Clinical biomechanics (Bristol, Avon) · 2026
Impact of symmetrical and asymmetrical foot pronation and arch deformities on three-dimensional pelvic kinematics during standing and walking: A systematic review and Meta-analysis.
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Lee Ki-Back, Lee Dong-Yeop
Аннотация
BACKGROUND: Foot pronation and structural arch deformities may influence pelvic motion, but effects vary across conditions and tasks. This review examined whether three-dimensional pelvic responses differ by foot-condition symmetry and between standing and dynamic weight-bearing.
METHODS: Following PRISMA 2020, observational and non-randomized experimental studies of habitual foot arch dysfunction or experimentally induced calcaneal eversion/inversion were reviewed. Primary outcomes were sagittal pelvic tilt, frontal pelvic tilt or drop, and transverse pelvic rotation. Comparable standing pelvic angles were analyzed using exploratory random-effects mean differences (MDs, degrees); repeated-measures contrasts used reported paired-change statistics. Other outcomes were summarized narratively. Risk of bias was assessed with JBI tools and certainty with GRADE.
FINDINGS: Sixteen publications representing 15 independent study samples were included. Two bilateral 10° wedge studies showed increases in anterior pelvic tilt, but exploratory pooling was imprecise (MD 0.97°, 95% CI [-0.05, 1.99]; I2 = 81.8%). Habitual bilateral flatfoot was not pooled because compatible summary data were unavailable. Three studies reported positive lateral pelvic tilt differences for unilateral foot conditions; their exploratory pooled estimate was highly heterogeneous (MD 2.18°, 95% CI [-0.36, 4.71]; I2 = 96.5%). High-arched/inversion and dynamic transverse-plane outcomes were summarized narratively. Certainty was very low for pooled outcomes.
INTERPRETATION: Foot-condition type and assessment task appear relevant to pelvic alignment, but the small evidence base and substantial heterogeneity limit pooled conclusions. These results are preliminary biomechanical observations rather than evidence of causation or treatment effectiveness. PROSPERO registration number: CRD420261329855.
METHODS: Following PRISMA 2020, observational and non-randomized experimental studies of habitual foot arch dysfunction or experimentally induced calcaneal eversion/inversion were reviewed. Primary outcomes were sagittal pelvic tilt, frontal pelvic tilt or drop, and transverse pelvic rotation. Comparable standing pelvic angles were analyzed using exploratory random-effects mean differences (MDs, degrees); repeated-measures contrasts used reported paired-change statistics. Other outcomes were summarized narratively. Risk of bias was assessed with JBI tools and certainty with GRADE.
FINDINGS: Sixteen publications representing 15 independent study samples were included. Two bilateral 10° wedge studies showed increases in anterior pelvic tilt, but exploratory pooling was imprecise (MD 0.97°, 95% CI [-0.05, 1.99]; I2 = 81.8%). Habitual bilateral flatfoot was not pooled because compatible summary data were unavailable. Three studies reported positive lateral pelvic tilt differences for unilateral foot conditions; their exploratory pooled estimate was highly heterogeneous (MD 2.18°, 95% CI [-0.36, 4.71]; I2 = 96.5%). High-arched/inversion and dynamic transverse-plane outcomes were summarized narratively. Certainty was very low for pooled outcomes.
INTERPRETATION: Foot-condition type and assessment task appear relevant to pelvic alignment, but the small evidence base and substantial heterogeneity limit pooled conclusions. These results are preliminary biomechanical observations rather than evidence of causation or treatment effectiveness. PROSPERO registration number: CRD420261329855.