Investigating the Effect of Semi-Hard Medical Insoles Made with CAD-CAM Technology on Balance and Pressure Caused by Flexible Flatfoot in the Ages of 12 to 40 Years: Systematic Review

Flexible flatfoot causes pain in higher joints and disturbs the pressure distribution of soles in affected people. In this study, we aimed to determine the effect of three-dimensional (3D)-printed insoles and computer-aided design/computer-aided manufacturing (CAD/CAM) in reducing pressure and pain in people with flexible flatfoot.

The present study was designed as a systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An extensive search was conducted in the most important databases including PubMed, Web of Science, Embase, Cochrane, and Scopus. The methodological quality of the included studies was evaluated through Downs and Black's checklist. A form was also designed to extract the most important findings of the studies based on the research objectives, and finally the results of the studies were evaluated.

In the electronic search, 19 articles that met the inclusion criteria were published between 2003 and 2022. Insoles that used 3D-design technology and CAD/CAM might have a positive effect on pain and function and distribution of foot pressure in patients with flat feet during the period of patient investigation. But there was no reliable evidence due to the examination of different outcomes and the small number of studies in this regard.

Although the use of 3D insoles and CAD/CAM played a role in reducing pressure and pain and increasing the comfort of patients with flexible flatfoot, the evidence in this field is insufficient and requires more studies.