School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
PLoS One. 2018 Feb 16;13(2):e0193060. doi: 10.1371/journal.pone.0193060. eCollection 2018.
Flexible pes planus (flat feet) in children is a common presenting condition in clinical practice due to concerns amongst parents and caregivers. While Foot Orthoses (FOs) are a popular intervention, their effectiveness remains unclear. Thus, the aim of this systematic review was to update the current evidence base for the effectiveness of FOs for paediatric flexible pes planus.
A systematic search of electronic databases (Cochrane, Medline, AMED, EMBASE, CINHAL, SportDiscus, Scopus and PEDro) was conducted from January 2011 to July 2017. Studies of children (0-18 years) diagnosed with flexible pes planus and intervention to be any type of Foot Orthoses (FOs) were included. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. McMaster critical review form for quantitative studies, was used to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.
Out of 606 articles identified, 11 studies (three RCTs; two case-controls; five case-series and one single case study) met the inclusion criteria. A diverse range of pre-fabricated and customised FOs were utilised and effectiveness measured through a plethora of outcomes. Summarised findings from the heterogeneous evidence base indicated that FOs may have a positive impact across a range of outcomes including pain, foot posture, gait, function and structural and kinetic measures. Despite these consistent positive outcomes reported in several studies, the current evidence base lacks clarity and uniformity in terms of diagnostic criteria, interventions delivered and outcomes measured for paediatric flexible pes planus.
There continues to remain uncertainty on the effectiveness of FOs for paediatric flexible pes planus. Despite a number of methodological limitations, FOs show potential as a treatment method for children with flexible pes planus.
CRD42017057310.
儿童柔韧性足平（扁平足）是临床实践中常见的一种表现，这是由于家长和护理人员的担忧所致。虽然足部矫形器（FOs）是一种流行的干预方法，但它们的有效性仍不清楚。因此，本系统评价的目的是更新目前关于 FO 治疗儿童柔韧性足平的有效性的证据基础。
从 2011 年 1 月至 2017 年 7 月，对电子数据库（Cochrane、Medline、AMED、EMBASE、CINHAL、SportDiscus、Scopus 和 PEDro）进行了系统检索。纳入研究对象为诊断为柔韧性足平的儿童（0-18 岁）和任何类型的足部矫形器（FOs）干预。本综述按照系统评价和荟萃分析的首选报告项目（PRISMA）声明进行。使用 McMaster 定量研究批判性评价表来评估纳入研究的方法学质量。鉴于纳入研究的异质性，对纳入研究进行了描述性综合。
在 606 篇文章中，有 11 项研究（三项 RCT、两项病例对照、五项病例系列和一项单病例研究）符合纳入标准。使用了各种预制和定制的 FO，并通过大量的结果来衡量其有效性。从异质性证据基础中总结出的发现表明，FO 可能对一系列结果（包括疼痛、足姿势、步态、功能以及结构和动力学测量）产生积极影响。尽管有几项研究报告了这些一致的积极结果，但目前的证据基础在儿童柔韧性足平的诊断标准、干预措施和测量结果方面缺乏清晰度和一致性。
对于 FO 治疗儿童柔韧性足平的有效性仍存在不确定性。尽管存在一些方法学限制，但 FO 作为一种治疗柔韧性足平儿童的方法具有潜力。
PROSPERO 注册号：CRD42017057310。
Zotero 插件