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Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review
BACKGROUND: Dynamic foot function is considered a risk factor for lower limb overuse injuries including Achilles tendinopathy, shin pain, patellofemoral pain and stress fractures. However, no single source has systematically appraised and summarised the literature to evaluate this proposed relations...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296532/ https://www.ncbi.nlm.nih.gov/pubmed/25598843 http://dx.doi.org/10.1186/s13047-014-0053-6 |
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author | Dowling, Geoffrey J Murley, George S Munteanu, Shannon E Smith, Melinda M Franettovich Neal, Bradley S Griffiths, Ian B Barton, Christian J Collins, Natalie J |
author_facet | Dowling, Geoffrey J Murley, George S Munteanu, Shannon E Smith, Melinda M Franettovich Neal, Bradley S Griffiths, Ian B Barton, Christian J Collins, Natalie J |
author_sort | Dowling, Geoffrey J |
collection | PubMed |
description | BACKGROUND: Dynamic foot function is considered a risk factor for lower limb overuse injuries including Achilles tendinopathy, shin pain, patellofemoral pain and stress fractures. However, no single source has systematically appraised and summarised the literature to evaluate this proposed relationship. The aim of this systematic review was to investigate dynamic foot function as a risk factor for lower limb overuse injury. METHODS: A systematic search was performed using Medline, CINAHL, Embase and SportDiscus in April 2014 to identify prospective cohort studies that utilised dynamic methods of foot assessment. Included studies underwent methodological quality appraisal by two independent reviewers using an adapted version of the Epidemiological Appraisal Instrument (EAI). Effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. RESULTS: Twelve studies were included (total n = 3,773; EAI 0.44 to 1.20 out of 2.00, representing low to moderate quality). There was limited to very limited evidence for forefoot, midfoot and rearfoot plantar loading variables (SMD 0.47 to 0.85) and rearfoot kinematic variables (RR 2.67 to 3.43) as risk factors for patellofemoral pain; and plantar loading variables (forefoot, midfoot, rearfoot) as risk factors for Achilles tendinopathy (SMD 0.81 to 1.08). While there were significant findings from individual studies for plantar loading variables (SMD 0.3 to 0.84) and rearfoot kinematic variables (SMD 0.29 to 0.62) as risk factors for ‘non-specific lower limb overuse injuries’, these were often conflicting regarding different anatomical regions of the foot. Findings from three studies indicated no evidence that dynamic foot function is a risk factor for iliotibial band syndrome or lower limb stress fractures. CONCLUSION: This systematic review identified very limited evidence that dynamic foot function during walking and running is a risk factor for patellofemoral pain, Achilles tendinopathy, and non-specific lower limb overuse injuries. It is unclear whether these risk factors can be identified clinically (without sophisticated equipment), or modified to prevent or manage these injuries. Future prospective cohort studies should address methodological limitations, avoid grouping different lower limb overuse injuries, and explore clinically meaningful representations of dynamic foot function. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13047-014-0053-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4296532 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42965322015-01-17 Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review Dowling, Geoffrey J Murley, George S Munteanu, Shannon E Smith, Melinda M Franettovich Neal, Bradley S Griffiths, Ian B Barton, Christian J Collins, Natalie J J Foot Ankle Res Review BACKGROUND: Dynamic foot function is considered a risk factor for lower limb overuse injuries including Achilles tendinopathy, shin pain, patellofemoral pain and stress fractures. However, no single source has systematically appraised and summarised the literature to evaluate this proposed relationship. The aim of this systematic review was to investigate dynamic foot function as a risk factor for lower limb overuse injury. METHODS: A systematic search was performed using Medline, CINAHL, Embase and SportDiscus in April 2014 to identify prospective cohort studies that utilised dynamic methods of foot assessment. Included studies underwent methodological quality appraisal by two independent reviewers using an adapted version of the Epidemiological Appraisal Instrument (EAI). Effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. RESULTS: Twelve studies were included (total n = 3,773; EAI 0.44 to 1.20 out of 2.00, representing low to moderate quality). There was limited to very limited evidence for forefoot, midfoot and rearfoot plantar loading variables (SMD 0.47 to 0.85) and rearfoot kinematic variables (RR 2.67 to 3.43) as risk factors for patellofemoral pain; and plantar loading variables (forefoot, midfoot, rearfoot) as risk factors for Achilles tendinopathy (SMD 0.81 to 1.08). While there were significant findings from individual studies for plantar loading variables (SMD 0.3 to 0.84) and rearfoot kinematic variables (SMD 0.29 to 0.62) as risk factors for ‘non-specific lower limb overuse injuries’, these were often conflicting regarding different anatomical regions of the foot. Findings from three studies indicated no evidence that dynamic foot function is a risk factor for iliotibial band syndrome or lower limb stress fractures. CONCLUSION: This systematic review identified very limited evidence that dynamic foot function during walking and running is a risk factor for patellofemoral pain, Achilles tendinopathy, and non-specific lower limb overuse injuries. It is unclear whether these risk factors can be identified clinically (without sophisticated equipment), or modified to prevent or manage these injuries. Future prospective cohort studies should address methodological limitations, avoid grouping different lower limb overuse injuries, and explore clinically meaningful representations of dynamic foot function. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13047-014-0053-6) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-19 /pmc/articles/PMC4296532/ /pubmed/25598843 http://dx.doi.org/10.1186/s13047-014-0053-6 Text en © Dowling et al.; licensee BioMed Central. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Dowling, Geoffrey J Murley, George S Munteanu, Shannon E Smith, Melinda M Franettovich Neal, Bradley S Griffiths, Ian B Barton, Christian J Collins, Natalie J Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
title | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
title_full | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
title_fullStr | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
title_full_unstemmed | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
title_short | Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
title_sort | dynamic foot function as a risk factor for lower limb overuse injury: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296532/ https://www.ncbi.nlm.nih.gov/pubmed/25598843 http://dx.doi.org/10.1186/s13047-014-0053-6 |
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