The effectiveness of therapeutic shoes in patients with rheumatoid arthritis: a systematic review and meta-analysis
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The study summarizes the evidence on the effectiveness of therapeutic shoes on foot function, foot pain, physical functioning, health-related quality of life, adherence, adverse events and patient satisfaction in patients with rheumatoid arthritis (RA). Studies investigating the effect of (ready- or custom-made) therapeutic shoes were included. For between-group designs, studies comparing therapeutic shoes versus non-therapeutic shoes were included. A literature search was conducted in The Cochrane Central Registry for Controlled Trials (CENTRAL), PubMed, EMBASE and PEDro up to January 19, 2017. Quantitative data analysis was conducted; when this was not possible qualitative data analysis was performed. Eleven studies were identified. For custom-made shoes, no studies reporting between-group differences were available. Qualitative data-syntheses of the within-group differences resulted in weak evidence for the reduction of foot pain and improvement of physical functioning. For ready-made shoes, one study reported between-group differences, resulting in inconclusive evidence for improvement of foot function. Quantitative data-analyses of within-group differences resulted in a medium to large effect for the reduction of foot pain (SMD 0.60, 95% CI 0.28–0.92; P ≤ 0.001; 184 participants) and a small to medium effect for the improvement of physical functioning (SMD 0.30, 95% CI 0.04–0.56; P = 0.02; 150 participants). Qualitative data-synthesis of within-group differences resulted in weak evidence for improvement of foot function. Within-group results indicate that therapeutic shoes are likely to be effective in patients with RA. Definitive high-quality RCTs are necessary to investigate the between-group effectiveness of therapeutic shoes in patients with RA.
KeywordsRheumatoid arthritis Foot Shoes, therapeutic Footwear, therapeutic Medical device Review, systematic
The present study was financially supported by (1) the Dutch Association of Podiatrists ‘NVvP’, (2) the Dutch industry organization for orthopedic shoe technicians ‘NVOS Orthobanda’, and (3) the Dutch industry organization for pedicures ‘ProVoet’. None of these organizations had a role in developing the study design, collection, analysis, interpretation or manuscript writing.
Compliance with ethical standards
Conflict of interest
The first author (MTD) declares to have a cooperation with a company in producing therapeutic shoes. This company may potentially benefit from, or be harmed by, publication of the results of the study. The co-authors declare that they have no competing interests.
A poster of the present study was presented at the annual European congress of rheumatology (EULAR) in Madrid, June 15 2017.
Research involving human participants and/or animals
This article does not contain any studies with human participants or animals performed by any of the authors.
This article does not contain any studies with human participants performed by any of the authors. Therefore, obtaining informed consent was not applicable.
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