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. 2021 Aug 18;11(8):e047273. doi: 10.1136/bmjopen-2020-047273

Table 1.

Selected characteristics of studies included in analysis (nine unique studies)

Authors(s)/country Reference no. Study aim Method/device Number of patients with
HV
Age (mean±SD) Orthosis Orthosis material/wearing duration Result
Chadchavalpa nichaya et al 2018/Thailand 36 To investigate the effect of custom-moulded RTV silicone toe separator to reduce HVA. Randomised controlled trial/ radiographic measurement and clinical assessment 45 HV group: 60.3±9.4 Control group: 60.8±10.8 Custom-moulded RTV toe separator Silicone/12 months Both groups have significant differences in mean HVA with a decrease of 3.3°±2.4° for the study group and increase of 1.9°±1.9° for the control group. Hallux pain of study group is reduced.
Doty et al 2015/USA 37 To compare the plantar pressure distribution in standard footwear and in the same footwear with orthoses of three different lengths. Randomised controlled trial/Tactilus Free Form Sensor System 25 Mean: 57 Full-length orthosis Not Reported/immediate No significant changes in medial pressure with the addition of any orthosis compared with standard footwear alone.
Sulcus-length orthosis
3/4-length orthosis
Farzadi et al 2015/Iran 22 To investigate the effect of orthosis with medial arch support on plantar pressure distribution. Quasi-experimental/Pedar-X in-shoe system 16 26.1±5.7 Prefabricated arch support foot orthosis 5 mm thick polypropylene/1 month The use of the foot orthosis leads to a decrease in peak pressure and maximum force.
Moulodi et al 2019/Iran 38 To compare the HVA, ROM, FAOS, pain and function in daily activities after the use of orthosis. Randomised controlled trial/clinical assessment 24 22.79±1.44 Static orthosis with toe separator A bar and a single strap/1 month Both orthoses can reduce HVA up to 3°; significant difference in ROM by using dynamic orthosis.
Dynamic orthosis Firm plastic, straps & a free joint/ 1 month
Plaass et al 2020/Germany 39 To analyse the effect of a dynamic orthosis on IMA and HVA. Randomised controlled trial/radiographic measurement and clinical assessment 36 HV group: 53.2±14.0
Control group: 48.5±12.9
Dynamic orthosis Not Reported/3 months Dynamic orthosis can provide pain relief in patients but showed no effect on HVA.
Reina et al 2013/ Spain 40 To determine if the use of custom-made foot orthotics prevents the advancement of IMA and HVA. Randomised controlled trial/radiographic measurement 23 HV group: 30.31±9.27
Control group: 30.94±14.06
Custom-made foot orthoses 3 mm thick polypropylene sheet and 3 mm thick polyethylene foam sheet/12 months Custom-made orthoses appear to have no effect.
Tang et al 2002/Taiwan 43 To assess the effects of a new foot–toe orthosis on HVA. Uncontrolled intervention study/radiographic measurement and clinical assessment 17 42.59±16.52 Total contact orthosis with toe separator Plastazote poron, microcell pull, plastazote and mineral oil-based polymer gel toe separator/3 months The new total contact orthosis with fixed toe separator reduces HVA.
Tehraninasr et al 2008/Iran 41 To compare the effects of wearing an orthosis with toe separator and night-time orthosis on IMA, HVA and foot pain. Randomised controlled trial/radiographic measurement 30 27±8.91 Orthosis with toe separator Polyfoam, polyethylene, plastazote toe separator/3 months IMA and HVA are reduced in both groups; however, the reduction is not significant; the orthosis with toe separator significantly reduces the pain intensity.
Nighttime orthosis Polyfoam and a rigid polyethylene bar/3 months
Torkki et al 2003/Finland 42 To compare the effectiveness of surgical and orthotic treatment with patients on VAS. Randomised controlled trial/Not Reported 69 HV group: 49±10
Control group: 47±9
Not Reported Not Reported/12 months Orthoses provide short-term symptomatic relief.

FAOS, Foot and Ankle Outcome Score; HV, hallux valgus; HVA, hallux valgus angle; IMA, intermetatarsal angle; ROM, range of motion; RTV, room temperature vulcanising; VAS, Visual Analogue Scale.