Current Pedorthics | March-April 2021 | Vol. 53, Issue 2 | Page 29

Footwear Interventions for Foot and Ankle Arthritis
Table 1 . Quality assessment scores of included studies
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Moncur and Ward [ 17 ]
1
1
1
1
0
1
0
1
1
0
0
0
0
0
0
1
0
0
1
0
1
0
0
0
0
1
0
Fransen and Edmonds [ 18 ]
1
1
1
1
1
1
1
0
0
1
0
0
0
0
0
1
1
0
1
1
1
0
1
0
0
1
1
Chalmers et al . [ 19 ]
1
1
1
1
1
1
1
1
1
1
0
0
1
0
1
1
1
1
1
1
1
1
1
0
0
1
1
Williams et al . [ 13 ]
1
1
1
1
1
1
1
1
1
1
0
0
1
1
0
1
1
1
0
1
1
0
1
1
0
0
1
Hennessy et al . [ 20 ]
1
1
1
1
1
1
1
0
na
1
0
0
1
1
0
1
na
1
na
1
1
1
1
1
0
na
1
Cho et al . [ 21 ]
1
1
1
1
1
1
1
0
1
1
0
0
1
0
0
0
1
1
0
1
1
1
1
0
0
0
1
Rome et al . [ 11 ]
1
1
1
1
1
1
1
1
1
1
0
1
1
1
0
1
1
1
1
1
1
0
1
1
1
1
1
Bagherzadeh Cham et al . [ 22 ]
1
1
1
1
1
1
1
0
1
1
0
0
0
0
0
1
1
1
0
1
0
0
0
0
0
1
0
Stewart et al . [ 23 ]
1
1
1
1
1
1
1
0
na
1
0
1
1
1
0
1
na
1
na
1
1
0
1
1
1
na
0
Menz et al . [ 12 ]
1
1
1
1
2
1
1
1
1
1
1
1
1
0
1
1
1
1
1
1
1
1
1
1
1
1
1
Menz et al . [ 24 ]
1
1
1
1
2
1
1
0
na
1
1
1
1
0
0
1
na
1
na
1
1
1
1
1
1
na
0
( 1 ) Study objectives clearly described ? ( 15 ) Blinding of assessors measuring main outcomes ? ( 2 ) Main outcome measures described in introduction and methods ? ( 16 ) Results based on data dredging made clear ? ( 3 ) Patient characteristics clearly described ? ( 17 ) Adjustment for different lengths of follow-up ? ( 4 ) Interventions clearly described ? ( 18 ) Statistical tests for main outcomes appropriate ? ( 5 ) Distribution of confounders described ? ( 19 ) Compliance with intervention reliable ? ( 6 ) Main study findings clearly described ? ( 20 ) Main outcome measures accurate ( valid and reliable )? ( 7 ) Estimates of random variability in data for main outcomes described ? ( 21 ) Cases and controls recruited from same population ? ( 8 ) Adverse events reported ? ( 22 ) Cases and controls recruited over the same period of time ? ( 9 ) Characteristics of patients lost to follow-up described ? ( 23 ) Patients randomized to intervention groups ?
( 10 ) Confidence intervals and / or actual p values reported ?
( 24 ) Randomization concealed from patients and assessors until after recruitment ?
( 11 ) Subjects asked to participate representative of entire population ? ( 25 ) Adequate adjustment for confounding ? ( 12 ) Subjects who agreed to participate representative of entire population ? ( 26 ) Losses of patients to follow-up take into account ? ( 13 ) Staff and facilities representative of treatment patients receive ? ( 27 ) Power calculation ? ( 14 ) Blinding of patients to interventions ?
Methodological quality of studies
The inter-rater agreement between reviewers showed good agreement ( kappa statistic = 0.81 ). Quality index scores ranged from 39 % to 96 % ( Table 1 ). Quality assessment of studies highlighted higher bias with respect to blinding of participants and assessors to treatment allocation , blinding of assessors to main outcomes , external validity , adjustment for confounding and reporting adverse events attributed to inventions .
Study characteristics
Study characteristics are displayed in Table 2 , Table 3 , Table 4 . A total of 382 participants with arthritis affecting the foot and ankle were reported , with 218 RA , 92 1MTP OA and 72 participants with gout . In the gout and RA studies , the majority of participants had wellestablished disease duration , but for 1MTP OA the majority had early disease duration . Follow-up period ranged between 8 and 24 weeks . Meta-analysis and GRADE assessment
Current Pedorthics | March-April 2021 27