Randomized Controlled Trial of Laser Therapy Versus Conventional Therapy in the Treatment of Medial Tibial Stress Syndrome

Authors

  • Chen-Ling Chen Department of Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan
  • Hua-Ying Chuang Department of Internal Medicine, Chiali Hospital, Chi Mei Medical Center, Tainan, Taiwan
  • Cheng-Chiang Chang Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center, Taipei, Taiwan and Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei, Taiwan
  • Chih-Hung Ku School of Public Health, National Defense Medical Center, Taipei, Taiwan and Center for General Education, Kainain University, Taoyuan, Taiwan
  • Shin-Tsu Chang Department of Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan and Department of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center, Taipei, Taiwan

DOI:

https://doi.org/10.12974/2313-0954.2016.03.02.1

Keywords:

Sacroiliac joint stress, laser, scintigraphy, kinematic chain, medial tibial stress syndrome, medial tibial traction periostitis, dynamic knee valgus.

Abstract

Introduction: Medial tibial stress syndrome (MTSS) can induce defective biomechanics and cause sacroiliac (SI) joint stress. The purpose of this study was to investigate whether successful therapy of MTSS normalizes SI joint stress.

Methods: Fifty-three patients with MTSS and SI joint stress confirmed by nuclear scintigraphy were enrolled in this prospective trial. Patients were randomly assigned to receive laser therapy or conventional therapy. Patients in the laser therapy group underwent 15 laser sessions over a 5-day period (60 seconds in duration, three times per day). The SI ratio was measured using quantitative sacroiliac scintigraphy (QSS) before and after therapy. Outcome measures included Lower Extremity Functional Scale (LEFS). Generalized estimating equation models were used to evaluate the associations of LEFS. We adjusted for the correlations between QSS and different parts of the SI joint, and adjusted for potential confounders as well.

Results: Age, body weight, and duration did not correlate with QSS or lateralization. There was no significant difference in QSS and laterality of MTSS. However, the LEFS measured after therapy were significantly increased 38.45 (P < 0.0001) from LEFS measured before therapy. The QSS was significantly lower after therapy (P < 0.0001), indicating that successful therapy of MTSS has a buttom-up effect on SI joint stress (P < 0.0001). There was also a significant association between the middle part and the lower part of the SI joint. The QSS for the middle part on both sides was significantly higher than that for the lower part (P = 0.0250).

Conclusion: SI joint stress due to bottom-up processing of MTSS can be normalized after successful therapy of MTSS by either laser therapy or conventional therapy. 

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Published

2016-09-04

How to Cite

Chen, C.-L., Chuang, H.-Y., Chang, C.-C., Ku, C.-H., & Chang, S.-T. (2016). Randomized Controlled Trial of Laser Therapy Versus Conventional Therapy in the Treatment of Medial Tibial Stress Syndrome. International Journal of Orthopedics and Rehabilitation, 3(2), 43–50. https://doi.org/10.12974/2313-0954.2016.03.02.1

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