title: Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the evidence relating to the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of musculoskeletal injury.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Clinical trials evaluating the effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury.
  
  
  METHODS
  Cochrane Library, CINAHL, EMBASE, MEDLINE and SPORTDiscus from their inception up to the first week of June 2016.
  
  
  RESULTS
  11 trials that had evaluated foot orthoses and 7 trials that had evaluated shock-absorbing insoles were included. The median Physiotherapy Evidence Database (PEDro) score for trials that had evaluated foot orthoses and shock-absorbing insoles was 5 (range 3-8/10) and 3 (range 1-7/10), respectively. Meta-analysis found that foot orthoses were effective for preventing overall injuries (risk ratio (RR) 0.72, 95% CI 0.55 to 0.94) and stress fractures (RR 0.59, 95% CI 0.45 to 0.76), but not soft-tissue injuries (RR 0.79, 95% CI 0.55 to 1.14). In contrast, shock-absorbing insoles were not effective for preventing overall injuries (RR 0.92, 95% CI 0.73 to 1.16), stress fractures (RR 1.15, 95% CI 0.57 to 2.32) or soft-tissue injuries (RR 0.92, 95% CI 0.74 to 1.15).
  
  
  CONCLUSIONS
  Foot orthoses were found to be effective for preventing overall injuries and stress fractures but not soft-tissue injuries, while shock-absorbing insoles were not found to be effective for preventing any injury. However, further well-designed trials will assist the accuracy and precision of the estimates of risk reduction as the quality of the included trials varied greatly.
authors.affiliation: Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.|La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Bonanno
authors.affiliation: Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.|La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.|Department of Allied Health, Melbourne Health, Parkville, Victoria, Australia.
authors.forename: Karl B
authors.initials: KB
authors.lastname: Landorf
authors.affiliation: Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.|La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Shannon E
authors.initials: SE
authors.lastname: Munteanu
authors.affiliation: Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: George S
authors.initials: GS
authors.lastname: Murley
authors.affiliation: Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.|La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
mesh_terms: D001265:Athletic Injuries / Q000517:prevention & control*; D061826:Foot Orthoses; D015775:Fractures, Stress / Q000517:prevention & control*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017695:Soft Tissue Injuries / Q000517:prevention & control*
keywords: Injury prevention; Orthotics; Overuse injury; Sporting injuries