![]() Overall the article scores as poor evidence.Ĭlinical trial with 10 subjects. The training-intervention in this study though is very well-described and therefore easy to reproduce. The authors have used this case-study as a pilot for a slightly bigger clinical trial. The male subject ran 4 km, and then complained of pain to the left foot arch, why the test was stopped.Ī 7 month follow-up questionnaire showed significant improvement of running distance in both subjects, with the female being able to run up to 12.9 km, and the male subject running 6,5 km.Ī case study has a very low evidence-level, but can be used to generate hypotheses regarding a given disease or treatment procedure. The two subjects were instructed in forefoot running techniques 3 times a week, over a period of 6 weeks, and slowly increased their running distance in the course of these 6 weeks.Īfter 6 weeks of training the female subject was capable of running a distance of 5 km with no pain. A 21 y/o female with a 4 year history on CECS, and a 21 y/o male with bilateral pain, 7 months after two right-legged fasciotomies. Search Matrix Critical evaluationĬase study with 2 subjects. After thoroughly reading these articles, we decided to critically evaluate 2, since these were the only intervention studies that exist.ĭiebal 2011: “Effects of forefoot running on chronic exertional compartment syndrome: a case series”ĭiebal 2012: “Forefoot running improves pain and disability associated with chronic exertional compartment syndrome”Ĭhronic exertional compartment syndrome (MESH)įigure 1. 10 articles were ultimately included for this CAT. One article was not possible to find in its full form and was excluded. We read the abstracts of the remaining 37 and included 11 based on the inclusion criteria. Of the 184 articles found, 56 were selected based on title. Exclusion criteriaĪrticles that were solely concerning surgery and surgical techniques. Furthermore articles were included if they concerned the lower leg and contained a conservative treatment regime. Articles were included if they were newer than the year 1995, were written in Danish, English or German and were sports related. We included articles of all evidence levels. Is there any evidence for conservative treatment of chronic exertional compartment syndrome? Inclusion criteria For instance in-elastic fascial sheath, increased volume of muscle with exertion due to blood flow and edema, muscle hypertrophy as a response to exercise and dynamic contraction factors due to the gait cycle (2).Ĭonservative treatment consists of rest from aggravating activity, stretching and strengthening of the involved muscles and orthotics (1,2), however the literature describes conservative treatment as non-effective in most cases (1,2,3) and no randomized controlled studies exist in the literature with focus on conservative treatment (4). Several factors contribute to an increase in intra compartmental pressure. CECS can occur in all four compartments, however it is most common in the anterior and the deep posterior compartment (2,3). There are four major compartments: the anterior, the lateral, the deep posterior and the superficial posterior. The pain is described as a cramplike or squeezing ache over a specific compartment of the leg (2). The symptom is pain, which often occurs after a certain duration and/ or intensity of exercise. Therefore we find it relevant to examine the literature on this matter to identify the most effective conservative treatment regime for this group of patients.Ĭhronic exertional compartment syndrome (CECS) of the lower leg is a common condition in athletes, particularly running (1). We experience inconsistent results in the treatment of these patients with many not being able to return to previous activity level. In the rehabilitation we focus on strength training, stretching exercises and alignment correction of the lower extremity. ![]() In the Clinic of Sports Medicine at Bispebjerg and Frederiksberg Hospitals we treat patients with chronic exertional compartment syndrome referred to us by the doctors. Sports Rehabilitation and Therapy Date of publication Derfor opfordrer vi alle til at kommentere, tilføje egne erfaringer og viden til den aktuelle CAT.Ĭonservative treatment for chronic exertional compartment syndrome in the lower leg SpecialeĬamilla Cullum, BSc PT, M.Sc. En CAT er et dynamisk redskab, som ikke har været igennem en videnskabelig bedømmelse.
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