Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review
Abstract Background Dynamic foot function is considered a risk factor for lower limb overuse injuries including Achilles tendinopathy, shin pain, patellofemoral pain and stress fractures. However, no single source has systematically appraised and summarised the literature to evaluate this proposed r...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-014-0053-6 |
| _version_ | 1797321332642283520 |
|---|---|
| author | Geoffrey J Dowling George S Murley Shannon E Munteanu Melinda M Franettovich Smith Bradley S Neal Ian B Griffiths Christian J Barton Natalie J Collins |
| author_facet | Geoffrey J Dowling George S Murley Shannon E Munteanu Melinda M Franettovich Smith Bradley S Neal Ian B Griffiths Christian J Barton Natalie J Collins |
| author_sort | Geoffrey J Dowling |
| collection | DOAJ |
| description | Abstract Background Dynamic foot function is considered a risk factor for lower limb overuse injuries including Achilles tendinopathy, shin pain, patellofemoral pain and stress fractures. However, no single source has systematically appraised and summarised the literature to evaluate this proposed relationship. The aim of this systematic review was to investigate dynamic foot function as a risk factor for lower limb overuse injury. Methods A systematic search was performed using Medline, CINAHL, Embase and SportDiscus in April 2014 to identify prospective cohort studies that utilised dynamic methods of foot assessment. Included studies underwent methodological quality appraisal by two independent reviewers using an adapted version of the Epidemiological Appraisal Instrument (EAI). Effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Results Twelve studies were included (total n = 3,773; EAI 0.44 to 1.20 out of 2.00, representing low to moderate quality). There was limited to very limited evidence for forefoot, midfoot and rearfoot plantar loading variables (SMD 0.47 to 0.85) and rearfoot kinematic variables (RR 2.67 to 3.43) as risk factors for patellofemoral pain; and plantar loading variables (forefoot, midfoot, rearfoot) as risk factors for Achilles tendinopathy (SMD 0.81 to 1.08). While there were significant findings from individual studies for plantar loading variables (SMD 0.3 to 0.84) and rearfoot kinematic variables (SMD 0.29 to 0.62) as risk factors for ‘non‐specific lower limb overuse injuries', these were often conflicting regarding different anatomical regions of the foot. Findings from three studies indicated no evidence that dynamic foot function is a risk factor for iliotibial band syndrome or lower limb stress fractures. Conclusion This systematic review identified very limited evidence that dynamic foot function during walking and running is a risk factor for patellofemoral pain, Achilles tendinopathy, and non‐specific lower limb overuse injuries. It is unclear whether these risk factors can be identified clinically (without sophisticated equipment), or modified to prevent or manage these injuries. Future prospective cohort studies should address methodological limitations, avoid grouping different lower limb overuse injuries, and explore clinically meaningful representations of dynamic foot function. |
| first_indexed | 2024-03-08T04:56:05Z |
| format | Article |
| id | doaj.art-fc3db8e1d1f94a3d977ef81a942c28e5 |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:56:05Z |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-fc3db8e1d1f94a3d977ef81a942c28e52024-02-07T15:16:17ZengWileyJournal of Foot and Ankle Research1757-11462014-01-0171n/an/a10.1186/s13047-014-0053-6Dynamic foot function as a risk factor for lower limb overuse injury: a systematic reviewGeoffrey J Dowling0George S Murley1Shannon E Munteanu2Melinda M Franettovich Smith3Bradley S Neal4Ian B Griffiths5Christian J Barton6Natalie J Collins7Department of PodiatryFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaDepartment of PodiatryFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaDepartment of PodiatryFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaSchool of PhysiotherapyAustralian Catholic UniversityBrisbaneAustraliaPure Sports MedicineLondonUKPure Sports MedicineLondonUKLower Extremity and Gait studies programFaculty of Health SciencesLa Trobe UniversityMelbourneAustraliaDepartment of Mechanical EngineeringMelbourne School of EngineeringThe University of MelbourneMelbourneAustraliaAbstract Background Dynamic foot function is considered a risk factor for lower limb overuse injuries including Achilles tendinopathy, shin pain, patellofemoral pain and stress fractures. However, no single source has systematically appraised and summarised the literature to evaluate this proposed relationship. The aim of this systematic review was to investigate dynamic foot function as a risk factor for lower limb overuse injury. Methods A systematic search was performed using Medline, CINAHL, Embase and SportDiscus in April 2014 to identify prospective cohort studies that utilised dynamic methods of foot assessment. Included studies underwent methodological quality appraisal by two independent reviewers using an adapted version of the Epidemiological Appraisal Instrument (EAI). Effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Results Twelve studies were included (total n = 3,773; EAI 0.44 to 1.20 out of 2.00, representing low to moderate quality). There was limited to very limited evidence for forefoot, midfoot and rearfoot plantar loading variables (SMD 0.47 to 0.85) and rearfoot kinematic variables (RR 2.67 to 3.43) as risk factors for patellofemoral pain; and plantar loading variables (forefoot, midfoot, rearfoot) as risk factors for Achilles tendinopathy (SMD 0.81 to 1.08). While there were significant findings from individual studies for plantar loading variables (SMD 0.3 to 0.84) and rearfoot kinematic variables (SMD 0.29 to 0.62) as risk factors for ‘non‐specific lower limb overuse injuries', these were often conflicting regarding different anatomical regions of the foot. Findings from three studies indicated no evidence that dynamic foot function is a risk factor for iliotibial band syndrome or lower limb stress fractures. Conclusion This systematic review identified very limited evidence that dynamic foot function during walking and running is a risk factor for patellofemoral pain, Achilles tendinopathy, and non‐specific lower limb overuse injuries. It is unclear whether these risk factors can be identified clinically (without sophisticated equipment), or modified to prevent or manage these injuries. Future prospective cohort studies should address methodological limitations, avoid grouping different lower limb overuse injuries, and explore clinically meaningful representations of dynamic foot function.https://doi.org/10.1186/s13047-014-0053-6BiomechanicsPlantar pressuresKinematicsProspective studiesMusculoskeletal diseasesReview |
| spellingShingle | Geoffrey J Dowling George S Murley Shannon E Munteanu Melinda M Franettovich Smith Bradley S Neal Ian B Griffiths Christian J Barton Natalie J Collins Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review Journal of Foot and Ankle Research Biomechanics Plantar pressures Kinematics Prospective studies Musculoskeletal diseases Review |
| title | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
| title_full | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
| title_fullStr | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
| title_full_unstemmed | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
| title_short | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
| title_sort | dynamic foot function as a risk factor for lower limb overuse injury a systematic review |
| topic | Biomechanics Plantar pressures Kinematics Prospective studies Musculoskeletal diseases Review |
| url | https://doi.org/10.1186/s13047-014-0053-6 |
| work_keys_str_mv | AT geoffreyjdowling dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT georgesmurley dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT shannonemunteanu dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT melindamfranettovichsmith dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT bradleysneal dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT ianbgriffiths dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT christianjbarton dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview AT nataliejcollins dynamicfootfunctionasariskfactorforlowerlimboveruseinjuryasystematicreview |