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Optimizing Flatfoot Management With Foot Orthoses: A Systemic Review and Meta-analysis.

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  • 1Department of Rehabilitation Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.

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Foot orthoses, specifically insoles, are effective for treating flexible flatfoot. Combining insoles with exercise offers significant pain reduction and improved biomechanical outcomes for flatfoot management.

Keywords:
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Area of Science:

  • Orthopedics and Sports Medicine
  • Biomechanics
  • Rehabilitation

Background:

  • Flexible flatfoot is a common condition affecting foot posture and function.
  • Conservative management strategies aim to alleviate pain and improve biomechanics.
  • Various interventions, including foot orthoses (insoles) and exercises, are used for flatfoot treatment.

Purpose of the Study:

  • To conduct a network meta-analysis evaluating the effectiveness of different foot orthoses for flatfoot.
  • To compare the clinical, biomechanical, and radiological outcomes of various interventions for flatfoot.

Main Methods:

  • A systematic search of randomized controlled trials (RCTs) was performed in major databases (PubMed, Cochrane Library, Embase) up to November 2024.
  • Included studies focused on flatfoot interventions such as insoles and exercises, with diverse outcome measures.
  • Eight RCTs involving 369 participants were analyzed.

Main Results:

  • Insoles, alone or combined with exercise, significantly reduced pain in individuals with flatfoot.
  • Exercise alone demonstrated the most substantial improvement in navicular drop.
  • Insole use positively impacted calcaneal pitch and reduced center of pressure displacement, indicating improved biomechanics.

Conclusions:

  • Foot orthoses, particularly insoles, represent an effective conservative treatment for flexible flatfoot.
  • Future research should integrate clinical, biomechanical, and radiographic outcomes to refine flatfoot management strategies.