Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Musculoskeletal Disorders

Background Although foot orthosis may play a role in patellofemoral pain syndrome, its significance is still conflicting and previous studies are low evidence level. Objective To assess the latest evidence regarding the effectiveness of foot orthosis (FO) on adult patients with patellofemoral pain syndrome (PFPS). Methods A comprehensive electronic database search of PubMed, Cochrane Library Database, the Physiotherapy Evidence Database (Pedro), ProQuest, EBSCo host, and Ovid databases was performed for randomized controlled trials (RCTs) in the English language since January 2000 till February 2019 on an adult with patellofemoral pain syndrome treated by foot orthosis and physical therapy, with hand searching to reference lists of previous systematic reviews and included papers. At least one primary outcome measure for pain or function must have been reported. Two authors independently reviewed and assessed each citation for inclusion, The Cochrane risk of bias tool was used to rate methodological quality and risk of bias. Data was met analyzed when this was not possible, qualitative data analysis was performed. Results A total of nine RCTs with a total number of 914 patients (6 on non- runners and 3 on runners) were included. the findings were summarized in four main comparisons as follows 1)foot orthosis versus flat insoles these results showed the positive efficacy of FO on pain, function and muscular activity, 2) foot orthoses alone versus physiotherapy have a poor indication of PFO alone as an intervention alternative to physiotherapy for PFPS, 3)foot orthoses versus no treatment may provide greater improvements on pain, function and neuromotor changes than natural history concerning foot posture, and 4)foot orthoses combined physiotherapy is better than physiotherapy alone even though the success may relate to clinical foot predictors for foot orthosis

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