REHABILITATION AND PREVENTION OF THE MEDIAL TIBIAL STRESS SYNDROME IN MILITARY PERSONNEL

Abstract

Abstract.Medial tibial stress syndrome is an injury that occurs as a result of cumulative and chronic damage to the lower extremities during excessive physical exertion. It is manifested by pain in the posterior medial part of the tibia, which is caused by microtraumas of the shin muscles and overstrain of their attachment sites, as well as tibial periostitis progressing to a stress fracture. It is most often found among athletes and military personnel and can significantly limit their ability to perform professional physical activities. The risk of receiving this injury is especially high among military personnel in their first year of service, which includes cadets of higher military educational institutions. Persons who have developed medial tibial stress syndrome are prone to relapses of the disease, and without proper treatment and rehabilitation, its chronic form may develop, which leads to deterioration of functioning. In addition, medial tibial stress syndrome is considered a precursor to a tibial stress fracture, requiring longer treatment and recovery.
 Based on the results of the analysis of the existing methodical approaches to physical therapy of people with medial tibial stress syndrome in Ukraine, a small number of publications dealing with this problem were found. Also, complex physical therapy programs for servicemen with injuries from heavy workload were not developed and implemented.
 Aim. The aim of the research is to analyze approaches to the rehabilitation and prevention of medial tibial stress syndrome among military personnel.
 Materials and methods. The publications selected on the basis of a search in the databases PubMed, PEDro, Cochrane Library, Google Scholar, and Vernadsky National Library of Ukraine were analyzed.
 Results. It was found that almost all physical therapy methods used in the treatment of the syndrome were part of an individual (standard) treatment program for military personnel with stress syndrome, which also included medication and surgical intervention as indicated. In only one research, after treatment of an acute period of the disease, patients were offered a multidisciplinary rehabilitation program based on therapeutic exercises, which were used to reduce symptoms, improve endurance, and return servicemen to duty.
 It has been established that therapeutic exercises, as the main means of physical therapy, are ineffective in the rehabilitation and prevention of medial tibial stress syndrome without combination with other interventions. The insufficient effectiveness of the treatment of the syndrome by combining therapeutic exercises with means of physical therapy was determined.
 It has been found that gait retraining in combination with therapeutic exercises accelerates recovery and prevents the occurrence of medial tibial stress syndrome in military personnel.
 Conclusions. The data obtained in the analyzed scientific researches, a significant difference in the organization of research, rehabilitation programs, and research methods make it impossible to draw certain conclusions about optimal approaches to therapy and prevention of medial tibial stress syndrome in military personnel. This makes it necessary to continue research on this issue.
 Since the results of the research did not reveal a consensus regarding effective physical therapy programs for the prevention and rehabilitation of medial tibial stress syndrome, as well as the lack of relevant research in Ukraine, it is important to continue studying this issue.