{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:33:45Z","timestamp":1786707225178,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Iskra Medical to the Electrotherapy Laboratory, Department of Physiotherapy, International Hellenic University"},{"id":[{"id":"https:\/\/ror.org\/00708jp83","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Funct. Morphol. Kinesiol.","JFMK"],"abstract":"<jats:p>Background: Tibial bone stress injury (TBSI) with associated bone marrow edema (BME) is a common and clinically challenging condition in athletes, often requiring prolonged load restriction and delayed return to sport. Evidence for adjunctive interventions that improve both symptoms and MRI-derived recovery remains limited. The aim of this study was to investigate whether adding Functional Magnetic Stimulation (FMS) to standardized rehabilitation improves pain, function, and MRI-derived outcomes over 16 weeks in athletes with MRI-confirmed TBSI. Materials and Methods: Forty athletes with Fredericson grade 2\u20133 TBSI were randomized to FMS plus rehabilitation (n = 20) or rehabilitation alone (n = 20). Both groups completed a 4-week load-based rehabilitation program, while the FMS group additionally received eight 30 min FMS sessions at 40 Hz. Outcomes were assessed at baseline, 4 weeks, and 16 weeks. The primary outcome was activity-related pain (NPRS), while secondary outcomes included lower-limb function (LEFS-GR), BME extent, and Fredericson grade. Continuous outcomes were analyzed using two-way mixed ANOVA, whereas Fredericson grade was analyzed using an ordinal generalized estimating equation model. The level of statistical significance was set at p &lt; 0.05. Results: Groups were comparable at baseline. Significant group \u00d7 time interactions favored FMS for NPRS, F(2, 76) = 12.46, p &lt; 0.001, \u03b72p = 0.247; LEFS-GR, F(1.08, 41.09) = 81.56, p &lt; 0.001, \u03b72p = 0.682; and BME extent, F(1.44, 54.85) = 49.33, p &lt; 0.001, \u03b72p = 0.565. At 16 weeks, the FMS group showed lower NPRS scores, higher LEFS-GR scores, and lower BME extent than controls. Fredericson grade also showed a significant group \u00d7 time effect, Wald \u03c72(2) = 20.38, p &lt; 0.001. The FMS group had significantly lower cumulative odds of classification in a higher Fredericson grade at 4 weeks (OR = 0.045, 95% CI: 0.012\u20130.163, p &lt; 0.001), whereas the corresponding difference at 16 weeks remained directionally favorable but did not reach statistical significance (OR = 0.033, 95% CI: 0.001\u20131.029, p = 0.052). Conclusions: The addition of FMS to load-based rehabilitation was associated with greater clinical and functional improvements, greater reductions in BME extent, and a more favorable longitudinal trajectory in MRI severity classification than rehabilitation alone in athletes with TBSI. However, because the study did not include a sham-FMS condition and participants could not be blinded, the self-reported pain and functional outcomes should be interpreted cautiously. FMS may represent a useful adjunct to structured rehabilitation, although sham-controlled and longer-term studies should determine its effects on return-to-sport progression and recurrence risk.<\/jats:p>","DOI":"10.3390\/jfmk11030317","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:39:01Z","timestamp":1786703941000},"page":"317","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Functional Magnetic Stimulation on Pain, Function, and MRI-Derived Outcomes in Athletes with Tibial Bone Stress Injury: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-2036","authenticated-orcid":false,"given":"Dimitrios","family":"Lytras","sequence":"first","affiliation":[{"name":"Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7060-5581","authenticated-orcid":false,"given":"Ioannis","family":"Algiounidis","sequence":"additional","affiliation":[{"name":"Giannitsa General Hospital, 58100 Giannitsa, Pella, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2065-1116","authenticated-orcid":false,"given":"Vasileios","family":"Georgoulas","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kasimis","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4311-359X","authenticated-orcid":false,"given":"Georgia Maria","family":"Kamparoudi","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Tsigaras","sequence":"additional","affiliation":[{"name":"Laboratory of Basic and Applied Research in Physiotherapeutic Rehabilitation, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Vergidou","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Sidiropoulos","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Tarfali","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9674-7394","authenticated-orcid":false,"given":"Ilias","family":"Kallistratos","sequence":"additional","affiliation":[{"name":"Laboratory of Basic and Applied Research in Physiotherapeutic Rehabilitation, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0451-9577","authenticated-orcid":false,"given":"Paris","family":"Iakovidis","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Sindos, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2511","DOI":"10.1136\/bmj.e2511","article-title":"Diagnosis and management of bone stress injuries of the lower limb in athletes","volume":"344","author":"Pegrum","year":"2012","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.surge.2022.06.002","article-title":"Therapeutic ultrasound related pain threshold in elite track & field athletes 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Roentgenol."}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/3\/317\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:00:15Z","timestamp":1786705215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/3\/317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jfmk11030317"],"URL":"https:\/\/doi.org\/10.3390\/jfmk11030317","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]}}}