Efficacies of different external controls for excessive foot pronation : a meta-analysis

Objectives: This meta-analysis investigated the efficacies of foot orthoses, motion control footwear and therapeutic adhesive taping in controlling foot pronation as compared with no-intervention conditions. Data sources: Electronic searches on four electronic databases were performed and the reference lists of the screened articles were also scrutinised. Review methods: Two reviewers screened the quasi-randomised or clinical controlled trials that examined the efficacy of the selected interventions in controlling calcaneal eversion. Heterogeneity and publication bias were assessed by I2 index and Egger’s regression intercept, respectively. Trial quality was rated by the Physiotherapy Evidence Database scale. Results: 29 studies were selected. The I2 indices revealed large heterogeneity which supported the use of a random effect model of meta-analysis. The Egger’s regression intercepts suggested that publication bias of the included studies was marginally present in the motion control footwear and the therapeutic adhesive taping groups (p=0.06–0.07). All three interventions were effective in reducing calcaneal eversion (p<0.001) with therapeutic adhesive taping being most effective whereas Low-dye taping was less effective than the other taping techniques, such as high-dye and stirrups taping. Custom-made foot orthoses were more effective than prefabricated orthoses. Motion control footwear with heel flare or wedge design was less effective than those with dual midsole materials. Conclusions: Foot orthoses, motion control footwear and therapeutic adhesive taping were able to control rearfoot eversion with therapeutic adhesive taping being the most effective. In the clinical practice, selection of an antipronation intervention should be based on patient characteristics, type of activity and personal preference.