Article

Rocker profiles are commonly used in the prevention of diabetic foot ulcers.
Rockers are mostly stiffened to restrict toe plantarflexion to ensure proper
offloading. It is also described that toe dorsiflexion should be restricted.
However, the difference in effect on plantar pressure between rigid rockers that
restrict this motion and flexible rockers that do not is unknown. In-shoe plantar
pressure data were collected for a control shoe and the same shoe with rigid and
flexible rockers with the apex positioned at 50% and 60%.
For 29 healthy female
adults peak plantar pressure (PP), maximum mean pressure (MMP) and force-time
integral (FTI) were determined for seven regions of the foot. Generalized
estimate equation was used to analyse the effect of the different shoes on the
outcome measures for these regions. Compared to the control shoe a significant
increase of PP and FTI was found at the first toe for both rigid rockers and the
flexible rocker with the apex positioned at 60%, while MMP was significantly
increased in rockers with an apex position of 60% (p<0.001). PP at the first toe
was significantly lower in flexible rockers when compared to rigid rockers
(p<0.001). For both central and lateral forefoot PP and MMP were significantly
more reduced in rigid rockers (p<0.001), while for the medial forefoot no
differences were found. The use of rigid rockers results in larger reductions of
forefoot plantar pressures, but in worse increase of plantar pressures at the
first toe compared to rockers that allow toe dorsiflexion.
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