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Do foot orthoses prevent injury?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Hylton Menz, Jul 26, 2007.

  1. Hylton Menz

    Hylton Menz Guest


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    From the 2nd edition of Evidence-Based Sports Medicine:

    Landorf KB and Keenan A-M. Do foot orthoses prevent injury? In McCauley D and Best T (Eds.), Evidence-based Sports Medicine (2nd ed.); Pages 73-92. Blackwell Publishing: Malden Massachusetts.

    This book chapter presents the findings from a systematic review of the literature. Using rigorous systematic review methodology the authors attempted to answer the question “Do foot orthoses prevent injury?” All trials identified in the review were rated for methodological quality using a validated quality index (the PEDro scale) and a summary of the evidence is provided. The following are the Conclusion and Summary from this book chapter.

    Conclusion

    Twelve randomized or quasi-randomized trials were identified in this systematic review, of which six related to shock-absorbing orthoses and six to motion-controlling orthoses. The trials mostly used large sample sizes, but their quality ratings were generally low. The evidence suggests (i) that shock-absorbing insoles and heel pads do not prevent injury, and (ii) that motion-controlling foot orthoses decrease the incidence of stress fractures (particularly femoral stress fractures) and shin splints. Better-quality trials are required in order to confirm or refute the evidence to date. Future trials should attempt to evaluate commonly used orthoses; should use consistent outcome measures to assist with pooling results for meta-analysis; and the findings should be reported using the CONSORT guidelines to ensure greater transparency.

    Summary

    • Foot orthoses are widely used to treat and prevent injury.

    • Although a considerable amount is known about the biomechanical/functional effects of foot orthoses, less is known about their effectiveness for preventing injury.

    • Most trials that have evaluated whether they prevent injury have used military recruits during basic training.

    • Although most of these trials have included large sample sizes, they are generally methodologically poor.

    • This limited evidence suggests that shock-absorbing insoles and heel pads do not prevent injury.

    • Limited evidence suggests that motion-controlling (biomechanical) foot orthoses decrease the incidence of stress fractures (particularly femoral stress fractures) and shin splints.

    • Better-quality randomized trials are required in order to provide more precise estimates of the effect of foot orthoses when used to prevent injury.
     
  2. Looks like an interesting chapter. Congratulations to Karl and Anne-Marie.

    I have also just finished a chapter on foot orthoses for sports. The chapter is titled "Evolution of Foot Orthoses in Sports: Biomechanical Effects" in a book to be published next year by Springer titled "Athletic Footwear and Foot Orthoses in Sports Medicine" in which I go through the definition of foot orthoses, history of foot orthoses, the research on therapeutic effectiveness of foot orthoses, the research on the biomechanics of foot orthoses, and on proposed theories of foot orthosis function.

    It is very good to see mainstream publishers become interested in foot orthoses. This is very positive news for the podiatry profession and for those who specialize in foot orthoses for athletes.
     
  3. Question: How do you know if a foot orthosis prevented an injury if we cannot accurately predict injury?

    Which injuries can we accurately predict and what are the equations for these?
     
  4. Paulo Silva

    Paulo Silva Active Member

    It sounds very interesting can you please let me know after the release?

    Tank you :)
     
  5. Stanley

    Stanley Well-Known Member

    I remember Dick Schuster did a study on runners on the cross country team at Rutgers University. He would measure total varus, and from this he would predict injuries. He would predict an injury for anyone that had total varus above 10 degrees . If I remember correctly, he was 90% accurate in his predictions. I looked for a reference, and I found this:

    CF Ross and RO Schuster
    A preliminary report on predicting injuries in distance runners
    J Am Podiatr Med Assoc 1983 73: 275-277.

    I don't have the reprints or abstract, but the timing is correct, so I am pretty sure this is the article.

    Regards,

    Stanley
     
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