Faculty of Allied Health Sciences, Department of Physical Therapy, Chulalongkorn University, Bangkok, Thailand.
PLoS One. 2024 Mar 8;19(3):e0299446. doi: 10.1371/journal.pone.0299446. eCollection 2024.
Individuals with flatfoot have impaired proprioception owing to ligament laxity and impaired tendons, which can result in poor balance. Foot orthoses (FOs) have been reported to stimulate plantar mechanical receptors and are used to manage foot overpronation in individuals with flatfoot. However, the results of the use of FOs to improve balance are inconsistent. In this systematic review and meta-analysis, we aimed to identify and investigate the effects of FOs on balance in individuals with flatfoot. Electronic databases were searched for articles published before March 2023. Peer-reviewed journal studies that included adult participants with flexible flatfoot and reported the effects of FOs on balance were included and classified based on the study design: randomized control trials (RCT) and non-RCTs. Four RCT studies were retained, and their methodological quality was assessed (mean, 63.2%; range 47.3%-73.1%: high), as were three non-RCT studies (mean, 54.1%; range, 42.1%-68.4%: high). Meta-analysis was performed by calculating the effect size using the standardized mean differences between the control and FO conditions. Transverse-arch insoles immediately improved static balance after use. However, no immediate significant effect was found for medial archsupport FOs, cuboid-posting FOs, or University of California Berkeley Laboratory FOs during the study period (2-5 weeks) when compared with the controls. The transverse-arch insole is the most effective FO feature for improving static balance. However, the high heterogeneity between study protocols contributes to the lack of evidence for the effects of FO on balance in people with flatfoot.
扁平足患者由于韧带松弛和肌腱功能受损而存在本体感觉障碍，可能导致平衡能力差。足矫形器（foot orthoses，FOs）已被报道可刺激足底机械感受器，并用于管理扁平足患者的过度内旋。然而，FO 改善平衡的效果结果不一致。在本系统评价和荟萃分析中，我们旨在确定和研究 FOs 对扁平足患者平衡的影响。检索了截至 2023 年 3 月之前发表的文章的电子数据库。纳入了包含柔韧性扁平足成年参与者的同行评审期刊研究，并报告了 FOs 对平衡的影响，并根据研究设计进行分类：随机对照试验（randomized control trials，RCT）和非 RCT。保留了四项 RCT 研究，并对其方法学质量进行了评估（平均为 63.2%；范围为 47.3%-73.1%：高），还评估了三项非 RCT 研究（平均为 54.1%；范围为 42.1%-68.4%：高）。使用对照和 FO 条件之间的标准化均数差来计算效应大小，从而进行荟萃分析。使用横向足弓鞋垫后，静态平衡立即得到改善。然而，与对照组相比，在研究期间（2-5 周），内侧足弓支撑 FO、骰骨posting FO 或加利福尼亚大学伯克利实验室 FO 并未立即发现对静态平衡有显著影响。横向足弓鞋垫是改善静态平衡最有效的 FO 特征。然而，研究方案之间的高度异质性导致缺乏 FO 对扁平足患者平衡影响的证据。
