Liu Chao, Zhang HongHao, Li JianPing, Li ShiJia, Li GuQiang, Jiang XiangZhan
Department of Special Education and Rehabilitation, Binzhou Medical University, Yantai, Shandong, China.
Front Pediatr. 2024 Aug 2;12:1388248. doi: 10.3389/fped.2024.1388248. eCollection 2024.
This study aimed to investigate the impact of foot orthoses on foot radiological parameters and pain in children diagnosed with flexible flatfoot.
A comprehensive search was conducted across several databases, including PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO, covering publications from the inception of each database up to 8 June 2024. The study focused on randomized controlled trials investigating the use of foot orthoses for treating flexible flat feet in children. Four researchers independently reviewed the identified literature, extracted relevant data, assessed the quality of the studies, and performed statistical analyses using RevMan 5.4 software.
Six studies involving 297 participants were included. The methodological quality of the included literature ranged from moderate to high. Radiological parameters of the foot improved significantly in older children with flexible flat feet following foot orthotic intervention compared to controls, particularly in the lateral talar-first metatarsal angle [mean difference (MD) = -2.76, 95% confidence interval (95% CI) -4.30 to -1.21, = 0.0005], lateral talo-heel angle (MD = -5.14, 95% CI -7.76 to -2.52, = 0.0001) and calcaneal pitch angle (MD = 1.79, 95% CI 0.88-2.69, = 0.0001). These differences were statistically significant. Additionally, foot orthoses significantly improved the ankle internal rotation angle and reduced foot pain in children with symptomatic flexible flatfoot (MD = -2.51, 95% CI -4.94 to -0.07, = 0.04).
The use of foot orthoses positively impacts the improvement of radiological parameters of the foot and reduces pain in older children with flexible flat feet. However, in younger children with flexible flat feet, the improvement from foot orthoses was not significant, likely due to challenges in radiological measurements caused by the underdevelopment of the ossification centers in the foot. Further studies are needed. Consequently, the results of this meta-analysis support the implementation of an early intervention strategy using foot orthoses for the management of symptomatic flat feet in older children.
https://www.crd.york.ac.uk/, PROSPERO [CRD42023441229].
本研究旨在调查足部矫形器对被诊断为柔韧性扁平足儿童的足部放射学参数及疼痛的影响。
在多个数据库中进行了全面检索，包括PubMed、科学网、EMBASE、考克兰图书馆和EBSCO，涵盖各数据库自创建起至2024年6月8日的出版物。该研究聚焦于调查使用足部矫形器治疗儿童柔韧性扁平足的随机对照试验。四名研究人员独立审查了所识别的文献，提取相关数据，评估研究质量，并使用RevMan 5.4软件进行统计分析。
纳入了六项涉及297名参与者的研究。所纳入文献的方法学质量从中等到高等不等。与对照组相比，柔韧性扁平足的大龄儿童在接受足部矫形器干预后足部放射学参数有显著改善，尤其是在距骨-第一跖骨外侧角[平均差（MD）=-2.76，95%置信区间（95%CI）-4.30至-1.21，P=0.0005]、距骨-跟骨外侧角（MD=-5.14，95%CI -7.76至-2.52，P=0.0001）和跟骨倾斜角（MD=1.79，95%CI 0.88 - 2.69，P=0.0001）方面。这些差异具有统计学意义。此外，足部矫形器显著改善了有症状的柔韧性扁平足儿童的踝关节内旋角度并减轻了足部疼痛（MD=-2.51，95%CI -4.94至-0.07，P=0.04）。
使用足部矫形器对改善足部放射学参数有积极影响，并减轻了柔韧性扁平足大龄儿童的疼痛。然而，对于柔韧性扁平足的年幼儿童，足部矫形器的改善并不显著，这可能是由于足部骨化中心发育不全导致放射学测量存在困难。需要进一步研究。因此，本荟萃分析的结果支持实施一项早期干预策略，即使用足部矫形器来管理大龄儿童有症状的扁平足。
https://www.crd.york.ac.uk/，PROSPERO [CRD42023441229] 。
