Footwear Interventions for Foot and Ankle Arthritis
Inclusion / exclusion criteria
Titles and abstracts were screened by a single reviewer ( M . F .). Full-text articles were obtained from selected abstracts and compared against the following inclusion criteria by a single reviewer ( M . F .). Studies were included if they met the following criteria : being a randomized controlled trial , prospective observational intervention trials or cross-sectional intervention trials ; published in English ; peer-reviewed publications ; participants over the age of 18 years ; studies reporting on findings of footwear interventions for people with arthritis with foot pain , function ( including temporal-spatial , plantar pressure , kinematic and kinetic data ), impairment and / or disability measured as a primary outcome . Studies were excluded if : investigated arthritis not affecting the foot or ankle , case study and case series design , studies reporting findings of interventions where footwear was not been standardized for participants ( custom footwear ), studies where footwear was used as a control condition for foot orthoses or adapted for three-dimensional marker placement for foot orthosis interventions . Off-the-shelf footwear was defined as commercially available walking and running shoes . Therapeutic footwear was defined as readymade , orthopaedic-style footwear . Citations of retrieved publications were examined to obtain further sources .
Data extraction
A standardized form was used to extract publication details [ author ( s ) and year ], study design , participant sample characteristics ( age gender and participants entered into study ), follow-up period , description of footwear intervention , control / comparator intervention and outcome measures used to assess foot pain , function , impairment and disability were recorded .
Assessment of methodological quality
Methodological quality was independently assessed by two authors ( M . F . and M . C .) using the Quality Index Tool [ 14 ]. The Quality Index Tool comprises of 27 items allowing for the assessment of internal validity , external validity , power , analysis and reporting . Item 27 was adapted to be scored , 0 or 1 based on the reporting of a powered sample size calculation . Total raw scores were converted into a percentage . The tool displays high internal consistency , test – retest reliability and inter-rater reliability [ 14 ] . Kappa statistic was used to assess intra-tester agreement between reviewers . All disagreements in scoring were resolved following discussion , with a third reviewer ( K . R .) consulted if consensus could not be reached . The methodological variation of the included studies was assessed to determine the suitability of meta-analysis and the grading of recommendations , assessment , development and evaluation ( GRADE ) system
[ 15 ]
. Between and within group effect sizes were calculated for the included studies using Cohen ’ s d , with effect sizes interpreted as negligible (< 0.2 ), small ( ≥0.2 ), medium ( ≥0.5 ) and large ( ≥0.8 ) [ 16 ] .
Results Search results
Following the removal of duplicates , 1440 studies were screened with 1384 records excluded with 56 full-text records obtained ( Fig .). A further 45 records were excluded .
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