Effects of exercise combined with external support on hallux valgus angle and pain: A systematic review and network meta-analysis.

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-09-13 DOI:10.1016/j.fas.2025.09.004

Zhitao Zhu, Yue Liu, Ling Wang, Haitao Liu, Jinwu Wang

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引用次数: 0

Abstract

Background: Hallux valgus (HV) is a common foot deformity that causes pain and functional limitations. For mild-to-moderate cases, conservative treatment such as exercise therapy and external supports is preferred. Optimal protocols remain uncertain due to variation in exercise types and combinations. This study compares conservative approaches to rank their effectiveness in reducing the hallux valgus angle (HVA) and pain relief.

Methods: PubMed, Cochrane Library, EMBASE, Medline, Web of Science, CNKI, and Wanfang were searched from inception to June 15, 2025, for RCTs evaluating exercise therapy alone or with external supports in HV patients. Outcomes included HVA and pain relief. Network meta-analyses calculated the mean differences (MD) with 95 % CIs, and interventions were ranked using SUCRA.

Results: Eleven RCTs involving 401 HV patients were included. Exercise therapy (MD = -3.32, 95 % CI: -4.40 to -2.23) was significantly superior to adjusted placebo for HVA. Exercise combined with taping was the most effective intervention (MD = -6.72, 95 % CI: -9.34 to -4.11; 89.5 %), followed by exercise combined with orthoses (MD = -6.67, 95 % CI: -9.70 to -3.64; 85.6 %). For pain relief, exercise combined with taping ranked first (MD = -3.76, 95 % CI: -4.79 to -2.73; 92.7 %), followed by exercise combined with orthoses (MD = -3.43, 95 % CI: -3.98 to -2.87; 72.6 %).

Conclusion: For mild-to-moderate HV, exercise therapy was effective in reducing HVA. Exercise combined with external support provides greater benefits for HVA reduction and pain relief. Further large-scale, high-quality RCTs are needed confirm these findings and assess potential adverse events.

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运动联合外支撑对拇外翻角和疼痛的影响：系统回顾和网络荟萃分析。

背景：拇外翻（HV）是一种常见的足部畸形，引起疼痛和功能限制。对于轻度至中度病例，首选保守治疗，如运动治疗和外部支持。由于运动类型和组合的变化，最佳方案仍然不确定。本研究比较了保守入路在减小拇外翻角（HVA）和缓解疼痛方面的有效性。方法：检索PubMed、Cochrane Library、EMBASE、Medline、Web of Science、CNKI和万方数据库，检索自成立至2025年6月15日评估单独或联合外部支持运动疗法对HV患者疗效的随机对照试验。结果包括HVA和疼痛缓解。网络荟萃分析以95% % ci计算平均差异（MD），并使用SUCRA对干预措施进行排名。结果：纳入11项随机对照试验，共401例HV患者。运动疗法（MD = -3.32, 95 % CI: -4.40至-2.23）显著优于调整后安慰剂治疗HVA。运动联合胶带是最有效的干预措施（MD = -6.72, 95 % CI: -9.34至-4.11;89.5 %），其次是运动联合矫形器（MD = -6.67, 95 % CI: -9.70至-3.64;85.6 %）。在缓解疼痛方面，运动联合贴带效果最好（MD = -3.76, 95 % CI: -4.79 ~ -2.73; 92.7 %），其次是运动联合矫形器（MD = -3.43, 95 % CI: -3.98 ~ -2.87; 72.6 %）。结论：对于轻中度HV，运动疗法能有效降低HVA。运动结合外部支持为HVA的减少和疼痛的缓解提供了更大的好处。需要进一步大规模、高质量的随机对照试验来证实这些发现并评估潜在的不良事件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.