Shoes for the Insensitive Foot: The Effect of a “Rocker Bottom” Shoe Modification on Plantar Pressure Distribution

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Abstract
The purpose of this study was to examine the effects on plantar pressure of the rocker bottom shoe, which is a frequently used intervention for the ulcerated diabetic foot. In-shoe pressure distribution was recorded during walking in a conventional extra-depth shoe which was then modified into a rocker bottom configuration with a 24° rocker, and the experiment was repeated. Peak pressures in the rocker shoe were reduced by ≈30% compared to the conventional shoe in the medial and central forefoot and in the toe regions, but pressures were elevated in the heel, the midfoot, and in the lateral forefoot regions. These experiments suggest that a correctly designed rocker bottom shoe may reduce the risk of ulceration in certain areas of the foot. However, since pressures in some regions can also be elevated by this type of footwear, attention to individual design is critical.