranih FP nejasni. Na izbranem področju bi bilo treba izvesti dodatne raziskave z večjim številom preiskovancev in z vključitvijo placebo skupine.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, medialni tibialni stres sindrom, učinkovitost fizioterapevtskih postopkov, bolečina v predelu goleni
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [R. Sotošek]
• Year: 2024
• Number of pages: 28 str.
• PID: 20.500.12556/RUL-165857
• UDC: 615.8
• COBISS.SI-ID: 218837507
• Publication date in RUL: 12.12.2024

Secondary language

• Language: English
• Title: The efficiency of physiotherapy techniques in patients with a medial tibial stress syndrome - literature review : diploma work

Abstract

Introduction: Medial tibial stress syndrome (MTSS) is an overload injury that most often occurs as a result of overload, especially in athletes and runners. It manifests as diffuse pain along the posterior inner side of the tibia with occasional swelling. Risk factors include navicular drop, increased body mass index, increased plantar flexion of the ankle joint, and external rotation of the hip joint. Various physiotherapeutic procedures are used to treat MTSS. Purpose: The aim of this diploma work was to demonstrate the effects of physiotherapeutic procedures based on a literature review. Methods: The literature search was conducted in the PubMed and Pedro databases. Based on inclusion and exclusion criteria, we selected studies for more detailed analysis using the following keywords in English: medial tibial stress syndrome, physiotherapy in stress syndrome, treatment of MTSS, shin pain, leg pain in athletes, MTSS causes. Results: Based on inclusion and exclusion criteria, 5 studies were included in this review of the literature. Four studies examined the effects of shock wave therapy on the treatment of people with MTSS and one of them examined the effects of myofascial release on pain reduction in people with MTSS, where a statistically significant reduction in pain in VAS (from 7 to 2.1) (p < 0.001) was found. When using radial UGV, 76% of the subjects in the study group fully recovered or improved their function after three interventions compared to the control group, where 37% of the subjects achieved the same results. Discussion and Conclusion: The results show positive effects of shockwave therapy, physical activity, and myofascial release on pain reduction, recovery of function, quality of life, daily activity performance, and the time required to return to previous sports. Because most of the studies also include physical exercise programmes, it is more difficult to evaluate the effects of the examined physiotherapy methods alone. There is also a lack of evidence on the efficacy of selected physiotherapy methods in the treatment of people with MTSS because the authors of the studies used subjective measurement tools, different intervention programmes, and different samples. The long-term effects remain unclear due to a lack of research. Additional studies with a larger number of subjects should be conducted, and they should include a placebo group.

• Keywords: diploma theses, physiotherapy, medial tibial stress syndrome, effectiveness of the physiotherapy procedures, shin pain