Foot orthoses for flexible flatfeet in children and adults: a systematic review and meta-analysis of patient-reported outcome measures

Background: This systematic review and meta-analysis provides an overview of the effectiveness of orthoses for flexible flatfeet in terms of patient-reported outcome measures (PROMs) in children and adults. Methods: : Electronic databases were searched for studies comparing PROMs at baseline and follow-up in an orthoses versus control group. Methodological quality of the studies was assessed and a meta-analysis was performed if there were multiple studies with the same PROM. Results: : Four randomized controlled trials (RCTs) in children (N=353) and four RCTs and one prospective study in adults (N=268) were included. There was considerable heterogeneity between studies. A meta-analysis demonstrated that pain reduction between baseline and follow-up was significantly larger in the orthoses (N=167) than in the control groups in adults (N=157; p=0.05). Conclusion: Due to heterogeneity in study designs we cannot conclude that foot orthoses are useful for flexible flatfoot in children and adults. However, based on the meta-analysis orthoses might be useful in decreasing pain in adults.