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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 1

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Custom‐made foot orthoses versus sham, Outcome 1 Change in foot pain at three months.
Figuras y tablas -
Analysis 1.1

Comparison 1 Custom‐made foot orthoses versus sham, Outcome 1 Change in foot pain at three months.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 1 Change of calcaneal‐first metatarsal angle.
Figuras y tablas -
Analysis 2.1

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 1 Change of calcaneal‐first metatarsal angle.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 2 Change of tibia‐calcaneal angle.
Figuras y tablas -
Analysis 2.2

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 2 Change of tibia‐calcaneal angle.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 3 Change of Foot Posture Index.
Figuras y tablas -
Analysis 2.3

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 3 Change of Foot Posture Index.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 4 Change of ankle dorsiflexion range of motion.
Figuras y tablas -
Analysis 2.4

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 4 Change of ankle dorsiflexion range of motion.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 5 Change of dorsiflexion foot strength.
Figuras y tablas -
Analysis 2.5

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 5 Change of dorsiflexion foot strength.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 6 Change of plantarflexion foot strength.
Figuras y tablas -
Analysis 2.6

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 6 Change of plantarflexion foot strength.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 7 Change of inversion foot strength.
Figuras y tablas -
Analysis 2.7

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 7 Change of inversion foot strength.

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Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 8 Change of eversion foot strength.
Figuras y tablas -
Analysis 2.8

Comparison 2 Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text), Outcome 8 Change of eversion foot strength.

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Table 1. Custom foot orthoses on pain, function, quality of life and plantar pressure

Outcome measures

No. of participants

Sham orthoses

Custom orthoses

Statistical method

Effect size

Change in foot pain at three months

154

20.30 (22.70)

31.20 (25.80)

WMD (fixed), 95% CI

10.90 (3.21to 18.59)

Change in foot function at three months

154

14.60 (20.60)

25.60 (27.20)

WMD (fixed), 95% CI

11.0 (3.35 to 18.65)

Change in physical function at three months

154

2.60 (14.60)

12.10 (19.30)

WMD (fixed), 95% CI

9.50 (4.07 to 14.93)

Change in general health at three months

154

3.00 (20.80)

3.50 (18.40)

WMD (fixed), 95% CI

0.50 (‐5.70 to 6.70)

Change in vitality at three months

154

3.00 (15.20)

8.50 (17.80)

WMD (fixed), 95% CI

5.50 (0.26 to 10.74)

Change in social function at three months

154

6.20 (16.20)

8.70 (20.10)

WMD (fixed), 95% CI

2.50 (‐3.28 to 8.28)

Change in pressure‐time integral (N.s/cm2, whole foot) at baseline

154

‐1.60 (1.70)

‐4.50 (2.70)

WMD (fixed), 95% CI

‐2.90 (‐3.62 to ‐2.18)

Change in pressure‐time integral (N.s/cm2, rearfoot) at baseline

154

‐0.70 (0.80)

‐1.90 (1.40)

WMD (fixed), 95% CI

‐1.20 (‐1.56 to ‐0.84)

Change in pressure‐time integral (N.s/cm2, midfoot) at baseline

154

‐0.20 (0.60)

0.30 (2.20)

WMD (fixed), 95% CI

0.50 (‐0.02 to 1.02)

Change in pressure‐time integral (N.s/cm2, forefoot) at baseline

154

‐1.40 (2.00)

‐3.20 (2.90)

WMD (fixed), 95% CI

‐1.80 (‐2.59to ‐1.01)

Adverse events at three months

154

12/79

7/75

RR (fixed), 95% CI

0.61 (0.26 to 1.48)
Figuras y tablas -
Table 1. Custom foot orthoses on pain, function, quality of life and plantar pressure
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Table 2. Running footwear on plantar pressure

Outcome measure

No. of participants

1. Control

2. Asics Nimbus

3. Brooks Glycerin

Statistical method

Effect size (1 versus 2)

Effect size (1 versus 3)

Effect size (2 versus 3)

Peak pressure (kPa, whole foot)

22

513.4 (78.9)

399.4 (88.6)

361.2 (82.2)

WMD (Fixed), 95% CI

‐114.00 (‐163.58 to ‐64.42)

‐152.20 (‐199.81 to ‐104.59)

‐38.20 (‐88.70 to 12.30)

Peak pressure (kPa, rearfoot)

22

358.1 (173.8)

240.9 (91.9)

264.4 (90.5)

WMD (Fixed), 95% CI

‐117.20 (‐199.35 to ‐35.05)

‐93.70 (‐175.58 to ‐11.82)

23.50 (‐30.40 to 77.40)

Peak pressure (kPa, midfoot)

22

168.6 (68.1)

126.3 (31.0)

131.4 (34.4)

WMD (Fixed), 95% CI

‐42.30 (‐73.57to ‐11.03)

‐37.20 (‐69.08 to ‐5.32)

5.10 (‐14.25to 24.45)

Peak pressure (kPa, forefoot)

22

464.2 (106.4)

386.1 (100.0)

340.8 (89.4)

WMD (Fixed), 95% CI

‐78.10 (‐139.12to ‐17.08)

‐123.40 (‐181.47to ‐65.33)

‐45.30 (‐101.35to 10.75)

Pressure time integral (kPa.s, whole foot)

22

69.9 (12.4)

55.6 (12.2)

51.7 (9.7)

WMD (Fixed), 95% CI

‐14.30 (‐21.57to ‐7.03)

‐18.20 (‐24.78to ‐11.62)

‐3.90 (‐10.41to 2.61)

Pressure time integral (kPa.s, rearfoot)

22

19.8 (10.9)

17.2 (6.9)

18.8 (7.6)

WMD (Fixed), 95% CI

‐2.60 (‐7.99 to 2.79)

‐1.00 (‐6.55to 4.55)

1.60 (‐2.69 to 5.89)

Pressure time integral (kPa.s, midfoot)

22

15.3 (7.7)

14.4 (3.9)

14.8 (4.4)

WMD (Fixed), 95% CI

‐0.90 (‐4.51to 2.71)

‐0.50 (‐4.21to 3.21)

0.40 (‐2.06 to 2.86)

Pressure time integral (kPa.s, forefoot)

22

63.9 (13.2)

50.3 (12.3)

46.0 (9.6)

WMD (Fixed), 95% CI

‐13.60 (‐21.14 to ‐6.06)

‐17.90 (‐24.72 to ‐11.08)

‐4.30 (‐10.82 to 2.22)

Force (%Body Weight, whole foot)

22

226.2 (23.1)

217.1 (20.4)

219.4 (17.2)

WMD (Fixed), 95% CI

‐9.10 (‐21.98 to 3.78)

‐6.80 (‐18.83 to 5.23)

2.30 (‐8.85to 13.45)

Force (%Body Weight, rearfoot)

22

97.4 (43.3)

90.3 (34.9)

95.9 (30.3)

WMD (Fixed), 95% CI

‐7.10 (‐30.34 to 16.14)

‐1.50 (‐23.58 to 20.58)

5.60 (‐13.71 to 24.91)

Force (%Body Weight, midfoot)

22

25.6 (12.3)

30.0 (7.0)

28.6 (8.3)

WMD (Fixed), 95% CI

4.40 (‐1.51 to 10.31)

3.0 (‐3.20 to 9.20)

‐1.40 (‐5.94 to 3.14)

Force (%Body Weight, forefoot)

22

188.0 (21.5)

176.4 (24.3)

175.9 (20.6)

WMD (Fixed), 95% CI

‐11.60 (‐25.16 to 1.96)

‐12.10 (‐24.54 to 0.34)

‐0.50 (‐13.81 to 12.81)
Figuras y tablas -
Table 2. Running footwear on plantar pressure
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Table 3. Off‐the‐shelf foot orthoses on upper leg EMG during selected exercises

Outcome measure

No. of participants

1. No orthoses

2. Medial orthoses

3. Neutral orthoses

4. Lateral orthoses

Statistical method

Effect size (1 versus 2)

Effect size (1 versus 3)

Effect size (1 versus 4)

Vastus Medialis EMG during squat

10

1.14 (0.98)

1.19 (0.94)

1.24 (1.15)

1.22 (1.00)

WMD (fixed), 95% CI

0.05 ‐0.79 to 0.89)

0.10 (‐0.84 to 1.04)

0.08 (‐0.79 to 0.95

Vastus Medialis EMG during stepdown

10

0.99 (0.67)

1.33 (1.36)

1.27 (1.23)

1.42 (1.49)

WMD (fixed), 95% CI

0.34 (‐0.60 to 1.28)

0.28 (‐0.59 to 1.15)

0.43 (‐0.58to 1.44)

Vastus Medialis EMG during vertical jump

10

1.15 (0.54)

1.32 (0.88)

1.26 (0.70)

1.28 (0.73)

WMD (fixed), 95% CI

0.17 (‐0.47to 0.81)

0.11 (‐0.44to 0.66)

0.13 (‐0.43to 0.69)

Vastus Lateralis EMG during squat

10

1.07 (0.63)

0.95 (0.42)

0.99 (0.47)

0.97 (0.47)

WMD (fixed), 95% CI

‐0.12 (‐0.59to 0.35)

‐0.08 (‐0.57to 0.41)

‐0.10 (‐0.59to 0.39)

Vastus Lateralis EMG during stepdown

10

0.98 (0.56)

1.08 (0.60)

1.09 (0.65)

1.13 (0.70)

WMD (fixed), 95% CI

0.10 (‐0.41to 0.61)

0.11 (‐0.42to 0.64)

0.15 (‐0.41to 0.71)

Vastus Lateralis EMG during vertical jump

10

1.31 (1.31)

1.25 (0.62)

1.27 (0.62)

1.28 (0.54)

WMD (fixed), 95% CI

‐0.06 (‐0.96to 0.84)

‐0.04 (‐0.94 to 0.86)

‐0.03 (‐0.91to 0.85)

Gluteus Medius EMG during squat

10

0.66 (0.26)

0.67 (0.24)

0.69 (0.26)

0.70 (0.30)

WMD (fixed), 95% CI

0.01 (‐0.21to 0.23)

0.03 (‐0.20 to 0.26)

0.04 (‐0.21to 0.29)

Gluteus Medius EMG during stepdown

10

0.62 (0.23)

0.74 (0.39)

0.72 (0.33)

0.74 (0.44)

WMD (fixed), 95% CI

0.12 (‐0.16 to 0.40)

0.10 (‐0.15 to 0.35)

0.12 (‐0.19to 0.43)

Gluteus Medius EMG during vertical jump

10

0.90 (0.34)

1.02 (0.41)

0.96 (0.35)

1.05 (0.45)

WMD (fixed), 95% CI

0.12 (‐0.21to 0.45)

0.06 (‐0.24to 0.36)

0.15 (‐0.20to 0.50)
Figuras y tablas -
Table 3. Off‐the‐shelf foot orthoses on upper leg EMG during selected exercises
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Table 4. Botulinum toxin type‐A on radiographic alignment, Foot Posture Index, ankle dorsiflexion range of motion, foot strength

Outcome Measure

No. of participants

Control Leg

BoNT‐A Leg

Statistical Method

Effect Size

Change of calcaneal‐first metatarsal angle

10

‐3.2 (4.2)

‐2.2 (3.3)

WMD (fixed), 95% CI

1.00 (‐2.31 to 4.31)

Change of tibia‐calcaneal angle

10

‐2.1 (3.7)

‐1.0 (2.9)

WMD (fixed), 95% CI

1.10 (‐1.81 to 4.01)

Change of Foot Posture Index

10

1.3 (2.5)

‐0.2 (2.4)

WMD (fixed), 95% CI

‐1.50 ‐3.65 to 0.65)

Change of ankle dorsiflexion range of motion

10

5.3 (7.4)

3.1 (6.3)

WMD (fixed), 95% CI

‐2.20 ‐8.22 to 3.82)

Change of dorsiflexion foot strength

10

19.5 (22.7)

19.9 (24.8)

WMD (fixed), 95% CI

0.40 (‐20.44 to 21.24)

Change of plantarflexion foot strength

10

50.6 (58.1)

61.5 (59.9)

WMD (fixed), 95% CI

10.90 (‐40.82 to 62.62)

Change of inversion foot strength

10

28.8 (40.4)

35.8 (35.2)

WMD (fixed), 95% CI

7.00 (‐26.21 to 40.21)

Change of eversion foot strength

10

31.0 (34.5)

24.8 (26.0)

WMD (fixed), 95% CI

‐6.20 (‐32.98 to 20.58)
Figuras y tablas -
Table 4. Botulinum toxin type‐A on radiographic alignment, Foot Posture Index, ankle dorsiflexion range of motion, foot strength
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Comparison 1. Custom‐made foot orthoses versus sham

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in foot pain at three months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 Foot pain

1

154

Mean Difference (IV, Fixed, 95% CI)

10.90 [3.21, 18.59]
Figuras y tablas -
Comparison 1. Custom‐made foot orthoses versus sham
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Comparison 2. Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change of calcaneal‐first metatarsal angle Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

1.0 [‐2.31, 4.31]

2 Change of tibia‐calcaneal angle Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

1.1 [‐1.81, 4.01]

3 Change of Foot Posture Index Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

‐1.5 [‐3.65, 0.65]

4 Change of ankle dorsiflexion range of motion Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

‐2.20 [‐8.22, 3.82]

5 Change of dorsiflexion foot strength Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐20.44, 21.24]

6 Change of plantarflexion foot strength Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

10.90 [‐40.82, 62.62]

7 Change of inversion foot strength Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

7.00 [‐26.21, 40.21]

8 Change of eversion foot strength Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

‐6.20 [‐32.98, 20.58]
Figuras y tablas -
Comparison 2. Botulinum toxin type‐A versus control (note number of participants refers to legs not people ‐ see text)
Ir a la tabla de la revisión