Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Are foot orthoses effective at reducing pain in adults with foot osteoarthritis?”
STUDY DESIGN: A review of two randomized controlled trials and one case series from peer-reviewed journals published between 2010 and 2016.
DATA SOURCES: Two randomized controlled trials and one case series were found using PubMed.
OUTCOME MEASURED: Reduction of the subject’s foot pain was the patient-oriented outcome measured in each of these three articles. The subject’s pain was scored on a Likert scale and evaluated at baseline and at 12 weeks to assess their response to foot orthoses.
RESULTS: The first randomized controlled trial analyzed determined that prefabricated foot orthoses improved subject Foot Health Status Questionnaire (FHSQ) pain domain scores similar to rocker-sole footwear in patients with 1st metatarsophalangeal joint osteoarthritis (Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE. Arthritis Care Res. 2016;68(5):581-589. doi: 10.1002/acr.22750 [doi]). A case series determined that custom-made semi-rigid foot orthoses with or without carbon fiber foot plates reduced average pain scores in patients with midfoot osteoarthritis (Ibuki A, Cornoiu A, Clarke A, et al. Prosthet Orthot Int. 2010;34(4):461-471. doi: 10.3109/03093646.2010.503672.). The final randomized controlled trial examined found that functional foot orthoses (FFO) did reduce subject “average pain in the month” questionnaire scores similar to sham orthoses in adults with midfoot osteoarthritis. However, the study had a wide estimate of treatment effect making it difficult to determine if there was a difference between interventions (Chapman GJ, Halstead J, Redmond AC. Gait Posture. 2016;49:235-240. doi: 10.1016/j.gaitpost.2016.07.012.).
CONCLUSIONS: The two randomized controlled trials and one case series in this review showed some data to suggest foot orthoses are effective at reducing pain in adults with foot osteoarthritis. However, future randomized controlled trials are needed to determine if foot orthoses are superior to other treatment options for foot osteoarthritis.
Kemmerer, Jacob T., "Are Foot Orthoses Effective at Reducing Pain in Adults with Foot Osteoarthritis?" (2020). PCOM Physician Assistant Studies Student Scholarship. 513.