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Table 4 Outcome measures Biomechanical

From: Effectiveness of therapeutic footwear for children: A systematic review

Outcome

Study

Condition

Group

Baseline Mean (SD ±/-)

Final Mean (SD ±/-)

Statistical Result (Significant values given in bold)

Corrective Therapeutic Footwear

 Plantar pressure

  Average peak pressure (kPa): Lateral midfoot

Chen et al. (2015) [16]a

CTEV

Group 1 CTF and DB

N/A

62.21 (53.35-71.06) b

One-way MANOVA: p=0.005

Group2 DB and Own footwear

N/A

94.97 (66.38-123.59) b

Post hoc:

Group 1 vs. Group 2 p<0.01

Group 3 FAS and CTF

N/A

60.9 (49.26-72.54) b

Group 2 vs. Group 3 p<0.01

  Maximum peak pressure (kPa): Hindfoot

Group 1 CTF and DB

N/A

148.71 (135.49-161.94) b

One-way MANOVA: p<0.001

Group2 DB and Own footwear

N/A

105.51 (85.73-125.29) b

Post hoc:

Group 1 vs Group 2 p<0.01

Group 3 FAS and CTF

N/A

164.05 (148.22-179.90) b

Group 2 vs. Group 3 p<0.001

  Peak pressure ratio: Heel/forefoot

Group 1 CTF and DB

N/A

0.72 (0.58-0.87) b

One-way MANOVA:

p=0.009

Group2 DB and Own footwear

N/A

0.44 (0.29-0.58) b

Post hoc

Group 3 FAS and CTF

N/A

0.73 (0.61-0.86) b

Group 1 vs. Group 2 p<0.01;

Group 2 vs. Group 3 p<0.01

  Peak pressure ratio: Heel/lateral midfoot

Group 1 CTF and DB

N/A

1.45 (1.19-1.72) b

One-way MANOVA:

p<0.001

Group2 DB and Own footwear

N/A

0.77 (0.47-1.08) b

Post hoc:

Group 3 FAS and CTF

N/A

1.98 (1.68-2.29) b

Group 1 vs. Group2 p<0.01;

Group 1 vs. Group 3 p<0.01;

Group 2 vs. Group3 p<0.001

Functional Stability Therapeutic Footwear

 Kinematic

  Angle of gait (°)

Knittel and Staheli (1976) [41]

In toeing

SSF

- 17.3 (11.9)

 

ANOVA:

p<0.05

FSTF1

 

- 18.3 (12.4)

Post hoc

FSTF2

 

- 17.7 (13.9)

FSTF1 vs. SSF p<0.05

FSTF3

 

- 16.7 (12.7)

FSTF4

 

- 17.1 (12.5)

FSTF7 vs. SSF p<0.05

FSTF5

 

- 16.7 (14.2)

FSTF6

 

- 17.0 (14.3)

FSTF8 vs. SSF p<0.05

FSTF7

 

- 16.9 (12.4)

FSTF8

 

- 15.6 (14.1)

FSTF9 vs. SSF p<0.05

FSTF9

 

- 10.7 (14.9)

  Max. knee extension (°) stance

Jagadamma et al. (2009) [40]

Cerebral palsy

AFO and SSF

- 2.6 (2.8)

 

Wilcoxon signed rank: p=0.04

FSTF+AFO

 

3.7 (3.3)

  Knee flexion (°) initial contact

AFO and SSF

13.7 (8.4)

 

p=0.14

FSTF+AFO

 

17.2 (5.1)

  Max. knee flexion (°) stance

AFO and SSF

19.7 (9.3)

 

p=0.06

FSTF+AFO

 

25.2 (5.3)

  Shank to vertical angle (SVA) (°)

AFO and SSF

5.6 (3)

 

p=0.005

FSTF+AFO

 

10.8 (1.8)

 Kinetic

  Peak knee flexion moment (N m) stance

Jagadamma et al. (2009) [40]

Cerebral palsy

AFO and SSF

0.59 (0.31)

 

Wilcoxon signed rank: p=0.25

FSTF+AFO

 

0.7 (0.32)

  Peak Knee extension moment (N m) stance

AFO and SSF

- 0.44 (0.2)

 

p=0.14

FSTF+AFO

 

- 0.29 (0.24)

 Spatiotemporal

  Base of support (cm)

Abd Elkader et al. (2013) [14]

Mobile pes planus

Group 1 BF

11.80 (1.06)

 

Paired t test:

Group 1 FSTF

 

9.10 (1.31)

Group 1 p<0.05;

Group 2 p<0.05

Group 2 BF

12.63 (1.96)

 

Independent t test

Group 2 FT

 

9.20 (1.17)

BF p=0.12;

FSTF vs. FT p=0.86

  Cadence (Steps/min)

Jagadamma et al. (2009) [40]

Cerebral palsy

AFO and SSF

122.5 (16.6)

 

Paired t test:

FSTF+AFO

 

122.3 (12.4)

p=0.97

  CoP displacement (mm)

Aboutorabi et al. (2014) [11]

Mobile pes planus

BF

6.55 (6.40)

 

Repeated measures ANOVA:

p=0.016

FSTF

 

5.84 (6.15)

Post hoc:

SLS+FO

 

5.87 (6.40)

FSTF vs. BF p<0.05

  Standing balance (s)

Wesdock and Edge (2003) [42]

Cerebral palsy

Group1 SSF (after 4 weeks wear of solid AFO)

11 (13)

 

Mixed model maximum likelihood estimate: p>0.05

Crouch gait

Group 1 SSF + AFO (after 4 weeks wear of solid AFO)

18 (23)

 

Group 1 FSTF+AFO (after 4 weeks wear of solid AFO)

50 (68)

 

Group 1 SSF (after 4 weeks wear of FSTF+AFO)

 

14 (23)

Group 1 SSF + AFO (after 4 weeks wear of FSTF+AFO)

 

11 (24)

Group 1 FSTF+AFO (after 4 weeks wear of FSTF+AFO)

 

49 (70)

  Difference in standing balance (s)

Wesdock and Edge (2003) [42]

Cerebral palsy

Group 1 SSF vs. SSF+AFO (after 4 weeks wear of solid AFO)

(-6)-20 b

 

No Statistical test for significance performed

Group1 SSF+AFO vs. FSTF+AFO (after 4 weeks wear of solid AFO)

(-2)-66b

 

Group1 SSF vs. FSTF+AFO (after 4 weeks wear of solid AFO)

7 -73b

 

Group1 SSF vs. SSF+AFO (after 4 weeks wear of solid AFO)

 

(-19)-13b

Group 1 SSF+AFO vs. FSTF+AFO (after 4 weeks wear of solid AFO)

 

3-73 b

Group1 SSF vs. FSTF+AFO (after 4 weeks wear of solid AFO)

 

0-70 b

Cerebral palsy

SSF vs. SSF+AFO (after 4 weeks wear of solid AFO)

14 (6)

 

after 4 weeks wear of solid AFO

Subset of Group1 all participants who could stand ≥15s

SSF+AFO vs. FSTF+AFO (after 4 weeks wear of solid AFO)

84 (41)

 

SSF vs. FSTF+AFO p<0.05;

SSF vs. FSTF+AFO (after 4 weeks wear of solid AFO)

98 (47)

 

SSF+AFO vs. FSTF+AFO p<0.05;

SSF vs. SSF+AFO (after 4 weeks wear of FSTF+AFO)

 

- 8 (7)

after 4 weeks wear of solid FSTF+AFO

SSF+AFO vs. FSTF+AFO (after 4 weeks wear of FSTF+AFO)

 

101 (25)

SSF vs. FSTF+AFO p<0.05;

SSF vs. FSTF+AFO (after 4 weeks wear of FSTF+AFO)

 

93 (33)

SSF+AFO vs. FSTF+AFO p<0.05

(Sig based on 95% Confidence Interval of Group 1 differences in standing balance)

  Step length (cm)

Abd Elkader et al. (2013) [14]

Down’s Syndrome mobile pes planus

Group 1 BF

26.53 (3.72)

 

Paired t test:

Group1 FSTF

 

30.83 (4.28)

Group 1 p<0.05

Group 2 p<0.05

Group 2 BF

25.63 (4.62)

 

Independent t test:

Group 2 FT

 

30.73 (5.51)

BF Group 1 vs. 2 p=0.62;

FSTF vs. FT p=0.95

Aboutorabi et al. (2014) [11]

Mobile pes planus

BF

37.99 (3.82)

 

Repeated measures ANOVA: p=0.478

FSTF

 

38.85 (4.97)

SLS+FO

 

39.05 (4.68)

  Step symmetry (%)

Aboutorabi et al. (2014) [11]

Mobile pes planus

BF

-4.90 (4.66)

 

Repeated measures ANOVA: p=0.000

FSTF

 

-2.70 (25.54)

Post hoc

SLS+FO

 

16.08 (31.25)

FSTF vs. SLS+FO p<0.05

  Step width (cm)

Aboutorabi et al. (2014) [11]

Mobile pes planus

BF

8.87 (1.61)

 

Repeated measures ANOVA: p=0.170

FSTF

 

8.91 (1.99)

SLS+FO

 

9.41 (1.69)

  Stride length (m)

Abd Elkader et al. (2013) [14]

Down’s Syndrome mobile pes planus

Group 1 BF

0.448 (0.06)

 

Paired t test:

Group 1 FSTF

 

0.504 (0.064)

Group 1 p<0.05

Group 2 p<0.05

Group 2 BF

0.455 (0.071)

 

Independent t test:

Group 2 FT

 

0.524 (0.078)

BF Group 1 vs. 2 p=0.82;

FSTF vs. FT p=0.44

Jagadamma et al. (2009) [40]

Cerebral palsy

AFO and SSF

1.08 (0.19)

 

Paired t test: p=0.54

FSTF+AFO

 

1.06 (0.20)

  Velocity (m/s)

Abd Elkader et al. (2013) [14]

Down’s Syndrome mobile pes planus

Group 1 BF

0.674 (.059)

 

Paired t test:

Group 1 FSTF

 

0.775 (0.035)

Group 1 p<0.05

Group 2 p<0.05

Group 2 BF

0.672 (0.109)

 

Independent t test:

Group 2 FT

 

0.762 (0.090)

BF Group 1 vs. 2 p=0.95;

FSTF vs. FT p=0.61

Aboutorabi et al. (2014) [11]

Mobile pes planus

BF

0.727 (0.136)

 

Repeated measures ANOVA: p=0.000

FSTF

 

0.847 (0.156)

Post hoc:

SLS+FO

 

0.779 (0.128)

FSTF vs. BF p<0.05;

SLF +FO vs. BF p<0.05

Jagadamma et al. (2009) [40]

Cerebral palsy

AFO and SSF

1.08 (0.1)

 

Paired t test: p=0.80

FSTF+AFO

 

1.07 (0.14)

Functional Instability Therapeutic Footwear

 Balance (Dynamic)

  Anterior posterior control (CoP)

Ramstrand et al. (2008) [43]a

Cerebral Palsy + mixed developmental disability

BF Medium (at 4 weeks)

 

45.7 (25.5-66.5) b

Wilcoxon signed rank

FITF Medium (at 4 weeks)

 

51.44 (33.7-69.2) b

BF vs. FITF Medium at week 4 p<0.05

  Mediolateral control (CoP)

BF Slow (baseline)

57.2 (47.0-67.2) b

 

Friedman ANOVA:

BF Slow p<0.05

BF Medium (baseline)

66.4 (52.6-80.1) b

 

Post hoc

BF Slow at week 8 vs. week 4 and baseline p<0.05

Wilcoxon signed rank

BF Slow (at 4 weeks)

 

69.2 (59.9-78.5) b

BF vs. FITF Slow at 8 weeks p<0.05;

BF Medium (at 4 weeks)

 

75 (67.4-82.6) b

BF vs. FITF Medium at 4- and 8-weeks p<0.05

FITF Slow (at 4 weeks)

 

55.1 (36.3-73) b

FITF Medium (at 4 weeks)

 

67 (54.3-79.2) b

BF Slow (at 8 weeks)

 

74.89 (64.9-84.8) b

BF Medium (at 8 weeks)

 

72.44 (55.1-89.9) b

FITF Slow (at 8 weeks)

 

57.56 (40.3-74.8) b

FITF Medium (at 8 weeks)

 

65.33 (44.5-86.2) b

  Number of falls toes up condition

Subject 1,2,6,9,10

0

 

Chi Square:

Subject 3

2

 

Between testing occasions p<0.05

Subject 4

3

 

Subjects 5,8

4

 

Subject 7

10

 

Subjects 1,5, 8 -10 (at 4 weeks)

 

0

Subjects 2, 6 (at 4 weeks)

 

Did not participate

Subjects 3 ,4 (at 4 weeks)

 

1

Subject 7 (at 4 weeks)

 

2

Subjects 1,2, 4 - 10 (at 8 weeks)

 

0

Subject 3 (at 8 weeks)

 

1

Functional Lift Therapeutic Footwear

 Kinematic

  Ankle dorsiflexion at initial contact (°)

Eek et al. (2017) [10]

Cerebral palsy

BF Long leg

-2.3d (7.9) e

 

Wilcoxon signed rank:

BF Short leg

-9.2d (13.6) e

 

Comparison long to short

FLTF Long leg

 

4.3d (9.1) e

BF p = 0.009;

FLTF Short leg

 

-2d (17) e

FLTF p= 0.017;

SSF Long leg

 

3.5d (9.) e

SSF p=0.009

SSF Short leg

 

-6.2d (11.3) e

  Ankle dorsiflexion in stance (°)

BF Long leg

11.9d (11.6) e

 

Comparison long to short

BF Short leg

6.5d (6.4) e

 

BF p = 0.22;

FLTF Long leg

 

15.1d (4.9) e

FLTF p=0.241;

FLTF Short leg

 

14.4d (8.6) e

SSF p=0.022

SSF Long leg

 

16.5d (2.8) e

SSF Short leg

 

11.4d (10.7) e

  Ankle dorsiflexion in swing (°)

BF Long leg

3.7d (5.8) e

 

Comparison long to short

BF Short leg

3.2d (5.5) e

 

BF p = 0.007;

FLTF Long leg

 

6.5d (10.9) e

FLTF p=0.037;

FLTF Short leg

 

2.6d (9.3) e

SSF p=0.13

SSF Long leg

 

5.8d (7.8) e

SSF Short leg

 

0.5d (10.7) e

  Hip adduction in stance (°)

BF Long leg

8.4d (6.4) e

 

Comparison long to short

BF Short leg

7.4d (4.4) e

 

BF p = 0.959;

FLTF Long leg

 

6.6d (2.9) e

FLTF p=0.646;

FLTF Short leg

 

9.3d (7.5) e

SSF p=0.646

SSF Long leg

 

7.0d (4.8) e

SSF Short leg

 

6.3d (4.8) e

  Hip extension in stance (°)

BF Long leg

9.6d (6.2) e

 

Comparison long to short

BF Short leg

11.3d (3.7) e

 

BF p = 0.114

FLTF Long leg

 

12.8d (8) e

FLTF p=0.241

FLTF Short leg

 

12.3d (5.70e

SSF p=0.203

SSF Long leg

 

11.9d (7.3) e

SSF Short leg

 

12.5d (5.7) e

  Hip flexion at initial contact (°)

BF Long leg

36.3d (9.1) e

 

Comparison long to short

BF Short leg

29.8d (5.1) e

 

BF p = 0.005;

FLTF Long leg

 

34.9d (5.4) e

FLTF p=0.139;

FLTF Short leg

 

34.1d (4.1) e

SSF p=0.005

SSF Long leg

 

36.3d (4.3) e

SSF Short leg

 

30.5d (8.3) e

  Hip flexion in swing (°)

BF Long leg

37.3 (6.9) e

 

Comparison long to short

BF Short leg

33.0 (5.5) e

 

BF p = 0.009;

FLTF Long leg

 

38.7 (7.3) e

FLTF p=0.139;

FLTF Short leg

 

36.9 (6.1) e

SSF p=0.028

SSF Long leg

 

36.3 (7.5) e

SSF Short leg

 

33.3 (6.4) e

  Knee extension in stance (°)

BF Long leg

7.0d (9.6) e

 

Comparison long to short

BF Short leg

4.8d (12.6) e

 

BF p = 0.007;

FLTF Long leg

 

4.9d (10.2) e

FLTF p=0.028;

FLTF Short leg

 

1.9d (10.9) e

SSF p=0.007

SSF Long leg

 

8.8d (10.6)

SSF Short leg

 

1.6d (8.7) e

  Knee flexion at initial contact (°)

BF Long leg

13.4d (6.8) e

 

Comparison long to short

BF Short leg

11.9d (7.8) e

 

BF p = 0.508;

FLTF Long leg

 

7.7d (7.5) e

FLTF p=0.114;

FLTF Short leg

 

9.4d (6.7) e

SSF p=0.386;

SSF Long leg

 

7.3d (11.5) e

SSF Short leg

 

8.10d (7.5) e

  Knee flexion in swing (°)

BF Long leg

63.8d (5.0) e

 

Comparison long to short

BF Short leg

62.2d (12.7) e

 

BF p = 0.203;

FLTF Long leg

 

64.2d (5.2) e

FLTF p=0.445;

FLTF Short leg

 

60.8d (13.4) e

SSF p=0.093

SSF Long leg

 

65.6d (2.7) e

SSF Short leg

 

62.5d (15.3) e

 Spatiotemporal

  Cadence steps/min

Eek et al. (2017) [10]

Cerebral palsy

BF

100.6d (17.8) e

 

Friedman ANOVA: p>0.05

FLTF

 

98.4d (25.7) e

SSF

 

99.3d (24.9) e

  Stance phase %

BF Long leg

61.1d (2.03) e

 

Wilcoxon signed rank:

BF Short leg

56.8d (4.0) e

 

Comparison long to short

FLTF Long leg

 

60.8d (292) e

BF p = 0.022;

FLTF Short leg

 

60.0d (4.16) e

FLTF p=0.241;

SSF Long leg

 

62.5d (1.91) e

SSF p=0.005

SSF Short leg

 

58.9d (3.90) e

  Stride length (m)

BF

1.12d (0.13) e

 

Friedman ANOVA: p<0.05

FLTF

 

1.24d (0.12) e

Post hoc:

SSF

 

1.24d (0.12) e

BF vs. FLTF p<0.05;

BF vs. SSF p<0.05

  Velocity (m/s)

BF

1.18d (0.16) e

 

Friedman ANOVA: p<0.05

FLTF

 

1.24d (0.12) e

Post hoc:

SSF

 

1.21d (0.22) e

BF vs. FLTF p<0.05

  1. AFO Ankle Foot Orthosis, BF Barefoot, CoP Centre of Pressure, CTEV Congenital Talipes Equino Varus, CTF Corrective Therapeutic Footwear, DB Denis Brown Barred Night Boot, FAS Forefoot Abduct Night Shoe, FITF Functional Instability Therapeutic Footwear, FLTF Functional Lift Therapeutic Footwear, FO Foot Orthoses, FSTF Functional Stability Therapeutic Footwear, N/A Not Applicable, SLF Standard Last Footwear, SSF Standard Sole Footwear, a supplementary results in additional file 3, b 95% Confidence Interval, d Median, e Inter Quartile Range,