Sahar Tali, Cohen Matan J, Uval-Ne'eman Vered, Kandel Leonid, Odebiyi Daniel Oluwafemi, Lev Ishay, Brezis Mayer, Lahad Amnon
Family Medicine Department, Hebrew University, Jerusalem, Israel.
Spine (Phila Pa 1976). 2009 Apr 20;34(9):924-33. doi: 10.1097/BRS.0b013e31819f29be.
A systematic review of randomized controlled trials.
To determine the effectiveness of shoe insoles in the prevention and treatment of nonspecific back pain compared with placebo, no intervention, or other interventions.
There is lack of theoretical and clinical knowledge of the use of insoles for prevention or treatment of back pain.
We searched electronic databases from inception to October 2008. We reviewed reference lists in review articles, guidelines, and in the included trials; conducted citation tracking; and contacted individuals with expertise in this domain. One review author conducted the searches and blinded the retrieved references for authors, institution, and journal. Two review authors independently selected the relevant articles. Two different review authors independently assessed the methodological quality and clinical relevance and extracted the data from each trial using the criteria recommended by the Cochrane Back Review Group.
Six randomized controlled trials met inclusion criteria: 3 examined prevention of back pain (2061 participants) and 3 examined mixed populations (256 participants) without being clear whether they were aimed at primary or secondary prevention or treatment. No treatment trials were found. There is strong evidence that the use of insoles does not prevent back pain. There is limited evidence that insoles alleviate back pain or adversely shift the pain to the lower extremities.
There is strong evidence that insoles are not effective for the prevention of back pain. The current evidence on insoles as treatment for low back pain does not allow any conclusions.
对随机对照试验的系统评价。
确定与安慰剂、不干预或其他干预措施相比，鞋垫在预防和治疗非特异性背痛方面的有效性。
在使用鞋垫预防或治疗背痛方面，缺乏理论和临床知识。
我们检索了从数据库建立至2008年10月的电子数据库。我们查阅了综述文章、指南及纳入试验中的参考文献列表；进行了引文追踪；并联系了该领域的专家。由一名综述作者进行检索，并对检索到的参考文献隐匿作者、机构和期刊信息。两名综述作者独立选择相关文章。两名不同的综述作者独立评估方法学质量和临床相关性，并根据Cochrane背痛综述组推荐的标准从每个试验中提取数据。
六项随机对照试验符合纳入标准：3项试验研究了背痛的预防（2061名参与者），3项试验研究了混合人群（256名参与者），但不清楚其针对的是一级预防还是二级预防或治疗。未发现治疗试验。有强有力的证据表明使用鞋垫不能预防背痛。有有限的证据表明鞋垫可缓解背痛或使疼痛不利地转移至下肢。
有强有力的证据表明鞋垫对预防背痛无效。目前关于鞋垫治疗腰痛的证据无法得出任何结论。
