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The online version of this article (doi:10.1186/1757-1146-7-23) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
The protocol for the review was written by HB. Risk of bias, data extraction and analysis was undertaken by HB, SM & DT. All authors contributed to and approved of the final manuscript.
Foot orthoses are widely used in the management of flexible pes planus, yet the evidence to support this intervention has not been clearly defined. This systematic review aimed to critically appraise the evidence for the use of foot orthoses for flexible pes planus in adults.
Electronic databases (Medline, CINAHL, Cochrane, Web of science, SportDiscus, Embase) were systematically searched in June 2013 for randomised controlled, controlled clinical and repeated measure trials where participants had identified flexible pes planus using a validated and reliable measure of pes planus and the intervention was a rigid or semi-rigid orthoses with the comparison being a no-orthoses (shoes alone or flat non-posted insert) condition. Outcomes of interest were foot pain, rearfoot kinematics, foot kinetics and physical function.
Of the 2,211 articles identified by the searches, 13 studies met the inclusion criteria; two were randomised controlled trials, one was a controlled trial and 10 were repeated measure studies. Across the included studies, 59 relevant outcome measures were reported with 17 calculated as statistically significant large or medium effects observed with use of foot orthoses compared to the no orthoses condition (SMD range 1.13 to -4.11).
No high level evidence supported the use of foot orthoses for flexible pes planus. There is good to moderate level evidence that foot orthoses improve physical function (medial-lateral sway in standing (level II) and energy cost during walking (level III)). There is low level evidence (level IV) that foot orthoses improve pain, reduce rearfoot eversion, alter loading and impact forces; and reduce rearfoot inversion and eversion moments in flexible pes planus. Well-designed randomised controlled trials that include appropriate sample sizes, clinical cohorts and involve a measure of symptom change are required to determine the efficacy of foot orthoses to manage adult flexible pes planus.
Additional file 1: Search strategy example, Ovid MEDLINE.(DOCX 19 KB)13047_2013_742_MOESM1_ESM.docx
Additional file 2: Intra- and inter-rater reliability for commonly used measures of pes planus.(DOCX 24 KB)13047_2013_742_MOESM2_ESM.docx
Additional file 3: Risk of bias of included studies (alphabetical order). McMaster critical review tool – quantitative studies. (DOCX 20 KB)13047_2013_742_MOESM3_ESM.docx
Additional file 4: Excluded data based on novel, repetitious or extraneous outcome measures (results reported as significant are bolded).(DOCX 25 KB)13047_2013_742_MOESM4_ESM.docx
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- Foot orthoses for adults with flexible pes planus: a systematic review
Helen A Banwell
- BioMed Central