鞋墊介入於足底筋膜炎之效果: 系統性回顧與統合分析

Plantar fasciitis is a chronic condition which often results in heel or medial arch pain. A variety of conservative intervention options is available for plantar fasciitis, including foot orthotic intervention. However, there is only one systemic review and meta-analysis study describing the treatment effect of foot orthoses; and no study comparing treatment effect between customized and prefabricated orthoses. Therefore, the purpose of this study was to systemically review and meta-analyze the effects of foot orthoses on pain and function in patients with plantar fasciitis, including the effect of customized and prefabricated orthoses, and additional effect of using night splint. Methods: Studies were identified by a systematic computer database and cross-reference search. Original research studies which met these criteria were included: (1) subjects with plantar fasciitis, and with no other musculoskeletal and/or systematic problems and previous uses of foot orthoses, injection, or surgery; (2) using foot orthoses as the intervention, either customized or prefabricated; (3) outcome measure containing the efficacy of foot orthoses with self-reported pain and/or function, and giving pre-and-post data with means, standard deviations, and sample size of each group; (4) written in English. We excluded studies which used single group or used other treatment rather than sham orthoses in the control group, or studies with no original data available. Results: Seven studies were included. The results of meta-analysis showed that orthoses were significantly better than sham orthoses on short-term pain control (p = 0.007) and both short-term and long-term functional improvement (p ＜ 0.001). Customized orthoses and prefabricated orthoses had similar effect on pain and functional improvement (p ＞ 0.05). Orthoses combined with night splint resulted in better pain control (p = 0.022) and functional improvement (p = 0.015) as compared to the orthoses alone. Conclusion and clinical relevance: Orthoses could effectively decrease pain intensity and improve function in patients with plantar fasciitis. The combination of night splint and orthoses was better than orthoses only in pain control and functional improvement.