Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, ST4 2DF, UK.
J Foot Ankle Res. 2020 May 13;13(1):23. doi: 10.1186/s13047-020-00390-3.
It is estimated that 2% of the global childhood population is living with some form of mobility impairment. Although footwear interventions are proposed to aid ambulation, there appears to be a paucity in the understanding of the effects of therapeutic footwear. This review aims to explore the effectiveness of footwear as an intervention for mobility impairment in children.
A systematic search of MEDLINE, CINAHL, PubMed, SPORTdiscus and Scopus databases were performed. Studies which focused on children with some form of mobility impairment, age of 9 months to 18 years, therapeutic footwear that allowed walking, and outcome measures that had explored biomechanical or skeletal geometry or psychosocial aspects were included in this review. Modified Downs and Black quality assessment index of randomised and non-randomised studies were used to assess the methodologies of included papers.
Out of 5003 articles sourced, 13 met the inclusion criteria for this review. These were grouped into two titled "corrective and "functional" based on the types of footwear used for intervention. Studies within the corrective footwear group included participants aged 11 months to 5 years with moderate congenital talipes equino varus or mobile pes planus. While using skeletal geometry as an outcome, there was a limited fair quality (level II) evidence that corrective footwear has no significant effect on the development of pes planus but may assist in the reduction of deformity in congenital talipes equino varus. The functional footwear group included participants aged 3 to 17 years, predominantly with mobile pes planus or cerebral palsy. Based on biomechanical measures as an outcome, there was a limited fair quality (level III) evidence that functional footwear alters biomechanical parameters in mobile pes planus (spatiotemporal) and cerebral palsy (spatiotemporal, kinematic). Although psychosocial outcomes were considered within two studies, the analysis was limited.
Only a limited number of studies have explored the effects of therapeutic footwear and only in a narrow range of mobility impairments. Further high-quality research is required to improve the evidence base for the effectiveness of therapeutic footwear. This should include a wide range of mobility impairments and should focus both on physical and psychosocial outcomes.
据估计，全球有 2%的儿童存在某种形式的行动障碍。虽然有人提出通过矫形鞋来辅助行走，但对矫形鞋疗效的理解似乎仍存在不足。本综述旨在探讨矫形鞋作为儿童行动障碍干预手段的效果。
系统检索 MEDLINE、CINAHL、PubMed、SPORTDiscus 和 Scopus 数据库。纳入研究对象为存在某种形式行动障碍、年龄在 9 个月至 18 岁之间、可进行行走的矫形鞋、并探索了生物力学或骨骼几何形状或心理社会方面结果的儿童。采用改良 Downs 和 Black 随机和非随机研究质量评估指数对纳入文献的方法学进行评估。
从 5003 篇文章中筛选出 13 篇符合本综述纳入标准的文章。这些文章根据干预所使用的矫形鞋类型分为“矫正”和“功能”两类。矫正鞋组的研究纳入年龄在 11 个月至 5 岁的患有中度先天性马蹄内翻足或可活动性扁平足的参与者。虽然使用骨骼几何形状作为结果，但仅有有限的低质量（II 级）证据表明，矫正鞋对扁平足的发展没有显著影响，但可能有助于减轻先天性马蹄内翻足的畸形。功能性鞋组的参与者年龄为 3 至 17 岁，主要患有可活动性扁平足或脑瘫。基于作为结果的生物力学测量，仅有有限的低质量（III 级）证据表明，功能性矫形鞋改变了可活动性扁平足（时空）和脑瘫（时空、运动学）的生物力学参数。尽管有两项研究考虑了心理社会结果，但分析受到限制。
只有少数研究探索了矫形鞋的效果，而且仅在狭窄的行动障碍范围内进行。需要进一步开展高质量的研究，以提高矫形鞋疗效的证据基础。这应包括广泛的行动障碍，并应同时关注身体和心理社会结果。
