Orthotic treatment for stage I and II posterior tibial tendon dysfunction (flat foot): A systematic review

Abstract

Objective: To investigate whether orthotic treatment is effective for the treatment of posterior tibial tendon dysfunction stages I and II (flat foot). Data Sources: Five databases (PubMed, Scopus, PEDro, SPORTDiscus and The Cochrane Library) were searched for potential RCTs from their inception until August 2020. Review Methods: Only randomised controlled trials (RCT) that included subjects diagnosed with posterior tibial dysfunction in the initial stage and treated with orthotic treatments were selected. The outcomes assessed were whatever symptom related to posterior tibial tendon dysfunction stage I and II. Included RCTs were appraised using the Cochrane collaboration risk of bias tool. Results: Four RCT articles and 186 subjects were included. 75% were at high risk of bias for blinding of participants and personnel. Three different types of conservative treatment were used in the studies: foot/ankle-foot orthoses, footwear and stretching /strengthening exercises. Foot orthoses, together with exercise programmes, seemed to improve the effect of orthotic treatment. Foot orthoses with personalised internal longitudinal arch support were more effective than flat insoles or standard treatments in reducing pain. Conclusions: The use of orthotic treatment may be effective in reducing pain in the early stages of posterior tibial tendon dysfunction. Further research is needed into individualised orthotic treatment and high-intensity monitored exercise programmes.

The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot: A Network Meta-Analysis

“…First, navicular drop was not significantly decreased after using AI or PI over 2 to 16 weeks of follow-up. This result was similar to previous studies [12,13]. Banwell et al [13]…”

“…First, navicular drop was not significantly decreased after using AI or PI over 2 to 16 weeks of follow-up. This result was similar to previous studies [12,13]. Banwell et al [13] conducted a systematic review of 13 studies on the effect of orthoses on flexible flatfoot.…”

“…If the data were not published, we contacted the primary authors for more specific information; if none was available, the study was excluded. The quality of studies was verified by using the physiotherapy evidence database [12] tool. PEDro has 11 items, with "yes" scoring 1 and "no" scoring 0, ranked from 0 to 10, excluding the first item.…”

“…Half of all adults with flatfoot in Australia use foot orthoses to prevent excessive foot pronation [11]. The effect of orthoses on adult flatfoot in reducing pain cannot be denied, especially at the early stage of deformity [12,13]. Exercises for flatfoot are widely used and provide some benefits in terms of decreasing pain [14].…”

Custom-Made Foot Orthotics for People With Lower Limb Conditions

“…Six systematic reviews, 1,5,7,8,27,28 5 RCTs, 9,[29][30][31][32] 1 economic evaluation, 33 and 2 evidence-based guidelines 34,35 were included in this report.…”