Table 3 Summary of the study design, inclusion criteria, measured variables and main outcomes of the 17 articles included in the systematic review
Article | Study design | Injury criteria | Variables of interest | Main outcomes |
|---|---|---|---|---|
Akiyama et al. [13] | Case–control | Yates et al. [6] | Lower leg muscle shear modulus | Shear Moduli of MG, LG, SOL, PL and TA was significantly greater (p = 0.01) in participants with MTSS compared to control group |
Burne et al. [10] | Prospective cohort | Atraumatic, 7-day history of at least 10 cm of diffuse medial tibial pain | Lean lower leg girth | Men with EMTP had a significantly reduced right lean calf girth of 4.2% (p = 0.044) compared to control group |
Clement et al. [14] | Case series | Early stage bone stress continuum with end stage being TSF | Maximal lower leg girth | Atrophy of 1.46Â cm at level of maximal muscle mass of the anterior tibial group and gastrocnemius on the affected side compared to unaffected side |
Ercan et al. [23] | Case–control | Atraumatic activity related diffuse (> 5 cm) pain at the distal 2/3rd of the tibia | Lower leg peak isokinetic force | MTSS and control participants displayed no significant difference in isokinetic ankle plantar flexion and dorsiflexion strength |
Franettovich et al. [15] | Case–control | History of ERLP within previous 12 months. Excluded if diagnosis of CECS or TSF | Lower leg muscle recruitment parameters | Individuals with a history of ERLP demonstrated a significant lower peak LG activity during stance 20.5% (p = 0.04) and swing 1.7% (p = 0.03) of MVC respectively compared to control participants |
Garth et al. [16] | Case–control | Diffuse incapacitating pain at the posteromedial middle one-third of the tibia aggravated by repetitive weight bearing | MTPJ ROM | Injured participants displayed a significant increase (p ≤ 0.01) in sagittal plane ROM of the MTPJ, pain on flexion of FDL and mild claw toe deformity of digits 2–5 |
Hubbard et al. [17] | Prospective cohort | Yates et al. [6] | Lower leg muscle MVIC | MTSS and control participants demonstrated no significant difference in lower leg muscle strength measures compared to control participants |
Madeley et al. [12] | Case–control | Yates et al. [6] | Standing heel raise endurance | Injured participants completed significantly less heel raise repetitions (p < 0.001) compared to non-injured group |
Moen et al. [18] | Case–control | Yates et al. [6] | Maximal and lean lower leg girth | No significant difference in maximal or lean lower girth between injured and control participants |
Naderi et al. [37] | Prospective cohort | Yates et al. [6] | Lower leg muscle recruitment parameters | Injured group displayed significantly larger peak SOL EMG amplitude during propulsion (p = 0.01) compared to control group |
Rathleff et al. [19] | Case–control | Pain in the distal 2/3rd of the posterior-medial tibia, exacerbated with repetitive weight-bearing activity | Lower leg muscle recruitment parameters | Injured group displayed significantly increased complexity of EMG signal of the TA (p = 0.02) and SOL (p = 0.01) compared to control group |
Sabeti et al. [24] | Case–control | Yates et al. [6] | Maximal lower leg girth | No statistically significant difference between injured and control group |
Saeki et al. [22] | Case–control | Yates et al. [6] | Lower leg muscle shear modulus | Individuals with a history of MTSS have a statistically significant higher shear modulus of FDL (p < 0.01) and TP (p < 0.05) compared to the control group |
Saeki et al. [21] | Case–control | Yates et al. [6] | Lower leg muscle MVIC | Runners with a history of MTSS displayed a statistically significant higher plantarflexion MVIC torque of the 1st MTPJ (p = 0.04) compared to control participants |
Sobhani et al. [20] | Case–control | Yates et al. [6] | Maximal lower leg girth | No statistically significant difference in maximal lower leg girth between injured and control group |
Winters et al. [38] | Case–control | Yates et al. [6] | Musculoskeletal ultrasound | Tendinous abnormalities were commonly found in MTSS and asymptomatic individuals |
Yüksel et al. [11] | Case–control | Yates et al. [6] | Lower leg muscle peak isokinetic force | Average eversion concentric strength was significantly higher (p < 0.05) in the injured group with those individuals displaying a strength imbalance whereby the evertor muscles were stronger than the invertor muscles |