Article

OBJECTIVE: To determine whether shoe lifts effectively treat leg length
discrepancy (LLD)-associated morbidities in adults with common painful
musculoskeletal conditions. DATA SOURCES: Trip database, Cochrane Central
Register of Controlled Trials database, PubMed database, Physiotherapy Evidence
Database, and National Guideline Clearinghouse database.
The search was performed
in September 2017, was limited to English only, and had no time constraints.
STUDY SELECTION: Two reviewers independently determined study eligibility.
Inclusion criteria were (1) participants >/=18 years old with
musculoskeletal-related complaints and LLD; (2) a shoe lift intervention was
used; and (3) the study reported on pain, function, range of motion, patient
satisfaction, quality of life, or adverse events. Randomized controlled trials
(RCTs) and controlled intervention, cohort, before-and-after, case series, and
case report studies were included. Three-hundred and nineteen articles were
screened, and 9 guidelines were reviewed. DATA EXTRACTION: We extracted data
pertaining to participant demographic characteristics, study setting,
recruitment, randomization, method of LLD measurement, shoe lift characteristics,
treatment duration, and outcome measures. We included 10 studies, including 1
RCT. DATA SYNTHESIS: LLD was associated with low back pain, scoliosis, and
osteoarthritis of the hip and knee. Description of LLD correction strategy was
often inadequate. Study quality was very low or poor. In non-RCT studies
reporting on the proportion of participants who improved with a shoe lift,
88%+/-3% of 349 participants treated had partial or complete pain relief (effect
size range, 66.7%-100%). All 22 RCT participants receiving treatment experienced
pain relief (mean pain reduction, 27+/-9mm on a 150-mm visual analog scale). Two
of 9 guidelines recommended shoe lift use based on consensus and were of
moderate-to-high quality. CONCLUSIONS: There is low-quality evidence that shoe
lifts reduce pain and improve function in patients with LLD and common painful
musculoskeletal conditions.
High-quality research evaluating a threshold LLD to
correct and a strategy to do so is necessary.
Developing an appropriate
comparison group to test clinically relevant outcome measures would make a
valuable contribution in this regard.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS