Does shoe insole modification prevent stress fractures? A systematic review.

Does shoe insole modification prevent stress fractures? A systematic review.
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鞋垫修改可以防止应力性骨折吗?

DOI:
10.1007/s11420-009-9114-y
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发表时间:
2009
期刊:
HSS journal : the musculoskeletal journal of Hospital for Special Surgery
影响因子:
--
通讯作者:
Dunn,WarrenR
Dunn,WarrenR
中科院分区:
--
文献类型:
--
作者:
Snyder,RebeccaA;DeAngelis,JosephP;Koester,MichaelC;Spindler,KurtP;Dunn,WarrenR

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应力性骨折可能使运动员和军人衰弱。鞋垫可以通过改善生物力学、减轻疲劳和衰减冲击来降低应力性骨折率。本研究的目的是系统地审查使用鞋垫作为预防高危人群应力性骨折的方法的最佳证据。使用MEDLINE、科克伦、当前对照试验、英国国家研究注册中心、ScienceDirect、CINAHL和EMBASE,对随机(I级)和半随机(II级)对照试验进行了综述,使用鞋垫作为干预措施,应力性骨折发生率作为主要结局指标。纳入了五项试验,并使用随机效应模型来生成汇总估计值和总体比值比。一项研究发现,使用半刚性鞋垫的整体应力性骨折发生率显着降低,而四项研究发现,军事人员的整体应力性骨折发生率没有降低。然而,当数据汇总时,矫形器的使用是有益的。当按部位分层时,股骨和胫骨应力性骨折发生率降低。在军事训练中,鞋垫可以降低股骨和胫骨应力性骨折的发生率。目前还不清楚使用鞋垫是否会防止运动员的应力性骨折。需要进行更多的研究来确定鞋垫在运动人群中的功效。
Stress fractures can be debilitating in athletes and military personnel. Insoles may lower stress fracture rates by improving biomechanics, lessening fatigue, and attenuating impact. The objective of this study was to systematically review the best evidence on the use of insoles as a method of stress fracture prevention in a high-risk population. Using MEDLINE, Cochrane, Current Controlled Trials, UK National Research Register, ScienceDirect, CINAHL, and EMBASE, a review of randomized (level I) and quasi-randomized (level II) controlled trials was performed using an insole as the intervention and stress fracture incidence as the primary outcome measure. Five trials were included, and a random effects model was used to generate a summary estimate and an overall odds ratio. One study found a significant reduction in overall stress fracture incidence using a semirigid insole, while four studies found no overall reduction in military personnel. However, when the data are pooled, orthotic use was beneficial. When stratified by site, there was a reduction in femoral and tibial stress fracture incidence. Shoe insoles may reduce the overall femoral and tibial stress fracture incidence during military training. It is unclear if the use of insoles would prevent stress fractures in athletes. Additional studies are necessary to determine the efficacy of insoles in an athletic population.
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