conservative interventions for mobile pes planus in adults: a systematic review.

by:Keyuan     2020-05-28
Sumario: 1. Introduction. 2. Aim. 3. Methods. 4. Results. 5. Discussion. 6. Conclusion. References. 1.
Introduction Pes Planus is a descriptive term that includes flexible and rigid flat feet.
This is a common situation that has been recognized for many years, but its natural history has never been studied.
It is thought to be harmful to function and related to pain, although it is not easy to identify flat feet that will and will not show symptoms or predict them.
Flat feet are usually associated with a range of pathological conditions affecting the foot-
For example, a Arch or symptom of pain (5)--
And the proximal skeletal chain of muscles-
For example, Achilles tendon terminal disease or pain in the femoral joint (6).
This is despite the lack of generally accepted definition of normal arch height in the general population (7)
, And the lack of effective clinical or radiographic definitions (8).
The current classification system provides a wide range of guidelines for the treatment of flat feet, basically dividing flat feet into normal, flexible or stiff, and separating the tendon dysfunction after tibialis (9).
Where the flat feet are rigid, it is not possible to restore alignment and functionality, but in moving or flexible flat feet ---
When there is no normal arch, you can see the normal archweight bearing--
It is possible to use a series of treatments to improve the structure and function and relieve the symptoms.
In the absence of high-quality information, management methods have developed through experience, observation and theoretical assumptions, and many professional champions advocate specific and sometimes esoteric treatment systems.
Treatment options are based on clinical information and compromise evidence bases that report a large number of treatments from conservative treatment to surgical treatment.
First, conservative treatment is usually used, including advice (10-14)
, Stretching, footwear modification (15)and strapping (16).
Despite the wide and widespread use of a range of treatments, there is no consensus on the best approach. 2.
Objective the purpose of this review is to evaluate the evidence of a controlled trial of conservative treatment of adult mobile pes flat Moss to determine the optimal treatment strategy. 3.
Methodological criteria for considering research for this type of review
Randomized or controlled clinical trials that meet the following participant, intervention or outcome specifications are eligible for inclusion.
The types of participants included in this review are limited to participant trials that meet the following inclusion criteria: 1.
Adults> 16 years old. 2.
Pain in moving pes flat Moss for more than 3 weeks duration. 3.
Using the previously reported technology, a satisfactory system for the diagnosis of mobile pes flat Moss. 4.
There is no history of severe trauma or systemic inflammation, such as arthritis. 5.
Studies of various soft tissue conditions in all sites or pain caused by tendonitis/tendonitis are considered qualified, provided that pes flat Moss pain results are presented separately, or 90% of the study
Studies that exclude criteria for any specific diagnostic conditions reported separately, such as heel pain, toe stress fracture, post-tibialtendon dysfunction, ankle fracture, rheumatism foot pathology, and exclusion of neurological and diabetic foot pathology.
Type of intervention * any rigid, semi-
Regid or soft foot correction designed to manage pes flat Moss by redesign
Relieve and/or relieve pain * resistance
Pronunciation binding.
* Stretching exercise * footwear modification * measurement of results of type of foot health promotion Main results: * quantifiable measurement of pain (e. g.
Visual Analog Scale)
* Quantifiable measurements of functionality or consistency * Quality of Life * adverse effects of other outcomes: * patient satisfaction * measurement of shoe wear marker distribution * comfort * satisfaction search method looking from thecochane central controlled trial register for the determination of the research to be considered for review (CENTRAL).
The CMSGSpecialized trial register was also visited.
Do an electronic search using MEDLINE, EMBASE, CINAHL, paper index, paper summary, and current content.
In MEDLINE, the best search strategy for random trials described by Robinson (17)
Use with the specific search terms and strategies described below.
Electronic search complements manual search: * bibliographic references for identified Studies * latest content as of June 2012 (
Determine that the study is not yetindexed articles)
* A summary published in a special journal or a special journal of the minutes of the meeting.
Search the reference list by hand to find other studies reported in published papers, presentations at science conferences, and personal exchanges.
Contact content experts for more research and unpublished data.
In MEDLINE, the best search strategy for random trials described by Robinson (17)
Use with the following specific search terms: 1 exp flat /(966)2 flat foot[dollar]. mp. (156)3 flatfoot[dollar]. mp. (1016)4 flat feet. mp. (106)5 flatfeet. mp. (37)6 pes planus. mp. (146)
7 painful foot. mp. (57)
8-seat pes planovalgus. mp. (36)
9 tendon dysfunction after the tibia. mp. (86)10 or/1-9 (1267)
11 randomized controlled trials. pt. (188086)
Twelve controlled clinical trials. pt. (66155)
13 randomized controlled trials. sh. (32035)
14 random allocation. sh. (50531)
Double blind method. sh. (77825)16 single-blind method. sh. (8032)
Clinical trials. pt. (380807)
18 clinical trialssh. (114062)
Clinical trials. tw. (29898)20 ((singl[dollar]or doubl[dollar]or trebl[dollar]ortripl[dollar])and (mask[dollar]or blind[dollar])). tw. (79643)21 placebos. sh. (22956)22 placebo[dollar]. tw. (83635)23 random[dollar]. tw. (282433)
24 research design /(37786)
25 comparative studies. sh. (1114320)
26 evaluation studies. sh. (114841)27 follow-up studies. sh. (282159)
28 prospective studiessh. (172213)29 control[dollar]. tw. (1236021)30 prospectiv[dollar]. tw. (176671)31 volunteer[dollar]. tw. (83301)32 or/11-31 (2936912)33 (
Animals are not human). mp. (89340)34 32 not 33 (2904240)35 10 and 34 (275)
Electronic search is supplemented by manual search.
Search for the following. 1.
Bibliographic references for studies have been identified. 2.
Current content as of April 2007 (
Determine the provisions of yetindexed articles). 3.
A summary published in a special journal or conference record. 4.
The reference list is handwritten
Search for published papers, scientific conference speeches, and other studies reported in personal communication. 5.
Content experts were contacted for further research and unpublished data.
Identification of data collection and analysis research identification titles and summaries by searching for appropriate resources, and read by two reviewers.
Complete documentation of potential conformity test reports was obtained in order to conduct a comprehensive assessment of them, thus designing a list of conformity tests.
In the process, the details of the exclusion study were collected, as well as the reasons for the exclusion.
The inclusion and conclusions were discussed by the two main reviewers, and a third reviewer was available for dispute resolution.
The evaluation of the quality assessment method is carried out independently by two reviewers.
The results were compared and discussed, and in the event of a dispute, a 3rd commenter acted as an arbitrator. Domain-
Based on the recommendation of the fifth edition of the cochrane Handbook for Systematic review of interventions, the included papers were evaluated based on an explicit focus on assessing risk of bias. 1. 0 (
Highins & Green 2011)(21).
This focuses on areas such as selection, performance, detection, loss and reporting bias, including other sources of potential bias considered in individual studies.
This tool is the choice of a quality assessment tool, along with the overall (1996)(22)
Scale, whether to overcome the problem of judging quality according to the level of reporting rather than the degree of strictness (
Method quality)
The study was conducted.
Data extraction and bias risk assessment involves the completion of customized forms designed for this purpose, following the guidelines of the Cochrane Intervention data analysis system review manual, although it is intended to utilize various data analysis techniques, including the evaluation of the homogeneity of the study and the derivation of the evaluation rules for continuous/binary data and fordata pooling, the small number of qualified studies and the diversity of reported results measurements excluded this.
Therefore, the focus is on the narrative of the results. 4.
Description of the results of the study see: Features of the study included/features of the exclusion study (Tables 2-5/ Table 6)
Eighteen studies were identified, of which 14 were excluded for various reasons under \"excluded studies\" but were mainly focused on experimental design using standardized or control procedures.
The reasons for exclusion are included in the features of the excluded study.
This review includes four studies on the intervention of pes flat Moss in adult mobility: Rome (2004)(1); Esterman (2005)(3), Redmond(2009)(2)
Captain Zheng et al (2011)(4).
The number of subjects recruited was low. -
Rome n = 50, Eastman n = 47, Redmond n = 15, Zheng n = 28--
As a result, there were 140 subjects in total.
Although the descriptive terms and methods used for diagnosis vary, they are concentrated on flat feet. Rome(2004)
Index of posture with feet (Redmond 2006)(18)
If not absolutely effective, this is usually an acceptable method of measurement of foot postures for the diagnosis of \"overpronounced\" feet. Redmond (2009)
Supplement FPI with Rose\'s ValgusIndex (Rose 1985)(19)
And the relaxed heel position of> 5 degree valgus. Esterman(2005)
Using the arch index (Cavanagh 1987)(20)
This is an old technique based on footprints and Jung et al 2011 used a relaxed heel pose of> 4 degrees {
1 degree lower than Redmond\'s valuation (2009)--
And diagnosis of \"pes planus\"> 13mm of the boat decline.
Although the boat shape drops is a good one
Describedmeasure, it was suggested that it must be standardized with pedestrian length in order to improve effectiveness (Evans 2003). (8)
Changes in diagnostic criteria used mean that it is conceivable that not all subjects meet the inclusion criteria in different studies.
Although all the research uses some form of foot correction-
Customized or prefabricated--Jung et al (2011)
In addition, the effect of \"short foot exercise\" aimed at increasing the strength of the intrinsic muscle tissue in combination with foot correction was also studied. Rome (2004)
The effect of prefabrication correction instrument on three equilibrium parameters was investigated. -
Average balance and front
Andmedio on the back-
In the agroup of 50 participants, lateral swings were measured using the balance performance monitor.
Half of the 50 people were assigned to receive foot correction, and the other half were assigned as controls, and the trial lasted more than 4 weeks.
It is reported that the control group and the intervention group
After shaking, despite significant differences (p= 0. 02)
Reported medial swing. Esterman (2005)
47 New Royal Australian Air Force recruits were assessed for their impact of prefabrication correction on pain, injury, foot health and quality of life.
25 subjects were assigned to undergo 3/4-length prefabricated foot correction using a computer randomized digital generator, and 22 subjects were not treated.
No significant differences were found in any of the variables, although since only half of the treatment groups wore corrective ses within the specified time, the analysis was modified from two groups to three groups, the treatment group is divided into a person who has worn the device and a person who has not. Redmond (2009)
A laboratory-based random cross-test was conducted.
Fifteen subjects were recruited and randomly grouped through a sealed envelope system to determine if they would receive a customized 4mm polypropylene correction or a prefabricated internal posting correction first.
Baseline measurements were obtained and firstorsis was released according to the random grouping, and when the measurements were repeated, the subjects returned to the laboratory two weeks after wearing the first device. Cross-
On the appropriate second device, the participants returned again after two weeks for further measurements.
A wide range of 7 plantar pressure measurement variables were collected for 5 discrete plantar regions including heel, midfoot, medial front foot and lateral front foot, peak pressure, maximum average pressure, hallux, and lateral figures are included.
This analysis was carried out through the \"massage\" procedure, which divided the foot area of the foot into discrete areas to allow the investigation of the range of 35 variable/mask combinations.
Compared to the control conditions of 11 of the 35 variables/mask combinations, differences have been found, and the custom device shows the enhancement changes of the three variables on the prefabrication device, although this has not been translated
Thus, while it appears that prefabrication and custom equipment will produce a difference in the distribution of foot pressure, the effect does not seem to depend on the type of equipment. Jung et al (2011)
Examined the effect of custom foot correction, either individually or in combination with \"short foot exercises\", on the cross-sectional area of the hallucination of the muscles, using ultrasonic measurements, and the strength of the hallucination flexors, evaluate using a digital generator for more than 8 weeks.
240 volunteers identified bilateral pes flat Moss and 20-by relaxing Achilles tendon posture and boat-like descent measurements-
Eight subjects met all inclusion criteria and were randomly divided into two groups.
The first group received separate foot correction, and the second group received guidance on internal foot muscle movement techniques other than foot correction.
This corrective appliance is a functional corrective appliance of 1/8/3mm. Pre-test and post-
Test measurements of the illusion cross-sectional area of the kidnappers were evaluated using 7.
5 MHzlinear array ultrasonic probe.
The forces of the hallucinated flexors were measured with a digital force meter.
Although both groups showed significant differences compared to baselinep=0. 015)
Power of flexors (p=0. 000)
, There are significant differences in the changes observed in the groups that exercise and use custom correction (
Cross section of the abduction hallucisp = 0. 008;
Power p = 0. 008).
There is a risk of bias in the included studies the quality of the four methods included in the study is poor.
Use a tool focused on five key bias areas proposed by cochrane to conduct an independent evaluation of the quality of all methods included in the trial-
Select, perform, detect, loss, and report, and provide an additional section of any other area that produces deviations.
Although all studies have adopted a randomized controlled trial design, execution in at least one of these areas is flawed in each case, which increases the likelihood that results may be contaminated by bias (
See the properties of the study table).
Selection bias evaluation the focus of selection bias is to identify any risk of system differences between the groups being compared.
It is influenced by hidden objects of recruitment, random techniques and group allocation.
Subject: Although all four studies used an objective assessment system to diagnose pes flat Moss, none of the participants in either study were selected for complaints of persistent pain or restricted functioning, nor were theyRome (2004)
Hundreds and twenty states
Four subjects were identified but no reference was made to the population of origin.
74 people failed to meet the exclusion criteria and 50 participants entered the trial with demographic data (
Age, weight, height)
It shows that the population is physically homogeneous. Esterman (2005)
Recruiting 47 members of the Royal Australian Air Force (RAAF)
Recruits who are undergoing basic training, using the Arch index to diagnose pes flat Moss based on footprint assessment (19,20).
The entry requirements for RAAF again indicate the same source group, although the physical level of this group may compromise external effectiveness. Redmond (2009)
15 participants aged 18
45 were recruited through the viaa poster campaign at the University Clinic.
The exclusion criteria include a specific score for the foot posture index and the Valgus index for Rose, as well as any current pain or disability, so that the participants are healthy.
Although patients recruited through the clinic poster may have symptoms, there is only room for the exclusion criteria of asymptomatic patients, and the reasons for their participation in the clinic are unknown.
No further population data is provided, so the homogeneity of the population is unknown, which contradicts the external validity.
This may be considered irrelevant given the limited sample size of 15, which represents a more significant limitation. Jung et al (2011)
The statement screened 240 volunteers at a university, although no further clarification was made as to whether this refers to university staff, students or out-patient patients.
Application of exclusion criteria, including the use of relaxed Achilles tendon posture and boat descent to assess foot posture, as well as a range of factors associated with general health, to reduce this pool to 20-eight subjects.
Features of population and human body measurement are provided.
Although there is a certain degree of homogeneity in the study, there is a huge heterogeneity between the studies, which prevents the collection of data, and each study has a high risk of deviation (
Features of research tables).
An acceptable random process was used in all studies. Rome(2004)
Independent observers using a random table, Esterman (2005)
Using a computerized random number generator, Rong et al (2011)
Draw cards marked with group assignments from the card pool. Jung et al (2011)
Provides a comparison of population and human body measurement data (
Age, height, body mass, relaxed position of the heel, boat Bone Gap)--
It was also statistically confirmed that there was no significant difference in these variables between groups.
This useful confirmation exercise demonstrates a successful random process.
While these three studies use random programs for group allocation, Redmond (2009)used sealed-
The envelope is randomly assigned to the intervention used first, using cross
Over-methodology, during the study, each participant was subjected to two interventions, using two weeks before testing each corrective technique.
The use of acceptable random techniques reduces the risk of bias.
Distribution concealment although the random technique adopted reduces the possibility of bias, there is no hidden distribution in the three studies, resulting in the risk of bias. Rome (2004)
All measurements were recorded using an independent assessor, but did not blind the person. TheEsterman (2005)
This study is the second part of a large project for prospective cohort studies of recruits.
It is unlikely that the assessor will turn a blind eye to the purpose of subject assignment, intervention assignment, or outcome measurement, as this is not mentioned in the first part of the study ---
A prospective study-
Random trials are nested in it. Redmond (2009)
Without providing hidden details, it seems that the author is responsible for obtaining and analyzing data from the author contribution statement at the end of the article. Jung et al (2011)
State that all the tests were conducted by the same investigator, that the customized correction was obtained by the chief investigator, who turned a blind eye to the allocation of the intervention.
No details were provided on how to achieve this;
However, in particular, with respect to the weekly meetings of the main investigators with the subjects to ensure that the exercises are uninterrupted ---
There are opportunities for pollution.
Therefore, all studies are considered to be at risk of selective bias, as compromise in at least one area leads to this risk (
See the features of Table 2-5).
Performance bias evaluation focuses on determining whether the study participants and/or personnel are blind, which helps to ensure that the comparison group receives similar attention, adjuvant therapy, and diagnostic surveys. Rome (2004)
There was no placebo intervention, so one group knew that it had undergone correction, while the other group did not, and knew that.
All measurements are recorded using independent observers, but not blindly. Esterman (2005)
Corrections were randomly provided to about half of the subjects, which were installed by qualified correctors.
No information was provided about what was provided to the thisorist or that they were independent of the study.
After consultation with RAAF podiatrist, senior medical officer, physical training instructor and correction provider, corrective surgery was selected.
This suggests that an open and transparent study lacks information about blinding and there is no reason to believe that appropriate steps have been taken. Redmond (2009)
There was no mention of any blinding of participants to the condition being tested, and supervision of data collection by lead authors indicated that no assessors were blinding.
Jung et al. 2011 noted that all tests were conducted by the same investigator, but also indicated that the main investigator assisted manually-
According to personal abilities--
Maintain the longitudinal arch of the body during the first two months of short foot practice.
Participants in the \"correction only\" group were directly asked not to take part in any foot and ankle exercise program, which meant that the \"exercise\" group received close attention.
It is clear that the subjects were not blinded by the intervention, and the investigators played a key role in assessing the progress of the trial.
Therefore, the risk of performance bias was high in all 4 studies.
Detection deviation evaluation detection deviation focuses on determining whether there are systemic differences between groups in how to determine the results.
All studies evaluated the results of different groups in a consistent manner.
As mentioned earlier, the assessor will not be blind in any trial, which represents a potential bias.
However, a variety of results measurement methods, including multiple mass-are used-of-
Life questionnaires such as FHSQ and WHOQOL (Esterman2005)
Distribution of pressure to the sole (Redmond 2009)
Stable After (Rome 2004)
And muscle strength/CrossoverSection area (Jung2011).
It is generally believed that the failure to ignore the assessors is particularly relevant to subjective results, and therefore, except for Esterman (2005)
Studies have shown that, due to the objective nature of the measurement recorded, it is unlikely that an impact on the assessor could not be applied. Esterman (2005)
A series of results, including the injury rate, and provide a clear definition of the injury, that is, the need for> 3 days of rest training, thus including a mix of objective and subjective results.
Issues related to lack of assessor blinding and self-related incomplete information provided
Or assisting in the completion of the questionnaire makes it difficult to judge the risk of deviation from Esterman\'s detection (2005).
The use of objective results in the remaining three studies indicated a lower risk of detection bias.
The natural attrition bias assessment considers whether there is a systematic difference between groups withdrawn from one study. The four studies included in the review performed well in the following areas
Environmental control--
Mainly due to their experimental nature.
This reduces the loss in all studies, but does not eliminate the problem.
It is worth noting that Esterman (2005)
In the basic training of RAAF recruits.
Although no subjects have lost follow-up in the traditional sense, the level of use is different.
20 out of 25 reported frequency of use, 10 out of 20 wore it all or most of the time, and the rest said they did not use it regularly.
This exposure to the intervention is different and leads to a high risk of bias. Rome (2004)
100% follow-up was achieved.
Similarly, Redmond (2009)
The completion rate of 15 participants reached 100%. Jung et al (2011)
Do not mention natural attrition, although the 8-week period involving only 28 subjects suggests that it may be feasible to have no natural attrition, which and all other studies seem to be, except for Esterman 2005Esterman (2005)
Although the remaining studies have a lower risk of attrition bias, they can be judged to be at high risk.
The reporting bias focuses on whether there is a systemic difference between the report and the unreported findings.
The nature of the studies included-
There are clear, basically objective results. -
In three of the four studies, deviations were prevented from being reported and all results were reported. Rome (2004), Redmond (2009)and Jung etal (2011)
Everyone uses a small number of objective results of high specialization.
Rome, for example (2004)
Focused on balance assessment, Redmond 2009 focused on the distribution of plantar pressure, jung et al 2011 assessed muscle strength and muscle cross
Area, making the report simple, all variables are easily tracked and can be fully reported.
Although Esterman (2005)
The result of using the number of alarger, some of which are self
After completing the questionnaire, the risk of reporting deviations also appears to be low.
Other biases may reflect any issues not covered in the title of fivemain.
In addition to the risk of bias found in key areas, there are several other influencing factors --
These also affect the quality of learning. Esterman (2005)
A second-hand prefabricated appliance formed and issued by an appliance, but the manufacturer agreement is not used for hair dryers, nor for hot guns.
Therefore, it is unlikely that the ruler will reach the recommended temperature
Mold temperature.
The impact this may have on the outcome is unknown, but it does represent a flaw in the agreement.
A potentially more important bias is the use of crossover
Redmond design (2009)
Evaluate the relative effects of customization and reservation
Correction made under foot pressure.
The study recruited 15 subjects and conducted basic tests before random release of custom or pre-release
The devices were used for two weeks before the measurements were confirmed, and then the subjects were transferred to the second device.
The use cycle of two weeks before the last set of measurements. Cross-
Over-testing is considered appropriate to assess interventions that have a temporary impact on stable conditions.
If the situation changes during the study, or if the intervention has an impact that can be produced --
As for interfering with the second intervention, this design is inappropriate unless the flushing cycle is used, and the effect of one intervention is negligible before the introduction of the second intervention.
Failure to include any flushing period before the introduction of a secondary intervention could theoretically create a risk of bias.
Requirements and optimum length for washing-
In order to determine the applicability of this design function, a survey is required.
The risk of this bias increases the risk of occurrence in key areas and further highlights the lack of research on pes flat Moss interventions.
Effects of the intervention we included four studies in the review that met the inclusion criteria [
Table below] measures of results.
Is the treatment intervention effective?
It is clear that any interventions set out in the review will not have any significant impact on the short-term or long-term prognosis of this situation.
In each trial, both intervention and outcome measurement had unknown clinical utility. 5.
Discussion although there is a broad literature base on conservative treatment of pes flat Moss in adults, it is not possible to draw any conclusions about the effectiveness of the intervention.
This is the result of several clear, recurring problems related to the methods used and the measurement of the results selected in the research base.
The general approach is of poor quality, and biasin risk is high for at least two key areas per study.
Although it can be seen that the included studies use techniques to reduce the risk of bias, they are often associated with inexpensive and easy-to-implement technologies.
For example, it is common to see the use of robust random techniques, probably because they are relatively easy to implement and at the lowest cost.
On the contrary, more expensive and complex techniques that reduce the risk of bias, such as the use of independent, blind assessors, are not commonly used.
Such technology will increase the resources needed for research. -
It may reduce their financial viability.
If such a core problem is to be addressed, or if the quality of the method continues to be poor, sufficient resources are critical and the risk of bias will continue to be high.
In the pes planus literature, a large number of results measurements have been reported, including muscle activity in the lower limbs (
Franattovichet al 2012)
EMG of EPS and middle femoral muscles (Hertel2005)
Angle of EPS (Kuhn 2002)Gait Pattern (Kulcu et al 2007)
Activation after tibianca (Kulig 2005)
And ground reaction force (Miller 1996).
This is, at least to some extent, due to the duration of the trial and the difficulty in obtaining homogeneous symptom subjects over the long termterm follow up.
Pes flat Moss is a chronic, multiple
In theory, diseases related to various symptoms and signs.
Thus, the potential performance of this condition is multifaceted, including pain, functional limitations, and gait variables including movement, movement, and EMG variables.
This provides a lot of opportunities for experimental research.
Focus on gaitvariables eliminates the need for symptom subjects and allows
Long-term studies assess the impact of the intervention on gaitperformance, regardless of the long-term impact on pain and functional limitations. Gait-
However, the relevant variables are unproven measures of proxy effectiveness,
A clear association between pain and functional limitations.
Focus on Experimental research-
It is undoubtedly driven by convenience. -
Related to the subject of literature and the ability to draw conclusions from literature.
The result is that the results described in the basic table 1 of the literature have extreme heterogeneity, which prevents the meta
The analysis did not provide an indication of the impact of the intervention on clinically important outcomes.
Consistent with the focus of the Cochrane Collaboration Network, patient-oriented results such as aspain and functional limitations are required, and the recruitment of subjects with symptomatic pes flat Moss should be given priority. 6.
Conclusions while the intervention described in the included studies may have some benefits, there is not enough evidence to establish which conservative treatments are best suited for the treatment of pes flat Moss in adults.
The quality of the study is poor, and there is a large heterogeneity between the studies-
In terms of participants, interventions and outcomes.
Consensus should be reached on the types of participants, interventions and outcome measures that should be used to allow future meta-studies before conducting other studies
Analysis to be carried out.
Based on the results of this review, we conclude that there is no available evidence from a randomized controlled trial to determine which treatment is best suited for adult flat Moss.
There is no evidence of the use of strapping, lower foot modifications or stretching.
For the effectiveness of foot correction in the treatment of pes flat Moss in adults, there is only limited evidence: the evidence is characterized by focusing on asymptomatic subjects, not those experiencing symptoms, select a series of agency measures relative to the patient
Results-oriented, long term
The meaning of the term is not understood due to the short time of use.
However, despite the large literature base, the question of study quality, to what extent foot correction may alter foot function, quality of life and reduce pain, the use of experimental designs for evaluation of asymptomatic subjects in the study remains to be determined, as well as an evaluation of a range of results measures that frequently fall ill
A clear association with patient-oriented outcomes prevents any conclusion from being reached.
New trials should investigate long term
Compared to other non-football projects, the long-term advantages of football projects
Surgical procedures such as stretching, strengthening, or tying.
Reasonable lengthup (
At least one year or more)
Recurrence and long-term results need to be detected.
If foot correction is effective
Surgery and surgery should also be considered.
Los autorees announced that no more time was needed. 5209/rev_RICP. 2016. v10. n2.
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Comment on the research features of Robert L Ashford [1,2]
Ian matessen3], Keith ROME [4][1]
College of Health, Birmingham City University, Birmingham, United Kingdom. Robert. Ashford@bcu. ac. uk [2]
Research Institute of Work-based learning, London University of London. [3]
School of Health Sciences, City University, Cardiff, UK.
IMathieson @ cardiffmet. ac. uk [4]
Department of Rehabilitation and vocational studies, University of Auckland, Auckland 1020, Keith, New Zealand. rome@aut. ac.
New Zealand reporter: Professor Doctor
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