Effects of Foot Orthoses on Pain and the Prevention of Lower Limb Injuries in Runners: Systematic Review and Meta-Analysis

in Journal of Sport Rehabilitation

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Murilo Pires NevesPost-Graduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physiotherapy Research Group, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physical Therapist Staff, AF FISIOTERAPIA, Salvador, BA, Brazil

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Cristiano Sena da ConceiçãoPost-Graduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physiotherapy Research Group, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physical Therapist Staff, AF FISIOTERAPIA, Salvador, BA, Brazil
Physical Therapy Department, Federal University of Bahia—UFBA, Salvador, BA, Brazil

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Paulo Roberto Garcia LucareliDepartment of Rehabilitation Sciences, University Nove de Julho, São Paulo, SP, Brazil
Physical Therapist Staff, Einstein Movement Analysis Laboratory, São Paulo, SP, Brazil

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Renata Santana da Silva BarbosaPost-Graduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physiotherapy Research Group, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Center for Technological Innovation in Rehabilitation—NITRE, Federal University of Bahia—UFBA, Salvador, BA, Brazil

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João Paulo Bomfim Cruz VieiraPhysical Therapist Staff, AF FISIOTERAPIA, Salvador, BA, Brazil
Post-Graduate Program in Medicine and Health, Federal University of Bahia—UFBA, Salvador, BA, Brazil

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Alécio Jorge Alves de Lima BrasileiroPhysical Therapist Staff, AF FISIOTERAPIA, Salvador, BA, Brazil

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Grimaldo Ferreira da Silva JrPost-Graduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physiotherapy Research Group, Federal University of Bahia—UFBA, Salvador, BA, Brazil

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Mansueto Gomes-NetoPost-Graduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physiotherapy Research Group, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Physical Therapy Department, Federal University of Bahia—UFBA, Salvador, BA, Brazil
Post-Graduate Program in Medicine and Health, Federal University of Bahia—UFBA, Salvador, BA, Brazil

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Context: A variety of approaches have been proposed to prevent lower limb injuries in runners. However, the evidence for the effectiveness of interventions to reduce lower limb pain and injury after intensive running is very weak. Objective: The authors performed a systematic review to investigate the effects of foot orthoses on pain and the prevention of lower limb injuries in runners. Evidence Acquisition: The authors searched the MEDLINE/PubMed, Physiotherapy Evidence Database, Scielo, and Cochrane Central (from inception to February 2022) databases for randomized controlled trials that evaluated the effects of foot orthoses in runners. The authors then calculated mean differences and 95% confidence intervals from these trials. Heterogeneity was assessed using the I2 test. Furthermore, the authors compared the criteria between runners with foot orthoses and ones with no intervention (control group). Evidence Synthesis: Twelve studies (5321 runners) met our review criteria. The control and the foot orthoses group sustained 721 (37%) and 238 (24%) injuries, respectively. Compared with the control group, the use of foot orthoses resulted in a significant reduction in lower limb injury risk (risk ratio = 0.6; 95% confidence interval, 0.5–0.7; P = .00001, I2 = 54%; 7 studies, N = 2983: moderate-quality evidence). Moreover, the foot orthoses group corresponded to a 40% reduction in the risk of developing lower limb injuries. Conclusions: The use of foot orthoses may help reduce the incidence of lower limb injuries and pain in runners.

Gomes-Neto (mansueto.neto@ufba.br) is corresponding author.

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