Clinical and biomechanical outcomes of orthotic devices for progressive collapsing foot deformity: a systematic review and meta-analysis

Abstract

BACKGROUND: Progressive collapsing foot deformity (PCFD) represents a progressive medial longitudinal arch collapse of the foot. This study reviewed the clinical and biomechanical efficacy of orthotic interventions for PCFD. METHODS: A systematic search was performed on Web of Science, PubMed, and Scopus, resulting in 14 studies. We used the ROBINS-I tool to evaluate the methodological quality. For the narrative synthesis, we summarized the results in a textual format, while for the meta-analysis, Standardized Mean Differences were computed from the results whenever feasible. RESULTS: Major improvements were recorded in disability scores, pain intensity, and patient satisfaction. Orthotics decreased hindfoot eversion by 3-5 degrees and increased forefoot plantarflexion by 6-9 degrees . An ankle-foot orthosis with lateral extensions or an articulated design enhanced forefoot adduction and hindfoot inversion. Meta-analysis results indicate a 56.84 improvement in the Foot Functional Index (95 CI: 41.1-72.58) alongside a 28.53-point increase in the American Orthopedic Foot and Ankle Society Ankle/Hindfoot Scale (95 CI: 22.66-34.4). CONCLUSIONS: Orthotic interventions are effective treatments for PCFD, reducing pain, improving function, and correcting pathological kinematics.