Amsterdam Rehabilitation Research Center | Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, The Netherlands.
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Rheumatol Int. 2018 May;38(5):749-762. doi: 10.1007/s00296-018-4014-4. Epub 2018 Mar 20.
The study summarizes the evidence on the effectiveness of therapeutic shoes on foot function, foot pain, physical functioning, health-related quality of life, adherence, adverse events and patient satisfaction in patients with rheumatoid arthritis (RA). Studies investigating the effect of (ready- or custom-made) therapeutic shoes were included. For between-group designs, studies comparing therapeutic shoes versus non-therapeutic shoes were included. A literature search was conducted in The Cochrane Central Registry for Controlled Trials (CENTRAL), PubMed, EMBASE and PEDro up to January 19, 2017. Quantitative data analysis was conducted; when this was not possible qualitative data analysis was performed. Eleven studies were identified. For custom-made shoes, no studies reporting between-group differences were available. Qualitative data-syntheses of the within-group differences resulted in weak evidence for the reduction of foot pain and improvement of physical functioning. For ready-made shoes, one study reported between-group differences, resulting in inconclusive evidence for improvement of foot function. Quantitative data-analyses of within-group differences resulted in a medium to large effect for the reduction of foot pain (SMD 0.60, 95% CI 0.28-0.92; P ≤ 0.001; 184 participants) and a small to medium effect for the improvement of physical functioning (SMD 0.30, 95% CI 0.04-0.56; P = 0.02; 150 participants). Qualitative data-synthesis of within-group differences resulted in weak evidence for improvement of foot function. Within-group results indicate that therapeutic shoes are likely to be effective in patients with RA. Definitive high-quality RCTs are necessary to investigate the between-group effectiveness of therapeutic shoes in patients with RA.
本研究总结了治疗鞋对类风湿关节炎（RA）患者足部功能、足部疼痛、身体机能、健康相关生活质量、依从性、不良事件和患者满意度的有效性证据。纳入了研究（现成或定制）治疗鞋效果的研究。对于组间设计，纳入了比较治疗鞋与非治疗鞋的研究。截至 2017 年 1 月 19 日，在 Cochrane 对照试验中心注册库（CENTRAL）、PubMed、EMBASE 和 PEDro 进行了文献检索。进行了定量数据分析；当无法进行定量数据分析时，进行了定性数据分析。确定了 11 项研究。对于定制鞋，没有报告组间差异的研究。对组内差异的定性数据综合分析结果表明，足部疼痛减轻和身体机能改善的证据较弱。对于现成的鞋子，有一项研究报告了组间差异，结果表明对足部功能的改善没有确凿的证据。对组内差异的定量数据分析结果表明，治疗鞋在减轻足部疼痛方面有中到大的效果（SMD0.60，95%CI0.28-0.92；P≤0.001；184 名参与者），在改善身体机能方面有小到中等的效果（SMD0.30，95%CI0.04-0.56；P=0.02；150 名参与者）。对组内差异的定性数据综合分析结果表明，足部功能改善的证据较弱。组内结果表明，治疗鞋可能对 RA 患者有效。需要进行高质量的 RCT 研究，以调查 RA 患者治疗鞋的组间效果。
