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

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.