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

Hanieh Khaliliyan; Amir Reza Vosoughi; Mahmood Bahramizadeh; Amirhossein Zare; Majid Ansari; Farhad Ghaffari; Arash Sharafatvaziri

doi:10.1016/j.fas.2025.05.012

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

Foot Ankle Surg. 2025 May 31:S1268-7731(25)00127-4. doi: 10.1016/j.fas.2025.05.012. Online ahead of print.

Authors

Hanieh Khaliliyan¹, Amir Reza Vosoughi², Mahmood Bahramizadeh³, Amirhossein Zare⁴, Majid Ansari⁵, Farhad Ghaffari⁶, Arash Sharafatvaziri⁷

Affiliations

¹ Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: haniehkhaliliyan@rehab.mui.ac.ir.
² Orthopedic & Rehabilitation Research Center, Department of Orthopedic Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: vosoughiar@hotmail.com.
³ Neuromusculoskeletal Rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: ma.bahramizadeh@uswr.ac.ir.
⁴ Student research committee, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: zareamirhossein75@yahoo.com.
⁵ Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: majid.ansari@gmail.com.
⁶ Orthopedic & Rehabilitation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: Farhadb75@yahoo.com.
⁷ Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: arash.sharafatvaziri@gmail.com.

PMID: 40480881
DOI: 10.1016/j.fas.2025.05.012

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° and increased forefoot plantarflexion by 6-9°. 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.

Keywords: Biomechanics; Flatfoot; Orthotic devices; Progressive Collapsing Foot Deformity.

Publication types

Review