The medial tibial stress syndrome score: a new patient-reported outcome measure.
BACKGROUND
At present, there is no validated patient-reported outcome measure (PROM) for patients with medial tibial stress syndrome (MTSS).


OBJECTIVE
Our aim was to select and validate previously generated items and create a valid, reliable and responsive PROM for patients with MTSS: the MTSS score.


METHODS
A prospective cohort study was performed in multiple sports medicine, physiotherapy and military facilities in the Netherlands. Participants with MTSS filled out the previously generated items for the MTSS score on 3 occasions. From previously generated items, we selected the best items. We assessed the MTSS score for its validity, reliability and responsiveness.


RESULTS
The MTSS score was filled out by 133 participants with MTSS. Factor analysis showed the MTSS score to exhibit a single-factor structure with acceptable internal consistency (α=0.58) and good test-retest reliability (intraclass correlation coefficient=0.81). The MTSS score ranges from 0 to 10 points. The smallest detectable change in our sample was 0.69 at the group level and 4.80 at the individual level. Construct validity analysis showed significant moderate-to-large correlations (r=0.34-0.52, p<0.01). Responsiveness of the MTSS score was confirmed by a significant relation with the global perceived effect scale (β=-0.288, R(2)=0.21, p<0.001).


CONCLUSIONS
The MTSS score is a valid, reliable and responsive PROM to measure the severity of MTSS. It is designed to evaluate treatment outcomes in clinical studies.
Department of Rehabilitation, Nursing Science & Sports, University Medical Centre Utrecht, Utrecht, The Netherlands.
Marinus
M
Winters
Bergman Clinics, Naarden, The Netherlands The Sports Physician Group, St Lucas Andreas Hospital, Amsterdam, The Netherlands.
Maarten H
MH
Moen
Department of Training Medicine and Training Physiology, Royal Netherlands Army, Utrecht, The Netherlands Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Wessel O
WO
Zimmermann
Division of Clinical Methods and Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Robert
R
Lindeboom
Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
Adam
A
Weir
Department of Rehabilitation, Nursing Science & Sports, University Medical Centre Utrecht, Utrecht, The Netherlands.
Frank Jg
FJ
Backx
Division of Clinical Methods and Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Eric Wp
EW
Bakker
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D058923:Medial Tibial Stress Syndrome / Q000175:diagnosis*; D059352:Musculoskeletal Pain / Q000175:diagnosis; D009426:Netherlands; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D015203:Reproducibility of Results; D016896:Treatment Outcome; D055815:Young Adult
Evaluation; Observational study; Reliability; Shin splints