Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis
Abstract Background Static measures of foot posture are regularly used as part of a clinical examination to determine the need for foot level interventions. This is based on the premise that pronated and supinated foot postures may be risk factors for or associated with lower limb injury. This syste...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-014-0055-4 |
| _version_ | 1797321273586483200 |
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| author | Bradley S Neal Ian B Griffiths Geoffrey J Dowling George S Murley Shannon E Munteanu Melinda M Franettovich Smith Natalie J Collins Christian J Barton |
| author_facet | Bradley S Neal Ian B Griffiths Geoffrey J Dowling George S Murley Shannon E Munteanu Melinda M Franettovich Smith Natalie J Collins Christian J Barton |
| author_sort | Bradley S Neal |
| collection | DOAJ |
| description | Abstract Background Static measures of foot posture are regularly used as part of a clinical examination to determine the need for foot level interventions. This is based on the premise that pronated and supinated foot postures may be risk factors for or associated with lower limb injury. This systematic review and meta‐analysis investigates foot posture (measured statically) as a potential risk factor for lower limb overuse injuries. Methods A systematic search was performed using Medline, CINAHL, Embase, SportDiscus in April 2014, to identify prospective cohort studies that investigated foot posture and function as a risk factor for lower limb overuse injury. Eligible studies were classified based on the method of foot assessment: (i) static foot posture assessment; and/or (ii) dynamic foot function assessment. This review presents studies evaluating static foot posture. The methodological quality of included studies was evaluated by two independent reviewers, using an adapted version of the Epidemiological Appraisal Instrument (EAI). Where possible, effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Meta‐analysis was performed where injuries and outcomes were considered homogenous. Results Twenty‐one studies were included (total n = 6,228; EAI 0.8 to 1.7 out of 2.0). There was strong evidence that a pronated foot posture was a risk factor for medial tibial stress syndrome (MTSS) development and very limited evidence that a pronated foot posture was a risk factor for patellofemoral pain development, although associated effect sizes were small (0.28 to 0.33). No relationship was identified between a pronated foot posture and any other evaluated pathology (i.e. foot/ankle injury, bone stress reactions and non‐specific lower limb overuse injury). Conclusion This systematic review identified strong and very limited evidence of small effect that a pronated foot posture is a risk factor for MTSS and patellofemoral pain respectively. Evaluation of static foot posture should be included in a multifactorial assessment for both MTSS and patellofemoral pain, although only as a part of the potential injury risk profile. Whilst the included measures are clinically applicable, further studies are required to determine their relationship with dynamic foot function. |
| first_indexed | 2024-03-08T04:55:13Z |
| format | Article |
| id | doaj.art-12b7405d026149c490f911f3a6015f38 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:55:13Z |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-12b7405d026149c490f911f3a6015f382024-02-07T15:16:17ZengWileyJournal of Foot and Ankle Research1757-11462014-01-0171n/an/a10.1186/s13047-014-0055-4Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysisBradley S Neal0Ian B Griffiths1Geoffrey J Dowling2George S Murley3Shannon E Munteanu4Melinda M Franettovich Smith5Natalie J Collins6Christian J Barton7Pure Sports MedicineLondonUKPure Sports MedicineLondonUKDepartment of PodiatryFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaDepartment of PodiatryFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaDepartment of PodiatryFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaSchool of PhysiotherapyAustralian Catholic UniversityBrisbaneAustraliaDepartment of Mechanical EngineeringMelbourne School of EngineeringThe University of MelbourneMelbourneAustraliaPure Sports MedicineLondonUKAbstract Background Static measures of foot posture are regularly used as part of a clinical examination to determine the need for foot level interventions. This is based on the premise that pronated and supinated foot postures may be risk factors for or associated with lower limb injury. This systematic review and meta‐analysis investigates foot posture (measured statically) as a potential risk factor for lower limb overuse injuries. Methods A systematic search was performed using Medline, CINAHL, Embase, SportDiscus in April 2014, to identify prospective cohort studies that investigated foot posture and function as a risk factor for lower limb overuse injury. Eligible studies were classified based on the method of foot assessment: (i) static foot posture assessment; and/or (ii) dynamic foot function assessment. This review presents studies evaluating static foot posture. The methodological quality of included studies was evaluated by two independent reviewers, using an adapted version of the Epidemiological Appraisal Instrument (EAI). Where possible, effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Meta‐analysis was performed where injuries and outcomes were considered homogenous. Results Twenty‐one studies were included (total n = 6,228; EAI 0.8 to 1.7 out of 2.0). There was strong evidence that a pronated foot posture was a risk factor for medial tibial stress syndrome (MTSS) development and very limited evidence that a pronated foot posture was a risk factor for patellofemoral pain development, although associated effect sizes were small (0.28 to 0.33). No relationship was identified between a pronated foot posture and any other evaluated pathology (i.e. foot/ankle injury, bone stress reactions and non‐specific lower limb overuse injury). Conclusion This systematic review identified strong and very limited evidence of small effect that a pronated foot posture is a risk factor for MTSS and patellofemoral pain respectively. Evaluation of static foot posture should be included in a multifactorial assessment for both MTSS and patellofemoral pain, although only as a part of the potential injury risk profile. Whilst the included measures are clinically applicable, further studies are required to determine their relationship with dynamic foot function.https://doi.org/10.1186/s13047-014-0055-4Lower extremityFootPronationSupinationProspective studiesRisk factors |
| spellingShingle | Bradley S Neal Ian B Griffiths Geoffrey J Dowling George S Murley Shannon E Munteanu Melinda M Franettovich Smith Natalie J Collins Christian J Barton Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis Journal of Foot and Ankle Research Lower extremity Foot Pronation Supination Prospective studies Risk factors |
| title | Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis |
| title_full | Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis |
| title_fullStr | Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis |
| title_full_unstemmed | Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis |
| title_short | Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta‐analysis |
| title_sort | foot posture as a risk factor for lower limb overuse injury a systematic review and meta analysis |
| topic | Lower extremity Foot Pronation Supination Prospective studies Risk factors |
| url | https://doi.org/10.1186/s13047-014-0055-4 |
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