Effects of Sensorimotor Foot Orthoses on Joint Alignment and Muscle Activation in Pes Planus: A Systematic Review.

Sammanfattning

Background: Sensorimotor foot orthoses (SMFOs) could provide a benefit to the current management of musculoskeletal pathologies, for example the management of pes planus. To the authors knowledge they currently find no application in Swedish healthcare. More comprehensive evidence is needed. This systematic review evaluates the effect of sensorimotor foot orthoses (SMFO) on joint alignment and muscle activation, measured by electromyography (EMG) in children and adults with pes planus, compared to conventional orthopaedic foot orthoses or placebo. Methods: In accordance with the PRISMA 2020 guidelines, a systematic search across the databases CINAHL, PubMed, Medline, Scopus and Web of Science were conducted on the 15th of April 2026. Screening and data extraction was performed individually and blinded. Bias was assessed with the JBI Critical Appraisal Tool and the Cochrane Risk-of-Bias tool (RoB 2). Findings were synthesized qualitatively and presented narratively. Only RCTs published in English, German, and Swedish within the last 10 years were included in this review. Participants with pes planus and healthy participants investigated on arch elevating muscles were included to collect all clinical and mechanistic evidence. Results: A total of 217 participants (34 healthy adults; 52 children and 131 adults with pes planus) from 4 studies were included. The studies were heterogeneous in population and details of RCT design. EMG measure was done conducted in three, joint alignment evaluation in 2 studies. This review found that sensorimotor foot orthoses (SMFO) have an unclear effect on joint alignment. Both clinical and mechanistic evidence was found for the effect of SMFOs on muscle activation patterns for individuals with acquired pes planus. Discussion: Certainty in the findings is low due to limitations in the available evidence and in the review process. The included studies differed in population and design, which limited the ability to draw clear conclusions, and several studies had a high risk of bias. The findings suggest possible use of SMFOs, but the evidence is insufficient to support clinical recommendations. Further high-quality research is needed. Conflict of Interest: No funding was received, and the authors declare no conflict of interest. Registration: The protocol was registered in the PROSPERO student section and is available at: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261367159