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Table 4 Outcome measures Biomechanical

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

OutcomeStudyConditionGroupBaseline Mean (SD ±/-)Final Mean (SD ±/-)Statistical Result (Significant values given in bold)
Corrective Therapeutic Footwear
 Plantar pressure
  Average peak pressure (kPa): Lateral midfootChen et al. (2015) [16]aCTEVGroup 1 CTF and DBN/A62.21 (53.35-71.06) bOne-way MANOVA: p=0.005
Group2 DB and Own footwearN/A94.97 (66.38-123.59) bPost hoc:
Group 1 vs. Group 2 p<0.01
Group 3 FAS and CTFN/A60.9 (49.26-72.54) bGroup 2 vs. Group 3 p<0.01
  Maximum peak pressure (kPa): HindfootGroup 1 CTF and DBN/A148.71 (135.49-161.94) bOne-way MANOVA: p<0.001
Group2 DB and Own footwearN/A105.51 (85.73-125.29) bPost hoc:
Group 1 vs Group 2 p<0.01
Group 3 FAS and CTFN/A164.05 (148.22-179.90) bGroup 2 vs. Group 3 p<0.001
  Peak pressure ratio: Heel/forefootGroup 1 CTF and DBN/A0.72 (0.58-0.87) bOne-way MANOVA:
p=0.009
Group2 DB and Own footwearN/A0.44 (0.29-0.58) bPost hoc
Group 3 FAS and CTFN/A0.73 (0.61-0.86) bGroup 1 vs. Group 2 p<0.01;
Group 2 vs. Group 3 p<0.01
  Peak pressure ratio: Heel/lateral midfootGroup 1 CTF and DBN/A1.45 (1.19-1.72) bOne-way MANOVA:
p<0.001
Group2 DB and Own footwearN/A0.77 (0.47-1.08) bPost hoc:
Group 3 FAS and CTFN/A1.98 (1.68-2.29) bGroup 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 toeingSSF- 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 (°) stanceJagadamma et al. (2009) [40]Cerebral palsyAFO and SSF- 2.6 (2.8) Wilcoxon signed rank: p=0.04
FSTF+AFO 3.7 (3.3)
  Knee flexion (°) initial contactAFO and SSF13.7 (8.4) p=0.14
FSTF+AFO 17.2 (5.1)
  Max. knee flexion (°) stanceAFO and SSF19.7 (9.3) p=0.06
FSTF+AFO 25.2 (5.3)
  Shank to vertical angle (SVA) (°)AFO and SSF5.6 (3) p=0.005
FSTF+AFO 10.8 (1.8)
 Kinetic
  Peak knee flexion moment (N m) stanceJagadamma et al. (2009) [40]Cerebral palsyAFO and SSF0.59 (0.31) Wilcoxon signed rank: p=0.25
FSTF+AFO 0.7 (0.32)
  Peak Knee extension moment (N m) stanceAFO 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 planusGroup 1 BF11.80 (1.06) Paired t test:
Group 1 FSTF 9.10 (1.31)Group 1 p<0.05;
Group 2 p<0.05
Group 2 BF12.63 (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 palsyAFO and SSF122.5 (16.6) Paired t test:
FSTF+AFO 122.3 (12.4)p=0.97
  CoP displacement (mm)Aboutorabi et al. (2014) [11]Mobile pes planusBF6.55 (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 palsyGroup1 SSF (after 4 weeks wear of solid AFO)11 (13) Mixed model maximum likelihood estimate: p>0.05
Crouch gaitGroup 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 palsyGroup 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 palsySSF 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 ≥15sSSF+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 planusGroup 1 BF26.53 (3.72) Paired t test:
Group1 FSTF 30.83 (4.28)Group 1 p<0.05
Group 2 p<0.05
Group 2 BF25.63 (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 planusBF37.99 (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 planusBF-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 planusBF8.87 (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 planusGroup 1 BF0.448 (0.06) Paired t test:
Group 1 FSTF 0.504 (0.064)Group 1 p<0.05
Group 2 p<0.05
Group 2 BF0.455 (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 palsyAFO and SSF1.08 (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 planusGroup 1 BF0.674 (.059) Paired t test:
Group 1 FSTF 0.775 (0.035)Group 1 p<0.05
Group 2 p<0.05
Group 2 BF0.672 (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 planusBF0.727 (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 palsyAFO and SSF1.08 (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]aCerebral Palsy + mixed developmental disabilityBF Medium (at 4 weeks) 45.7 (25.5-66.5) bWilcoxon signed rank
FITF Medium (at 4 weeks) 51.44 (33.7-69.2) bBF 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) bBF vs. FITF Slow at 8 weeks p<0.05;
BF Medium (at 4 weeks) 75 (67.4-82.6) bBF 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 conditionSubject 1,2,6,9,100 Chi Square:
Subject 32 Between testing occasions p<0.05
Subject 43 
Subjects 5,84 
Subject 710 
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 palsyBF 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) eBF p = 0.009;
FLTF Short leg -2d (17) eFLTF p= 0.017;
SSF Long leg 3.5d (9.) eSSF p=0.009
SSF Short leg -6.2d (11.3) e
  Ankle dorsiflexion in stance (°)BF Long leg11.9d (11.6) e Comparison long to short
BF Short leg6.5d (6.4) e BF p = 0.22;
FLTF Long leg 15.1d (4.9) eFLTF p=0.241;
FLTF Short leg 14.4d (8.6) eSSF 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 leg3.7d (5.8) e Comparison long to short
BF Short leg3.2d (5.5) e BF p = 0.007;
FLTF Long leg 6.5d (10.9) eFLTF p=0.037;
FLTF Short leg 2.6d (9.3) eSSF 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 leg8.4d (6.4) e Comparison long to short
BF Short leg7.4d (4.4) e BF p = 0.959;
FLTF Long leg 6.6d (2.9) eFLTF p=0.646;
FLTF Short leg 9.3d (7.5) eSSF 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 leg9.6d (6.2) e Comparison long to short
BF Short leg11.3d (3.7) e BF p = 0.114
FLTF Long leg 12.8d (8) eFLTF p=0.241
FLTF Short leg 12.3d (5.70eSSF 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 leg36.3d (9.1) e Comparison long to short
BF Short leg29.8d (5.1) e BF p = 0.005;
FLTF Long leg 34.9d (5.4) eFLTF p=0.139;
FLTF Short leg 34.1d (4.1) eSSF 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 leg37.3 (6.9) e Comparison long to short
BF Short leg33.0 (5.5) e BF p = 0.009;
FLTF Long leg 38.7 (7.3) eFLTF p=0.139;
FLTF Short leg 36.9 (6.1) eSSF 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 leg7.0d (9.6) e Comparison long to short
BF Short leg4.8d (12.6) e BF p = 0.007;
FLTF Long leg 4.9d (10.2) eFLTF p=0.028;
FLTF Short leg 1.9d (10.9) eSSF 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 leg13.4d (6.8) e Comparison long to short
BF Short leg11.9d (7.8) e BF p = 0.508;
FLTF Long leg 7.7d (7.5) eFLTF p=0.114;
FLTF Short leg 9.4d (6.7) eSSF 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 leg63.8d (5.0) e Comparison long to short
BF Short leg62.2d (12.7) e BF p = 0.203;
FLTF Long leg 64.2d (5.2) eFLTF p=0.445;
FLTF Short leg 60.8d (13.4) eSSF p=0.093
SSF Long leg 65.6d (2.7) e
SSF Short leg 62.5d (15.3) e
 Spatiotemporal
  Cadence steps/minEek et al. (2017) [10]Cerebral palsyBF100.6d (17.8) e Friedman ANOVA: p>0.05
FLTF 98.4d (25.7) e
SSF 99.3d (24.9) e
  Stance phase %BF Long leg61.1d (2.03) e Wilcoxon signed rank:
BF Short leg56.8d (4.0) e Comparison long to short
FLTF Long leg 60.8d (292) eBF p = 0.022;
FLTF Short leg 60.0d (4.16) eFLTF p=0.241;
SSF Long leg 62.5d (1.91) eSSF p=0.005
SSF Short leg 58.9d (3.90) e
  Stride length (m)BF1.12d (0.13) e Friedman ANOVA: p<0.05
FLTF 1.24d (0.12) ePost hoc:
SSF 1.24d (0.12) eBF vs. FLTF p<0.05;
BF vs. SSF p<0.05
  Velocity (m/s)BF1.18d (0.16) e Friedman ANOVA: p<0.05
FLTF 1.24d (0.12) ePost hoc:
SSF 1.21d (0.22) eBF 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,