Alam Md Farhan, Ansari Sumbul, Zaki Saima, Sharma Saurabh, Nuhmani Shibili, Alnagmoosh Abdullah, Alsubaiei Mohammed Essa
Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India.
Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia.
Physiother Theory Pract. 2025 Feb;41(2):390-404. doi: 10.1080/09593985.2024.2325581. Epub 2024 Mar 3.
A link between pronated feet (PF) and chronic low back pain (CLBP) has been reported in the literature. However, physical interventions (PI) like physiotherapy and orthotics mainly target the lower back, neglecting the broader biomechanical impacts of PF that affect the feet, ankles, and overall posture. Currently, there is a lack of comprehensive meta-analyses or systematic reviews on this subject.
This systematic review with a meta-analysis aimed to evaluate the effects of PI on pain and disability in patients having CLBP with PF.
From inception until October 15, 2023, Medline/PubMed, Web of Science, and Scopus databases were searched using the desired keywords for randomized control trials (RCTs). The quality of the RCTs was evaluated using the PEDro scale and risk of bias tool.
Four studies involving 268 patients were identified, two compared custom-made foot orthoses to non-biomechanical foot insoles, while the other two used exercises. The meta-analysis included four studies for pain and three for disability. The results showed a significant change in pain [-2.43 (95% CI -2.73 to -2.13, < .001)] and disability of -6.69 (95% CI -8.04 to -5.33, < .001)].
This systematic review and meta-analysis of four RCTs elucidates that PI, specifically targeting PF, significantly alleviate pain and reduce disability in patients having CLBP with PF. These findings advocate for integrating foot-based PI within the treatment protocols for patients suffering from CLBP accompanied by PF.
文献报道了扁平足（PF）与慢性下腰痛（CLBP）之间的联系。然而，物理治疗和矫形器等物理干预措施主要针对下背部，而忽略了扁平足对足部、脚踝和整体姿势产生的更广泛生物力学影响。目前，关于这一主题缺乏全面的荟萃分析或系统评价。
本系统评价及荟萃分析旨在评估物理干预对患有CLBP合并PF患者的疼痛和功能障碍的影响。
从数据库建立至2023年10月15日，使用所需关键词在Medline/PubMed、科学网和Scopus数据库中检索随机对照试验（RCT）。使用PEDro量表和偏倚风险工具评估RCT的质量。
共纳入4项涉及268例患者的研究，其中2项将定制足部矫形器与非生物力学鞋垫进行比较，另外2项采用运动疗法。荟萃分析纳入了4项关于疼痛的研究和3项关于功能障碍的研究。结果显示疼痛有显著变化[-2.43（95%CI -2.73至-2.13，<0.001）]，功能障碍为-6.69（95%CI -8.04至-5.33，<0.001）。
这项对4项RCT的系统评价和荟萃分析表明，专门针对PF的物理干预可显著减轻患有CLBP合并PF患者的疼痛并降低功能障碍。这些发现支持将基于足部的物理干预纳入伴有PF的CLBP患者的治疗方案中。
