A Mayo Clinic study confirms previously reported offloading effects of a rocker bottom shoe design in patients with diabetic neuropathy and suggests that a plastazote insole may increase that benefit.
Researchers analyzed dynamic plantar pressures in 15 subjects with diabetic peripheral neuropathy and a history of forefoot ulceration. A stiff soled shoe with a rocker sole modification was compared to a flat stiff soled shoe; both types of footwear were tested with and without a 1.25-cm plastazote insert.
The rocker sole with insert most effectively decreased mean peak plantar pressures, associated with a 50% mean reduction overall compared to the flat shoe with no insert and a 35% mean reduction at the metatarsal heads and hallux specifically.
The findings, e-published on April 19 by Clinical Biomechanics, are consistent with those of a Dutch study published in the February 2003 issue of Diabetes Care, in which 50% less loading in the central forefoot was seen with a rocker bottom shoe with PPT insole than a conventional oxford-type shoe with no insole.