Effects and underlying mechanisms of unstable shoes on chronic low back pain: a randomized controlled trial

Lisón, Juan Francisco; Ortega-Santana, Borja; Antón-Nogués, Álvaro; González-Requena, Palmy; Vera-Hervás, Cristina; Doménech-Fernández, Julio; Sánchez‐Zuriaga, Daniel; Salvador-Coloma, Pablo

doi:10.1177/0269215517753972

Cited by 5 publications

(8 citation statements)

References 15 publications

(28 reference statements)

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“…Three studies used the RMDQ to evaluate the functional disability related to lower back pain. 2,7,8 Meta-analysis showed that wearing unstable shoes significantly reduced the functional disability scores of the RMDQ with a follow-up period of four to six weeks (MD −2.16, 95% CI −4.28 to −0.03; P = 0.05; I 2 = 53%) ( Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 995 records were obtained from the initial database searches, and five studies 2,4,5,7,8 that met the inclusion criteria and were ultimately included after being screened and reviewed by the authors. Update search was performed in June 2019 and additional 25 records are obtained and screened.…”

Section: Resultsmentioning

confidence: 99%

“…2,4,5,7 Two studies reported primary outcomes with a follow-up time of four weeks. 5,8 One study reported a longer follow-up time at half a year and one year. 7 The Roland–Morris disability questionnaire (RMDQ) score and the pain visual analogue scale were the primary outcomes evaluated for lower back pain reported in most studies.…”

Section: Resultsmentioning

confidence: 99%

“…The improvements of disability in patients wearing unstable shoes can be explained by the changes in lumbar spine range of motion. 8 In the included studies of the present review, different evaluation scales were applied to assess pain and functional disability caused by lower back pain. In one study by Vieira et al, the Oswestry Low Back Pain Disability Questionnaire was applied to evaluate the effect of wearing unstable shoes for a month on pain and disability in nurses.…”

Section: Discussionmentioning

confidence: 99%

“…8 On one hand, they thought that changes in trunk muscle, which generated trunk extensor and flexor moments to control the instability created by the unstable shoes, can explain the improvements in disability according to their measurement results. 8 On the other hand, they thought that LBP diagnosis and treatment is associated with the changes in the lumbar spine range of motion in the sagittal plane, which depend on the abdominal muscles, back muscles, and pelvic/spine ligament function. 8 They observed there was a significant increase in lumbar spine extension values in the unstable shoes group compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

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Unstable shoes for the treatment of lower back pain: a meta-analysis of randomized controlled trials

et al. 2019

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Objective: We aimed to perform a systematic review and meta-analysis to compare the treatment effects of unstable shoes and flat shoes on lower back pain patients. Data sources: Literature databases, including PubMed, Web of Science, and EMBASE (up to June 2019), were searched systematically. Review methods: Two authors independently screened the retrieved records and identified the randomized controlled trials where patients with lower back pain who wore unstable shoes as intervention and wore flat shoes as a control. Relevant data were extracted for meta-analysis using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the pooled outcome evidence levels. Results: Five randomized controlled trials and 251 patients were included in the analysis. The meta-analysis results showed that there was a tendency toward a reduction in the Roland–Morris disability questionnaire score (mean difference (MD) –2.16, 95% confidence interval (CI) –4.28 to −0.03, I2 = 53%) and pain score (MD −0.84, 95% CI −1.66 to −0.02, I2 = 84%) in patients wearing unstable shoes compared to those wearing flat shoes. There was no significant difference in the life quality scores between the unstable shoe and flat shoe groups (MD −0.59, 95% CI −6.18 to 5.01, I2 = 0%). Functional disability and pain scores were determined to have very low-quality evidence, and life quality scores were determined to have low-quality evidence according to the Grading of Recommendations Assessment, Development and Evaluation analysis. Conclusion: Unstable shoes may be effective in treating lower back pain in the clinic, but the conclusion was limited by the current low-quality studies.

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Section: Resultsmentioning

confidence: 99%