Toe Separators as a Therapeutic Tool in Physiotherapy-A Systematic Review

Background: Deformities of the foot represent a significant clinical problem. Toe separators constitute an available tool used in various forms of conservative treatment, primarily used for the correction of hallux valgus, but also for improvement in the condition of neurological patients, e.g., after a stroke, or to treat dermatological problems. The goal of this systematic review is to critically assess the current scientific literature on the application of toe separators as a therapeutic intervention in physiotherapy. Methods: A systematic search was conducted across several electronic databases, such as PubMed, Science Direct, and Web of Science. The review included randomized controlled trials, quasi-experimental studies, and observational studies that explored the use of toe separators in physiotherapeutic interventions. Two independent reviewers evaluated all search results to determine eligible studies and assess their methodological quality. Results: A total of 1020 studies were found through the database search. Out of these, 10 studies met the inclusion criteria and were incorporated into the review. The sample sizes of the selected studies varied from 9 to 90 participants. In the majority of the studies, the methodological quality was not mentioned, and a frequent lack of information was noted. Based on a literature analysis, separators were primarily used as a tool for the correction of hallux valgus, but there are also promising results for use in neurology and dermatology as well as affecting the lower leg muscles during gait. Conclusions: The use of toe separators can be a valuable tool for the conservative treatment of hallux valgus and the associated deformities. The research so far varies in describing the type, material, and method of the application of the separators. Studies showed a variety of applications as well as variation in the use of materials. Further research is needed to establish the effectiveness of toe separators in foot disorders more precisely.