Evidence Needed for Children’s Therapeutic Footwear

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An open-access study that explored the effectiveness of footwear as an intervention for mobility impairment in children found a limited number of studies that investigated the effects of therapeutic footwear and only in a narrow range of mobility impairments. The researchers suggested that high-quality research is necessary to improve the evidence base, which should include a wide range of mobility impairments and focus both on physical and psychosocial outcomes.

 

The researchers conducted a systematic search of MEDLINE, CINAHL, PubMed, SPORTdiscus, and Scopus databases. Studies that focused on children with a mobility impairment who were nine months to 18 years old, used therapeutic footwear that allowed walking, and had completed outcome measures that explored biomechanical or skeletal geometry or psychosocial aspects were included in the review. Modified Downs and Black quality assessment index of randomized and non-randomized studies were used to assess the methodologies of included papers.

 

Out of 5,003 articles sourced, 13 met the inclusion criteria. The articles were grouped into corrective or functional based on the types of footwear used for intervention. Studies within the corrective footwear group included participants age 11 months to five years old with moderate congenital talipes equinovarus or mobile pes planus. While using skeletal geometry as an outcome, there was a limited fair quality (level II) evidence that corrective footwear has no significant effect on the development of pes planus but may assist in the reduction of deformity in congenital talipes equinovarus.

 

The functional footwear group included participants three to 17 years old, predominantly with mobile pes planus or cerebral palsy. Based on biomechanical measures as an outcome, there was a limited fair quality (level III) evidence that functional footwear alters biomechanical parameters in mobile pes planus (spatiotemporal) and cerebral palsy (spatiotemporal, kinematic). Although psychosocial outcomes were considered in two studies, the analysis was limited.

 

For more information, see "Effectiveness of therapeutic footwear for children: A systematic review" in the Journal of Foot and Ankle Research.