necessary as the shoes used in this study were all manufactured using a standard last because this helps maintain shoe aesthetics. Patients had a mean (SD) age of 57(8), a mean weight of 86.0(12.4) Kg and a mean height of 1.71 (0.09) m and healthy participants had a mean (SD) age of 49(15), a mean weight of 79.8(11.9) Kg and a mean height of 1.75(0.09)m. Patients with diabetes were only included in the study if they did not demonstrate any serious neuropathy. The absence of neuropathy was assessed using two separate tests. Firstly, patients were required to sense a to sense a 10g monofilament at a minimum of 5 out of 6 sites on the plantar aspect of the foot (Feng et al., 2009). Secondly they had to be able to sense the vibration of a 128Hz tuning fork on the interphalangeal joint (Meijer et al., 2005). If patients were unable to detect more than one site or had absent vibration perception they were classed as neuropathic and not recruited for the study. Limiting the experimental work to low-risk patients with diabetes limits the generalisability of the findings. However, it was felt that this study would provide insight into the general principles of footwear design which could be incorporated into future footwear studies developed for high risk patients. Footwear All participants were required to walk in total of 12 pairs of rocker shoes plus one flexible control shoe which were manufactured specifically for the study by Duna®, Falconara Marittima, Italy. All shoes were made using the same last with a soft leather upper. In the control shoe, the outsole was manufactured from micro cellular rubber and this shoe had a bending stiffness similar to a running shoe (Figure 2a). For the rocker shoes (Figure 2b) the outsole was also constructed from micro cellular rubber and incorporated a 5mm thick piece of folex which created a very stiff outsole which did not flex. Different outsole geometries
necessary as the shoes used in this study were all manufactured using a standard last because this helps maintain shoe aesthetics. Patients had a mean (SD) age of 57(8), a mean weight of 86.0(12.4) Kg and a mean height of 1.71 (0.09) m and healthy participants had a mean (SD) age of 49(15), a mean weight of 79.8(11.9) Kg and a mean height of 1.75(0.09)m. Patients with diabetes were only included in the study if they did not demonstrate any serious neuropathy. The absence of neuropathy was assessed using two separate tests. Firstly, patients were required to sense a to sense a 10g monofilament at a minimum of 5 out of 6 sites on the plantar aspect of the foot (Feng et al., 2009). Secondly they had to be able to sense the vibration of a 128Hz tuning fork on the interphalangeal joint (Meijer et al., 2005). If patients were unable to detect more than one site or had absent vibration perception they were classed as neuropathic and not recruited for the study. Limiting the experimental work to low-risk patients with diabetes limits the generalisability of the findings. However, it was felt that this study would provide insight into the general principles of footwear design which could be incorporated into future footwear studies developed for high risk patients. Footwear All participants were required to walk in total of 12 pairs of rocker shoes plus one flexible control shoe which were manufactured specifically for the study by Duna®, Falconara Marittima, Italy. All shoes were made using the same last with a soft leather upper. In the control shoe, the outsole was manufactured from micro cellular rubber and this shoe had a bending stiffness similar to a running shoe (Figure 2a). For the rocker shoes (Figure 2b) the outsole was also constructed from micro cellular rubber and incorporated a 5mm thick piece of folex which created a very stiff outsole which did not flex. Different outsole geometries
Doc_with_figures_Effect_of_rocker_shoe_design_features_on_forefoot_plantar_pressures_in_people_with_and_without_diabetes_.docx