Efficacy of heel lifts for lower limb musculoskeletal conditions: A systematic review.

IF 2.5 3区医学 Q1 ORTHOPEDICS Journal of Foot and Ankle Research Pub Date : 2024-06-01 DOI:10.1002/jfa2.12031

Jaryd Bourke, Shannon Munteanu, Eman Merza, Alessandro Garofolini, Simon Taylor, Peter Malliaras

{"title":"Efficacy of heel lifts for lower limb musculoskeletal conditions: A systematic review.","authors":"Jaryd Bourke, Shannon Munteanu, Eman Merza, Alessandro Garofolini, Simon Taylor, Peter Malliaras","doi":"10.1002/jfa2.12031","DOIUrl":null,"url":null,"abstract":"Introduction: The objective of this systematic review is to determine the benefits and harms of heel lifts to any comparator for lower limb musculoskeletal conditions.Methods: Ovid MEDLINE, Ovid AMED, Ovid EMCARE, CINAHL Plus and SPORTDiscus were searched from inception to the end of May 2024. Randomised, quasi-randomised or non-randomised trials comparing heel lifts to any other intervention or no-treatment were eligible for inclusion. Data was extracted for the outcomes of pain, disability/function, participation, participant rating of overall condition, quality of life, composite measures and adverse events. Two authors independently assessed risk of bias and certainty of evidence using the GRADE approach at the primary time point 12 weeks (or next closest).Results: Eight trials (n = 903), investigating mid-portion Achilles tendinopathy, calcaneal apophysitis and plantar heel pain were included. Heel lifts were compared to exercise, ultrasound, cryotherapy orthotics, stretching, footwear, activity modification, felt pads and analgesic medication. No outcome was at low risk of bias and few effects (2 out of 47) were clinically important. Low-certainty evidence (1 trial, n = 199) indicates improved pain relief (55.7 points [95% CI: 50.3-61.1], on a 100 mm visual analogue scale) with custom orthotics compared to heel lifts at 12 weeks for calcaneal apophysitis. Very low-certainty evidence (1 trial, n = 62) indicates improved pain and function with heel lifts over indomethacin (35.5 points [95% CI: 21.1-49.9], Foot Function Index) at 12 months for plantar heel pain.Conclusions: Few trials have assessed the benefits and harms of heel lifts for lower limb musculoskeletal conditions. Only two outcomes out of 47 showed clinically meaningful between group differences. However, due to very low to low certainty evidence we are unable to be confident in the results and the true effect may be substantially different.Registration: PROSPERO registration number CRD42022309644.","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296721/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Foot and Ankle Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jfa2.12031","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: The objective of this systematic review is to determine the benefits and harms of heel lifts to any comparator for lower limb musculoskeletal conditions.

Methods: Ovid MEDLINE, Ovid AMED, Ovid EMCARE, CINAHL Plus and SPORTDiscus were searched from inception to the end of May 2024. Randomised, quasi-randomised or non-randomised trials comparing heel lifts to any other intervention or no-treatment were eligible for inclusion. Data was extracted for the outcomes of pain, disability/function, participation, participant rating of overall condition, quality of life, composite measures and adverse events. Two authors independently assessed risk of bias and certainty of evidence using the GRADE approach at the primary time point 12 weeks (or next closest).

Results: Eight trials (n = 903), investigating mid-portion Achilles tendinopathy, calcaneal apophysitis and plantar heel pain were included. Heel lifts were compared to exercise, ultrasound, cryotherapy orthotics, stretching, footwear, activity modification, felt pads and analgesic medication. No outcome was at low risk of bias and few effects (2 out of 47) were clinically important. Low-certainty evidence (1 trial, n = 199) indicates improved pain relief (55.7 points [95% CI: 50.3-61.1], on a 100 mm visual analogue scale) with custom orthotics compared to heel lifts at 12 weeks for calcaneal apophysitis. Very low-certainty evidence (1 trial, n = 62) indicates improved pain and function with heel lifts over indomethacin (35.5 points [95% CI: 21.1-49.9], Foot Function Index) at 12 months for plantar heel pain.

Conclusions: Few trials have assessed the benefits and harms of heel lifts for lower limb musculoskeletal conditions. Only two outcomes out of 47 showed clinically meaningful between group differences. However, due to very low to low certainty evidence we are unable to be confident in the results and the true effect may be substantially different.

Registration: PROSPERO registration number CRD42022309644.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

足跟升降机对下肢肌肉骨骼疾病的疗效：系统综述。

简介本系统性综述的目的是确定足跟升降机对下肢肌肉骨骼疾病的益处和危害：方法：检索了从开始到 2024 年 5 月底的 Ovid MEDLINE、Ovid AMED、Ovid EMCARE、CINAHL Plus 和 SPORTDiscus。将足跟提升术与任何其他干预或无治疗进行比较的随机、准随机或非随机试验均符合纳入条件。提取的数据包括疼痛、残疾/功能、参与度、参与者对整体状况的评分、生活质量、综合指标和不良事件等结果。两位作者采用 GRADE 方法独立评估了主要时间点 12 周（或最接近的时间点）的偏倚风险和证据的确定性：结果：共纳入八项试验（n = 903），研究对象包括跟腱中段病变、小跟骨远端炎和足底跟痛。将足跟升降器与运动、超声波、冷冻矫形器、拉伸、鞋类、活动调整、毡垫和镇痛药物进行了比较。没有一项结果存在低偏倚风险，只有少数效应（47 项中的 2 项）具有临床重要性。低确定性证据（1 项试验，n = 199）表明，与足跟升降器相比，定制矫形器在 12 周后可有效缓解小关节远端炎患者的疼痛（按 100 毫米视觉模拟量表计算，55.7 分 [95% CI：50.3-61.1]）。极低确定性证据（1 项试验，n = 62）表明，在治疗足跟痛方面，12 个月后使用足跟提升器比使用吲哚美辛可改善疼痛和功能（35.5 分[95% CI：21.1-49.9]，足部功能指数）：很少有试验评估了足跟升降器治疗下肢肌肉骨骼疾病的益处和害处。在47项结果中，只有两项结果显示出有临床意义的组间差异。然而，由于证据的确定性很低，我们无法对结果充满信心，真正的效果可能会大相径庭：PROSPERO注册号：CRD42022309644。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Foot and Ankle Research ORTHOPEDICS-

CiteScore

4.50

自引率

10.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.