Article type
Abstract
Objective: This study evaluates the effectiveness of foot orthoses versus control groups (waitlist, placebo, no treatment) in treating chronic low back pain (CLBP) among flatfooted patients.
Introduction: Flatfeet can impair lower extremity biomechanics, leading to fatigue and back pain. Foot orthoses aim to correct foot posture, potentially mitigating CLBP. However, research on their efficacy remains inconclusive, underscoring the need for clear treatment guidelines.
Inclusion Criteria: The focus was on custom foot orthoses, including arch supports and medial flanges, comparing their effects on pain intensity and disability against various controls. Data from randomized controlled trials (RCTs) were analyzed using the Visual Analogue Scale and Oswestry Low Back Pain Disability Questionnaire for post-intervention outcomes, without publication date restrictions.
Methods: Adhering to the JBI systematic review methodology and registered with PROSPERO, searches were conducted via PubMed, EBSCO, ProQuest, Google Scholar, and ScienceDirect in July 2023. Following title, abstract, and full-text screenings, selected studies underwent bias assessment using the Cochrane Risk of Bias tool. Data extraction utilized a standardized JBI tool, with analysis performed in RevMan 5.4 and evidence certainty evaluated using the GRADE approach.
Results: Of 3,102 papers, two RCTs with 152 participants (80 experimental, 72 control) were included. One study presented unclear selection bias; other biases were minimal. Significant reductions in pain (mean difference = 3.50; 95% CI = 4.04, 2.97) and disability improvements (mean difference = 13.87; 95% CI = 16.37, 11.37) were observed with no significant heterogeneity (I² = 0%). These findings suggest a statistically and clinically significant reduction in disability and a statistically significant reduction in pain for the experimental group.
Conclusions: Custom foot orthoses (CFO) demonstrate effectiveness in reducing pain and disability in flatfooted CLBP patients, with a notable impact on disability. CFOs potentially correct biomechanical issues by modifying gait and improving neuromuscular control. Despite these positive outcomes, the limited evidence highlights the need for further research to confirm the comprehensive benefits of foot orthotics in CLBP management.
Introduction: Flatfeet can impair lower extremity biomechanics, leading to fatigue and back pain. Foot orthoses aim to correct foot posture, potentially mitigating CLBP. However, research on their efficacy remains inconclusive, underscoring the need for clear treatment guidelines.
Inclusion Criteria: The focus was on custom foot orthoses, including arch supports and medial flanges, comparing their effects on pain intensity and disability against various controls. Data from randomized controlled trials (RCTs) were analyzed using the Visual Analogue Scale and Oswestry Low Back Pain Disability Questionnaire for post-intervention outcomes, without publication date restrictions.
Methods: Adhering to the JBI systematic review methodology and registered with PROSPERO, searches were conducted via PubMed, EBSCO, ProQuest, Google Scholar, and ScienceDirect in July 2023. Following title, abstract, and full-text screenings, selected studies underwent bias assessment using the Cochrane Risk of Bias tool. Data extraction utilized a standardized JBI tool, with analysis performed in RevMan 5.4 and evidence certainty evaluated using the GRADE approach.
Results: Of 3,102 papers, two RCTs with 152 participants (80 experimental, 72 control) were included. One study presented unclear selection bias; other biases were minimal. Significant reductions in pain (mean difference = 3.50; 95% CI = 4.04, 2.97) and disability improvements (mean difference = 13.87; 95% CI = 16.37, 11.37) were observed with no significant heterogeneity (I² = 0%). These findings suggest a statistically and clinically significant reduction in disability and a statistically significant reduction in pain for the experimental group.
Conclusions: Custom foot orthoses (CFO) demonstrate effectiveness in reducing pain and disability in flatfooted CLBP patients, with a notable impact on disability. CFOs potentially correct biomechanical issues by modifying gait and improving neuromuscular control. Despite these positive outcomes, the limited evidence highlights the need for further research to confirm the comprehensive benefits of foot orthotics in CLBP management.