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The online version of this article (doi:10.1186/s13047-014-0055-4) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
GSM, MMFS, BSN, IBG, CJB, SEM and NJC conceived the idea for this review. GSM, MMFS, BSN, IBG designed and piloted the search strategy. GJD undertook the search. Title and abstracts were reviewed by BSN and IBG. Quality appraisal was undertaken by BSN and IBG. Study information extracted by BSN and IBG. Data was extracted and meta-analysis was completed by BSN and CB. The manuscript was drafted by BSN, IBG, CJB, GJD, GSM, MMFS, SEM and NJC. All authors have read and approved the final manuscript.
Static measures of foot posture are regularly used as part of a clinical examination to determine the need for foot level interventions. This is based on the premise that pronated and supinated foot postures may be risk factors for or associated with lower limb injury. This systematic review and meta-analysis investigates foot posture (measured statically) as a potential risk factor for lower limb overuse injuries.
A systematic search was performed using Medline, CINAHL, Embase, SportDiscus in April 2014, to identify prospective cohort studies that investigated foot posture and function as a risk factor for lower limb overuse injury. Eligible studies were classified based on the method of foot assessment: (i) static foot posture assessment; and/or (ii) dynamic foot function assessment. This review presents studies evaluating static foot posture. The methodological quality of included studies was evaluated by two independent reviewers, using an adapted version of the Epidemiological Appraisal Instrument (EAI). Where possible, effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Meta-analysis was performed where injuries and outcomes were considered homogenous.
Twenty-one studies were included (total n = 6,228; EAI 0.8 to 1.7 out of 2.0). There was strong evidence that a pronated foot posture was a risk factor for medial tibial stress syndrome (MTSS) development and very limited evidence that a pronated foot posture was a risk factor for patellofemoral pain development, although associated effect sizes were small (0.28 to 0.33). No relationship was identified between a pronated foot posture and any other evaluated pathology (i.e. foot/ankle injury, bone stress reactions and non-specific lower limb overuse injury).
This systematic review identified strong and very limited evidence of small effect that a pronated foot posture is a risk factor for MTSS and patellofemoral pain respectively. Evaluation of static foot posture should be included in a multifactorial assessment for both MTSS and patellofemoral pain, although only as a part of the potential injury risk profile. Whilst the included measures are clinically applicable, further studies are required to determine their relationship with dynamic foot function.
Additional file 1: PRISMA statement checklist. (DOC 62 KB)13047_2014_55_MOESM1_ESM.doc
Additional file 2: Search strategy. (DOCX 23 KB)13047_2014_55_MOESM2_ESM.docx
Additional file 3: Epidemiological Appraisal Instrument used to rate the quality of the 21 included studies. (PDF 283 KB)13047_2014_55_MOESM3_ESM.pdf
Additional file 4: Results from quality assessment using the Epidemiological Appraisal Instrument (21 included studies). (PDF 221 KB)13047_2014_55_MOESM4_ESM.pdf
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Neely FG: Intrinsic risk factors for exercise related lower limb injuries. Sports Med. 1998, 24: 253-263. 10.2165/00007256-199826040-00004. CrossRef
Noehren B, Davis I, Hamill J: Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clin Biomech. 2007, 22: 951-956. 10.1016/j.clinbiomech.2007.07.001. CrossRef
Tiberio D: The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. J Orthop Sports Phys Ther. 1987, 9: 161-165. 10.2519/jospt.19220.127.116.11. CrossRef
Souza TR, Pinto RZ, Trede RG, Kirkwood RN, Fonseca ST: Temporal couplings between rearfoot shank complex and hip joint during walking. Clin Biomech. 2010, 25: 745-748. 10.1016/j.clinbiomech.2010.04.012. CrossRef
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Int Med. 2009, 151: W65-W94. 10.7326/0003-4819-151-4-200908180-00136. CrossRefPubMed
Dowling, GJ, Murley, GS, Munteanu, SE, Franettovich Smith, MM, Neal, BS, Griffiths, IB, Barton, CJ, Collins, NJ: Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review. J Foot Ankle Res in press.,
Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G: Intrinsic risk factors for the development of anterior knee pain in an athletic population. Am J Sports Med. 2000, 28: 480-489. PubMed
Mei-Dan O, Kahn G, Zeev A, Rubin A, Constantini N, Even A, Nyska M, Mann G: The medial longitudinal arch as a possible risk factor for ankle sprains: a prospective study in 83 female infantry recruits. Foot Ankle Int. 2005, 26: 180-183. PubMed
Twellar M, Verstappen FTJ, Huson A, van Mechelen W: Physical characteristics as risk factors for sports injuries: a four year prospective study. Int J Sports Med. 1997, 18: 66-71. 10.1055/s-2007-972597. CrossRef
Di Caprio F, Buda R, Mosca M, Calabro A, Giannini S: Foot and lower limb diseases in runners: assessment of risk factors. J Sci Med Sport. 2010, 9: 587-596.
Menz HB: Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine. Foot. 2004, 14: 2-5. 10.1016/S0958-2592(03)00047-6. CrossRef
van Tulder M, Furlan A, Bombardier C, Lex B: Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine. 2003, 28: 1290-1299. PubMed
Hubbard TJ, Carpenter EA, Cordova ML: Contributing factors to medial tibial stress syndrome: a prospective investigation. Med Sci Sport Ex. 2009, 41: 490-496. 10.1249/MSS.0b013e31818b98e6. CrossRef
Yagi S, Muneta T, Sekiya I: Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners. Knee Surg Traumatol Arthrosc. 2013, 21: 556-563. 10.1007/s00167-012-2160-x. CrossRef
Hetresoni I, Finestone A, Milgrom C, Ben Sira D, Nyska M, Radeva-Petrova D, Ayalon M: A prospective biomechanical study of the association between foot pronation and the incidence of anterior knee pain among military recruits. J Bone Joint Surg (Br). 2006, 88-B: 905-908. 10.1302/0301-620X.88B7.17826. CrossRef
Thjis Y, De Clercq D, Roosen P, Witvrouw E: Gait related intrinsic risk factors for patellofemoral pain in novice recreational runners. Br J Sports Med. 2008, 42: 466-471. 10.1136/bjsm.2008.046649. CrossRef
Beynonn BD, Renstrom PA, Alosa DM, Baumhauer JF, Vacek PM: Ankle ligament injury risk factors: a prospective study of college athletes. J Orthopt Res. 2001, 19: 213-220. 10.1016/S0736-0266(00)90004-4. CrossRef
Winfield C, Bracker M, Moore J, Johnson CW: Risk factors associated with stress reactions in female marines. Mil Med. 1997, 10: 698-702.
Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR: The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med. 1999, 27: 585-593. PubMed
Jarvis HL, Nester CJ, Jones RK, Williams A, Bowden PD: Inter-assessor reliability of practiced based biomechanical assessment of the foot and ankle. J Foot Ankle Res. 2012, 5: 1-10. 10.1186/1757-1146-5-14. CrossRef
Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, Willsom J, Earl-Beohm JE, Davis IS, Powers CM, McConnell J, Crossley KM: Patellofemoral pain: consensus statement from the 3rd international patellofemoral pain research retreat held in Vancouver, September 2013. Br J Sports Med. 2014, 48: 411-414. 10.1136/bjsports-2014-093450. CrossRefPubMed
Noehren B, Hamill J, Davis I: Prospective evidence for a hip etiology in patellofemoral pain. Med Sci Sport Ex. 2012, 45: 1120-4. 10.1249/MSS.0b013e31828249d2. CrossRef
McPoil TG, Cornwall MW: Relationship between three static angles of the rearfoot and the pattern of rearfoot motion during walking. J Orthopt Sports Phys Ther. 1996, 23: 370-375. 10.2519/jospt.1918.104.22.1680. CrossRef
Deng J, Joseph R, Wong CK: Reliability and validity of the sit to stand navicular drop test: do static measures of navicular height relate to dynamic navicular motion during gait. J Student Phys Ther Res. 2010, 2: 21-28.
Chuter V: Relationships between foot type and dynamic rearfoot frontal plane motion. J Foot Ankle Res. 2010, 3: 1-6. 10.1186/1757-1146-3-9. CrossRef
- Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis
Bradley S Neal
Ian B Griffiths
Geoffrey J Dowling
George S Murley
Shannon E Munteanu
Melinda M Franettovich Smith
Natalie J Collins
Christian J Barton
- BioMed Central