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

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  • Ngoc-Tuyet-Trinh Hoang

    (Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan
    Department Physiotherapy, Hong Bang International University, Ho Chi Minh City 700000, Vietnam
    These authors contributed equally to this work.)

  • Shuya Chen

    (Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan
    These authors contributed equally to this work.)

  • Li-Wei Chou

    (Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan
    Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404332, Taiwan
    Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung 413505, Taiwan)

Abstract

Background: Adult flatfoot leads to injury and decreased quality of life. The most widely applied noninvasive approaches are wearing foot orthoses or exercising. Both interventions raise controversy about reducing pain and neutralizing foot posture. This study investigated the impact of foot orthoses and exercise on pain and navicular drop (present for foot posture). Methods: Four databases were used: MEDLINE, PubMed, Web of Science, and Cochrane, from the earliest records to November 2020. Randomized controlled studies focused on adult flatfoot that evaluated the effect of exercise and foot orthoses on pain and navicular drop were extracted. We used data analysis to estimate the relative effect of heterogeneity using I 2 and publication bias using funnel plots. Results: Ten studies were identified through to November 2020. Active interventions (AIs) were exercise and exercise combined with foot orthoses; passive interventions (PIs) were foot orthoses and added stretching. Both AIs and PIs decreased pain significantly (SMD −0.94, 95% CI −1.35, −0.54 and SMD −1.4, 95% CI −1.87, −0.92). The AIs reduced pain level better than PIs. Controversially, no treatment was found to affect navicular drop. Conclusion: Both exercise and foot orthoses can reduce pain but not realign foot posture. Exercise alone or combined with foot orthoses showed a better effect on adult flatfoot than only wearing foot orthoses. Active intervention was shown to have better efficacy in reducing pain than passive intervention.

Suggested Citation

  • Ngoc-Tuyet-Trinh Hoang & Shuya Chen & Li-Wei Chou, 2021. "The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot: A Network Meta-Analysis," IJERPH, MDPI, vol. 18(15), pages 1-17, July.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:15:p:8063-:d:604666
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    References listed on IDEAS

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    1. Manuel Pabón-Carrasco & Aurora Castro-Méndez & Samuel Vilar-Palomo & Ana María Jiménez-Cebrián & Irene García-Paya & Inmaculada C. Palomo-Toucedo, 2020. "Randomized Clinical Trial: The Effect of Exercise of the Intrinsic Muscle on Foot Pronation," IJERPH, MDPI, vol. 17(13), pages 1-11, July.
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