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Abstract
Objective To evaluate the effects of biomechanical foot-based interventions (eg, footwear, insoles, taping and bracing on the foot) on patellofemoral loads during walking, running or walking and running combined in adults with and without patellofemoral pain or osteoarthritis.
Design Systematic review with meta-analysis.
Data sources MEDLINE, CINAHL, SPORTdiscus, Embase and CENTRAL.
Eligibility criteria for selecting studies English-language studies that assessed effects of biomechanical foot-based interventions on peak patellofemoral joint loads, quantified by patellofemoral joint pressure, reaction force or knee flexion moment during gait, in people with or without patellofemoral pain or osteoarthritis.
Results We identified 22 footwear and 11 insole studies (participant n=578). Pooled analyses indicated low-certainty evidence that minimalist footwear leads to a small reduction in peak patellofemoral joint loads compared with conventional footwear during running only (standardised mean difference (SMD) (95% CI) = −0.40 (–0.68 to –0.11)). Low-certainty evidence indicated that medial support insoles do not alter patellofemoral joint loads during walking (SMD (95% CI) = −0.08 (–0.42 to 0.27)) or running (SMD (95% CI) = 0.11 (–0.17 to 0.39)). Very low-certainty evidence indicated rocker-soled shoes have no effect on patellofemoral joint loads during walking and running combined (SMD (95% CI) = 0.37) (−0.06 to 0.79)).
Conclusion Minimalist footwear may reduce peak patellofemoral joint loads slightly compared with conventional footwear during running only. Medial support insoles may not alter patellofemoral joint loads during walking or running and the evidence is very uncertain about the effect of rocker-soled shoes during walking and running combined. Clinicians aiming to reduce patellofemoral joint loads during running in people with patellofemoral pain or osteoarthritis may consider minimalist footwear.
- patellofemoral joint
- patellofemoral pain syndrome
- biomechanical phenomena
- foot orthoses
- shoes
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
Statistics from Altmetric.com
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
Footnotes
Twitter @KayllSam, @HinmanRana, @KimBennell, @patrickrowe94, @KadePaterson
Contributors SAK, KLP, RSH, KLB and ALB devised the study. SAK wrote the first draft of the manuscript and all authors provided critical feedback. SAK ran the searches. SAK, PLR and KLP conducted the study screening, data extraction, risk of bias assessment and grading of evidence. SAK conducted the data analysis and synthesis. All authors have read and confirmed that they meet ICMJE criteria for authorship. All authors read and approved the final manuscript. KLP is the guarantor of the manuscript.
Funding RSH is supported by a National Health & Medical Research Council Fellowship (#1154217). KLB is supported by an NHMRC Investigator Fellowship (#1174431). KLP is supported by a National Health and Medical Research Council Emerging Leadership Investigator Grant (#1174229).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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