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Table 1 Table of included studies; level of evidence, cohort characteristics and type of FOs used

From: Foot orthoses for adults with flexible pes planus: a systematic review

Study Level of evidence Study design N Cohort Mean age (SD) Pes planus measure Domain of outcome measures FOs brand or type FOs shell material FOs posting
RF FF
Rome and Brown [48] II RCT 50 (25/25) Excessive pronators 23.8 (2.2) FPI-8 Physical function Talar made © EVA
Esterman and Pilotto [34] II RCT 47 (25/22) Air force recruits 21.6 (3.9) AI Pain AOL® Plastic
Otman et al. [50] III-2 CCT 20 (20/20) Female adults 25.8 (1.3) Radiographs Physical function Arch supports Polypropylene
Zifchock and Davis [41] IV RM 19 Low arched recreation runners 23.6 (6.4) AHI Rearfoot kinematics A. Modified Root device Graphite 0 – 7°
B. KLM® Graphite NR NR
Mündermann et al. [47] IV RM 21 Recreational runners 25.4 (5.6) RE Rearfoot kinematics and kinetics A. Modified Root device Polypropylene 6 mm 6 mm
B. Modified Root device Polypropylene
C. Pre-made Insert EVA 6 mm 6 mm
Cobb et al. [52] IV RM 16 Low mobile arch adults 25.4 (6.5) AHI Rearfoot kinematics A. MASS Device Polyethylene composite
B. Modified Root device Leather and composite material NR NR
Murley et al. [40] IV RM 30 Adults 21.8 (4.3) AI & NH Physical function A. Inverted (Blake) device Polypropylene 20 °
B. Formthotic ® Duel density polyethylene foam 6 mm
Redmond et al. [44] IV RM 22 Excessive pronators 24 RE Kinetics A. Modified Root device Polypropylene
B. Pre-made Insert Thin card with EVA posts
Zammit and Payne [42] IV RM 22 Excessive RF pronators (clinical practice) 44.3 (16.7) FPI-8 Pain and physical function Independently prescribed Variable IP IP
Murley and Bird [40] IV RM 17 Adults 23.0 (5.0) FPI-6 Physical function A. Inverted (Blake) device NR 30 °
B. Inverted (Blake) device NR 15°
C. Inverted (Blake) device NR
Hurd et al. [51] IV RM 15 Recreational runners 34.0 (10.0) FF to RF Rearfoot kinematics and kinetics A. Flat foot Insert © Polyurethane with a poron layer
B. SofSole® Graphite Polyurethane
Johanson et al. [49] IV RM 22 Physical therapy attendees (clinical practice) 30.5 (8.0) FF to RF Rearfoot kinematics A. Orthofeet Biothotics© Water injected polyurethane shells with EVA posting 80% of FF post Up to 7 mm
B. Orthofeet Biothotics© As above 80% of FF post
C. Orthofeet Biothotics© As above Up to 7 mm
D. Orthofeet Biothotics© As above
Chen et al. [39] IV RM 11 Adults 45.9 (15.7) AI Kinetics and physical function NR Vinyl-acetate & 12% far-infrared nanopowders NR NR
  1. RM – repeated measure. CCT – controlled clinical trial. AHI – arch height index, AI – arch index, FF to RF – forefoot to rearfoot relationship, NH – navicular height, FPI-8 – Foot Posture Index – 8- item version, FPI-6 – Foot Posture Index – 6- item version, RE- rearfoot eversion. MASS – maximum subtalar supination position, NR – not reported, FF – forefoot, EVA -ethyl vinyl acetate.
  2. Orthotic Labs: Formthotic (Foot Science International, Christchurch, New Zealand) Flatfoot insert, (Hickory Brands, Inc, Hickory, NC, USA), Sofsole, LLC, Durham, NC), KLM (KLM Orthotic Laboratories; Valencia, CA, USA), AOL (Australian Orthotics Laboratory, International, Kirrance, NSW, Australia), Talar made (Talar Made Orthotics, Chesterfield, UK), Orthofeet Biothotics (Orthofeet Inc, Hillsdale, NJ, USA).