Efficacy and strength of evidence for interventions considered for primary and secondary proof of efficacy in the form of an ‘evidence and gap map’*
Intervention | Outcome measure | Short term† | Medium term† | Long term† | |
Interventions with primary proof of efficacy | |||||
Custom orthoses | Pain | Between-group efficacy | Strong positive34 44–46 0.41 (0.07 to 0.74) | Limited positive45 0.55 (0.09 to 1.02) | Moderate neutral34 0.04 (−0.37 to 0.45) |
Within-group outcome | 1.24 (1.00 to 1.49),34 44–46 62‡ | 1.65 (1.12 to 2.18),45‡ | |||
First step pain | Between-group efficacy | Limited neutral44 46 −0.32 (−0.91 to 0.26) | |||
Within-group outcome | |||||
Function | Between-group efficacy | Moderate neutral34 45 46 −0.21 (−0.48 to 0.06) | Limited neutral45 −0.39 (−0.85 to 0.07) | Moderate neutral34 −0.12 (−0.53 to 0.29) | |
Within-group outcome | |||||
Prefabricated orthoses | Pain | Between-group efficacy | Moderate neutral34 46 −0.25 (−0.59 to 0.09) | Moderate neutral34 −0.08 (−0.50 to 0.33) | |
Within-group outcome | |||||
First step pain | Between-group efficacy | ||||
Within-group outcome | |||||
Function | Between-group efficacy | Moderate neutral34 46 −0.06 (−0.40 to 0.28) | Moderate neutral34 −0.08 (−0.50 to 0.33) | ||
Within-group outcome | |||||
Magnetised insoles | Pain | Between-group efficacy | Moderate neutral36 0.00 (−0.39 to 0.39) | ||
Within-group outcome | |||||
Radial ESWT | Pain | Between-group efficacy | Strong positive32 42 1.64 (−1.06 to 4.33)§ | Limited positive42 3.77 (2.82 to 4.72) | Strong positive32 42 0.78 (−0.15 to 1.72)§ |
Within-group outcome | 3.78 (−1.38 to 6.17)32 42 63 64 § | 5.81 (3.57 to 8.05)42 63 | 6.41 (4.99 to 7.83)32 42 | ||
First step pain | Between-group efficacy | Moderate positive32,‡ OR: 1.66 (1.00 to 2.76)§ | Moderate positive32 OR: 1.78 (1.07 to 2.96) | ||
Within-group outcome | 1.19 (0.76 to 1.63)39 † | 1.74 (1.26 to 2.21)39 † | 2.93 (2.34 to 3.51)39† | ||
Function | Between-group efficacy | Moderate positive32 0.35 (0.10 to 0.60) | Limited positive42 2.39 (1.65 to 3.12) | Limited positive42 0.90 (0.32 to 1.49) | |
Within-group outcome | 3.47 (2.57 to 4.37),42† | 4.57 (3.48 to 5.65)42† | 2.81 (2.02 to 3.61)42† | ||
Focused ESWT | Pain | Between-group efficacy | Moderate positive33 0.36 (0.11 to 0.61) | ||
Within-group outcome | 1.33 (0.94 to 1.72)40 64 ‡ | ||||
First step pain | Between-group efficacy | Strong positive33 41 OR: 1.89 (1.18 to 3.04) | Limited positive50 1.31 (0.61 to 2.01) | Limited positive50 1.67 (0.88 to 2.45) | |
Within-group outcome | 2.11 (0.75 to 3.48)43 65 | 2.84 (1.94 to 3.73)50 | 3.33 (2.78 to 3.87)50 | ||
Function | Between-group efficacy | Moderate positive33 0.36 (0.10 to 0.61) | |||
Within-group outcome | 1.26 (0.99 to 1.53)33 | ||||
Combined radial and focused ESWT | Pain | Between-group efficacy | Strong positive32 33 42 1.08 (0.20 to 1.97) | Limited positive40 42 3.77 (2.82 to 4.72) | |
Within-group outcome | 2.72 (1.39 to 4.05)40 42 63 64 | 4.33 (1.12 to 7.55)40 42 63 | |||
First step pain | Between-group efficacy | Strong positive32 33 41 OR 1.78 (1.26 to 2.52) | OR 1.95 (1.22 to 3.12)32 50 | ||
Within-group outcome | 1.79 (0.92 to 2.66)39 43 65 | 3.14 (2.74 to 3.54)39 43 50 | |||
Function | Between-group efficacy | Strong positive33 42 1.03 (−0.36 to 2.42) | |||
Within-group outcome | 2.32 (0.16 to 4.49)33 42 | ||||
Dry needling | Pain | Between-group efficacy | Moderate neutral35 −0.33 (−0.76 to 0.10) | ||
Within-group outcome | |||||
First step pain | Between-group efficacy | Moderate neutral35 −0.42 (−0.85 to 0.02) | |||
Within-group outcome | |||||
Function | Between-group efficacy | Moderate neutral35 0.11 (−0.31 to 0.54) | |||
Within-group outcome | |||||
Wheatgrass | Pain | Between-group efficacy | Moderate neutral38,‡ | ||
Within-group outcome | |||||
Function | Between-group efficacy | Moderate neutral38,‡ | |||
Within-group outcome | |||||
Calf stretching | First step pain | Between-group efficacy | Moderate neutral37 −0.39 (−0.80 to 0.03) | ||
Within-group outcome | |||||
Pain | Between-group efficacy | Moderate neutral37 0.00 (−0.40 to 0.41) | |||
Within-group outcome | |||||
Function | Between-group efficacy | Moderate neutral37 −0.24 (−0.65 to 0.17) | |||
Within-group outcome | |||||
Low dye taping | First step pain | Between-group efficacy | Moderate positive22 0.47 (0.05 to 0.88) | ||
Within-group outcome | 1.21 (0.77 to 1.66)22 | ||||
Pain | Between-group efficacy | Moderate neutral22 0.30 (−0.11 to 0.71) | |||
Within-group outcome | |||||
Function | Between-group efficacy | Moderate neutral22 −0.05 (−0.46 to 0.36) | |||
Within-group outcome | |||||
Interventions with secondary proof of efficacy | |||||
Plantar fascia stretching | First step pain | Between-group efficacy | Moderate positive39 1.21 (0.78 to 1.63) | Moderate positive39 0.64 (0.24 to 1.04) | Moderate neutral39 −0.04 (−0.43 to 0.35) |
Within-group outcome | 2.81 (2.27 to 3.35)39 | 3.25 (2.67 to 3.83)39 |
*Included below are definitions for efficacy and strength of the evidence. An analysis that revealed a significant effect in favour of the intervention was considered a positive effect. The strength of the evidence was rated as strong, moderate or limited based on the number of high-quality trials and whether the trial was adequately powered: strong evidence/positive effect: meta-analysis revealed multiple high-quality trials demonstrated efficacy/a positive effect in favour of the intervention; moderate evidence/positive effect: analysis revealed one high-quality trials demonstrated efficacy/a positive effect in favour of the intervention; limited evidence/positive effect: analysis revealed one high-quality trial, which did not meet the required sample size, demonstrated efficacy/a positive effect in favour of the intervention; strong evidence/neutral effect: meta-analysis revealed multiple high-quality trials demonstrated no efficacy/evidence of no effect; moderate evidence/neutral effect: analysis revealed one high-quality trial demonstrated no efficacy/evidence of no effect; limited evidence/neutral effect: analysis revealed one high-quality trial, which did not meet the required sample size, demonstrated no efficacy/evidence of no effect.
†All effect sizes are reported as an SMD (95% CI) unless otherwise stated, with no pooling of ORs and SMD being possible.
‡Incomplete data or within-group calculations being based on different statistic to between-group, explains apparent discrepancy in results and references used.
§Calculation of effect size using RevMan differs from the reported statistics, so original statistical report was accepted.
ESWT, extracorporeal shockwave therapy; SMD, standardised mean difference.