The effectiveness of therapeutic shoes in patients with rheumatoid arthritis: a systematic review and meta-analysis

Rheumatol Int. 2018 May;38(5):749-762. doi: 10.1007/s00296-018-4014-4. Epub 2018 Mar 20.

Abstract

The study summarizes the evidence on the effectiveness of therapeutic shoes on foot function, foot pain, physical functioning, health-related quality of life, adherence, adverse events and patient satisfaction in patients with rheumatoid arthritis (RA). Studies investigating the effect of (ready- or custom-made) therapeutic shoes were included. For between-group designs, studies comparing therapeutic shoes versus non-therapeutic shoes were included. A literature search was conducted in The Cochrane Central Registry for Controlled Trials (CENTRAL), PubMed, EMBASE and PEDro up to January 19, 2017. Quantitative data analysis was conducted; when this was not possible qualitative data analysis was performed. Eleven studies were identified. For custom-made shoes, no studies reporting between-group differences were available. Qualitative data-syntheses of the within-group differences resulted in weak evidence for the reduction of foot pain and improvement of physical functioning. For ready-made shoes, one study reported between-group differences, resulting in inconclusive evidence for improvement of foot function. Quantitative data-analyses of within-group differences resulted in a medium to large effect for the reduction of foot pain (SMD 0.60, 95% CI 0.28-0.92; P ≤ 0.001; 184 participants) and a small to medium effect for the improvement of physical functioning (SMD 0.30, 95% CI 0.04-0.56; P = 0.02; 150 participants). Qualitative data-synthesis of within-group differences resulted in weak evidence for improvement of foot function. Within-group results indicate that therapeutic shoes are likely to be effective in patients with RA. Definitive high-quality RCTs are necessary to investigate the between-group effectiveness of therapeutic shoes in patients with RA.

Keywords: Foot; Footwear, therapeutic; Medical device; Review, systematic; Rheumatoid arthritis; Shoes, therapeutic.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / therapy*
  • Chi-Square Distribution
  • Equipment Design
  • Evidence-Based Medicine
  • Foot / physiopathology*
  • Foot Orthoses*
  • Humans
  • Quality of Life
  • Recovery of Function
  • Shoes*
  • Treatment Outcome