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首页> 外文期刊>Journal of athletic training >Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis--critical appraisal and commentary.
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Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis--critical appraisal and commentary.

机译：下肢过度使用情况下的足部矫形器：系统的回顾和荟萃分析-关键评估和评论。

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REFERENCE/CITATION: Collins N, Bisset L, McPoil T, Vicenzino B. Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot Ankle Int. 2007;28(3):396-412. DATA SOURCES: Studies published through September 28, 2005, were identified by using MEDLINE, EMBASE, CINAHL and Pre-CINAHL, Physiotherapy Evidence Database (PEDro), PubMed, SPORTDiscus, Biological Abstracts, Web of Science, Allied Health and Complementary Medicine Database, and the full Cochrane Library. The authors did not provide the search strategy used. Reference lists of included randomized controlled trials (RCTs) and identified systematic reviews were searched by hand. STUDY SELECTION: Studies were included if (1) they were RCTs that included the use of foot orthoses (either custom or prefabricated) in 1 of the intervention groups, (2) the clinical problem was an overuse condition as defined by the American College of Foot and Ankle Orthopedics and Medicine guidelines for which foot orthoses were recommended, and (3) at least 1 clinically relevant outcome was measured for a minimum of 1 week. Limits were not placed on year of publication, status of publication, or language. DATA EXTRACTION: The journal, authors, and author affiliations of included RCTs were masked from 2 of the reviewers who independently assessed the included RCTs for methodologic quality using a modified PEDro scale plus 3 additional items (justification of sample size, use of outcome measures with known validity and reliability, and reporting of adverse or side effects). Disagreements on methodologic quality were resolved with consensus or by a third reviewer. The effect sizes for the included RCTs were represented by relative risk (RR) for dichotomous outcomes and standardized mean difference (SMD) for continuous data. Confidence intervals (CIs) were reported for RR and SMD. Study data were extracted directly from each of the included studies. If provided, data from intention-to-treat analysis were extracted. Study authors were contacted when insufficient data were reported. A meta-analysis (random-effects model) was conducted using Review Manager (version 4.2; The Nordic Cochrane Centre, Copenhagen, Denmark). MAIN RESULTS: The search identified 3192 potentially relevant studies. Full articles were retrieved for 327 studies. Twenty-two of the 327 studies met the inclusion criteria. Because the authors of 1 study used the same methods to report on 2 populations, a total of 23 RCTs were included in the systematic review. Prevention of lower limb overuse conditions with the use of foot orthoses was reported in 8 RCTs (7 studies). The effect of foot orthoses in the treatment of lower limb overuse conditions was reported in 15 RCTs. Of the 23 RCTs, the cost-effectiveness of foot orthoses was reported in 2 and the adverse effects of foot orthoses were reported in 8. Across the prevention RCTs, data were available for analysis for a range of 47 to 417 participants with 8 to 16 weeks of follow-up. Based on 4 RCTs in which the researchers examined prevention of lower limb overuse conditions with foot orthoses versus control in military personnel, the RR was 1.49 (95% CI = 1.07, 2.08). A clinically beneficial effect size was set a priori at 1.5 or greater for the foot-orthoses group or at 0.7 or less for the comparison group. Based on 2 RCTs reported in 1 study of the use of custom versus prefabricated foot orthoses for prevention of lower limb overuse conditions, no significant difference in risk was found (RR = 1.14, 95% CI = 0.90, 1.44). In their calculating and reporting of RR, the authors do not appear to have followed convention.
机译：参考/引用：Collins N，Bisset L，McPoil T，VincenzinoB。下肢过度使用情况下的足部矫形器：系统评价和荟萃分析。脚踝关节2007; 28（3）：396-412。数据来源：通过使用MEDLINE，EMBASE，CINAHL和CINAHL之前，物理疗法证据数据库（PEDro），PubMed，SPORTDiscus，生物学摘要，Web of Science，联合健康和补充医学数据库，以及完整的Cochrane库。作者未提供所使用的搜索策略。手工搜索包括随机对照试验（RCT）和已鉴定的系统评价的参考文献清单。研究选择：如果以下研究包括在内，则为：（1）其中的RCT包括在1个干预组中使用足部矫形器（定制或预制），（2）临床问题是美国大学医学院定义的过度使用状况建议足部矫形的《足踝骨科和医学指南》，以及（3）测量至少1项与临床相关的结果，至少持续1周。没有限制出版年份，出版状态或语言。数据提取：包括RCT的期刊，作者和作者隶属关系被2名审稿人掩盖，他们使用改良的PEDro量表加上3项其他条目（方法大小合理，采用已知的有效性和可靠性，并报告不良或副作用）。在方法学质量上的分歧通过协商一致或由第三位审稿人解决。包括在内的RCT的疗效大小以二分结果的相对风险（RR）和连续数据的标准化均值（SMD）表示。报告了RR和SMD的置信区间（CI）。研究数据直接从每个纳入研究中提取。如果提供，则从意向分析中提取数据。当报告数据不足时，与研究作者联系。使用Review Manager（4.2版;丹麦哥本哈根的Nordic Cochrane中心）进行了荟萃分析（随机效应模型）。主要结果：搜索确定3192项潜在相关研究。检索了327项研究的全文。 327项研究中有22项符合纳入标准。由于一项研究的作者使用相同的方法报告了2个人群，因此系统评价共包括23个RCT。 8项RCT中报告了使用足部矫形器预防下肢过度使用的情况（7项研究）。 15个RCT中报告了足部矫形器治疗下肢过度使用状况的效果。在23项RCT中，有2例报告了脚矫形器的成本效益，在8例中报告了脚矫形器的不良影响。在所有预防性RCT中，可用于分析47至417名参与者（8至16名）的数据数周的随访。研究人员根据4项RCT（研究人员检查了脚部矫形器对下肢过度使用情况的预防与军事人员的控制相比），RR为1.49（95％CI = 1.07，2.08）。先验临床治疗效果的大小在脚矫形器组中设置为1.5或更大，在比较组中设置为0.7或更小。根据一项关于使用定制脚踝矫形器与预制脚矫形器预防下肢过度使用状况的研究报告的2项RCT，发现风险无显着差异（RR = 1.14，95％CI = 0.90，1.44）。在计算和报告RR时，作者似乎没有遵循惯例。

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