Rocker sole shoe improved intermittent claudication symptoms

NewsBot · Apr 5, 2012

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Use of a three-curved rocker sole shoe modification to improve intermittent claudication calf pain — A pilot study
Stephen William Hutchins, Gwen Lawrence, Stephen Blair, Andrey Aksenov, Richard Jones
Journal of Vascular Nursing; Volume 30, Issue 1, March 2012, Pages 11–20

This was a pilot study utilizing hospital-based walking trials to compare two footwear conditions. Two pairs of identical therapeutic shoes were ordered for volunteer claudicant subjects. One pair was adapted with a specifically designed three-curve rocker sole. Volunteer claudicant subjects (n = 8, mean age 66 +/- 9.9 years) with stable pain-free distances of 10 – 400 meters to calf claudication pain were recruited into the study. Walking trials were used to compare differences in both the pain-free distance to claudication and the intensity of the calf pain once claudicating exhibited by each subject while walking separately with the two footwear conditions during the same clinical session. The results demonstrated that claudicant pain-free walking distance was increased, and the intensity of claudication calf pain reduced when walking with the rocker-soled in comparison with baseline. A specifically designed rocker sole has the potential to offer a reduction in the intensity of calf pain experienced by claudicants.
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Admin2 · Apr 5, 2012

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NewsBot · Jul 14, 2017

Lower leg swelling and muscle co-contraction during prolonged standing: an unstable footwear evaluation
Zanyar Karimi, Mahmood Reza Azghani & Teimour Allahyari
Footwear Science: 13 Jul 2017

The purpose of this study was to investigate the lower leg swelling and muscle co-contraction during prolonged standing with the focus on unstable footwear effects. The EMG signals of medial gastrocnemius and tibialis anterior muscles (bilaterally) were continuously recorded to quantify their co-contraction index (CCI) in 10 healthy asymptomatic subjects during two hours of standing in three footwear conditions including barefoot, stable shoe and unstable shoe. Lower leg circumference changes (swelling) were also monitored over the standing time. During two hours of standing remarkable reduction in lower leg circumference changes and significant reduced CCI level for both legs were observed only for unstable shoe compared to barefoot condition. However, bilaterally, no significant differences were found for both measures between barefoot condition and stable shoe or between two shoe conditions (stable and unstable). The unstable shoe produced changes in activity pattern of lower leg muscles which seems to be advantageous for venous pump mechanism during prolonged standing. These findings suggest that unstable footwear can be used as ergonomic intervention for prolonged standing during work or daily activities.
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NewsBot · Nov 29, 2017

Unloading shoes for intermittent claudication: a randomised crossover trial.
Tew GA et al
BMC Cardiovasc Disord. 2017 Nov 28;17(1):283. doi: 10.1186/s12872-017-0716-x.

BACKGROUND:
The purpose of this study was to assess the functional effects and acceptability of rocker-soled shoes that were designed to relatively "unload" the calf muscles during walking in people with calf claudication due to peripheral arterial disease.
METHODS:
In this randomised AB/BA crossover trial, participants completed two assessment visits up to two weeks apart. At each visit, participants completed walking tests whilst wearing the unloading shoes or visually-similar control shoes. At the end of the second visit, participants were given either the unloading or control shoes to use in their home environment for 2 weeks, with the instruction to wear them for at least 4 h every day. The primary outcome was 6-min walk distance. We also assessed pain-free walking distance and gait biomechanical variables during usual-pace walking, adverse events, and participants' opinions about the shoes. Data for continuous outcomes are presented as mean difference between conditions with corresponding 95% confidence interval.
RESULTS:
Thirty-four participants (27 males, mean age 68 years, mean ankle-brachial index 0.54) completed both assessment visits. On average, the 6-min walk distance was 11 m greater when participants wore the control shoes (95% CI -5 to 26), whereas mean pain-free walking distance was 7 m greater in the unloading shoes (95% CI -17 to 32). Neither of these differences were statistically significant (p = 0.18 and p = 0.55, respectively). This was despite the unloading shoes reducing peak ankle plantarflexion moment (mean difference 0.2 Nm/kg, 95% CI 0.0 to 0.3) and peak ankle power generation (mean difference 0.6 W/kg, 95% CI 0.2 to 1.0) during pain-free walking. The survey and interview data was mixed, with no clear differences between the unloading and control shoes.
CONCLUSIONS:
Shoes with modified soles to relatively unload the calf muscles during walking conferred no substantial acute functional benefit over control shoes.
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NewsBot · Sep 23, 2018

Three-curve rocker-soled shoes and gait adaptations to intermittent claudication pain: a randomised crossover trial
Alastair R. Jordan et al
Gait and Posture; Article in Press

Highlights
•Rocker shoes alleged greater initial claudication distance (ICD) than control shoes.
•We found a reduction in ankle power in rocker shoes relative to control shoes.
•Kinematic differences found between shoes, most during pain-free walking.
•Gait differences between shoes did not affect ICD or absolute claudication distance.
•More pronounced or posterior rocker might be required to improve walking distances.
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Background
Intermittent claudication (IC) is a symptom of peripheral arterial disease where a cramp-like leg pain is exhibited during walking, which affects gait and limits walking distance. Specifically-designed rocker-soled shoes were purported to mechanically unload the calf musculature and increase walking distances until IC pain.

Research Questions
Do three-curve rocker-soled shoes increase walking distance and what are the biomechanical differences during pain-free walking and IC pain-induced walking, when compared with control shoes?

Methods
Following NHS ethical approval, 31 individuals with claudication (age 69 ± 10 years, stature 1.7 ± 0.9 m, mass 83.2 ± 16.2 kg, ankle-brachial pressure index 0.55 ± 0.14) were randomised in this cross-over trial. Gait parameters whilst walking with rocker-soled shoes were compared with control shoes at three intervals of pain-free walking, at onset of IC pain (initial claudication distance) and when IC intensifies and prevents them walking any further (absolute claudication distance). Two-way repeated measures ANOVA were performed on gait variables.

Results
When compared with control shoes, rocker-soled shoes reduced ankle power generation (mean 2.1 vs 1.6 W/kg, respectively; p = 0.006) and altered sagittal kinematics of the hip, knee and ankle. However, this did not translate to a significant increase in initial (138 m vs 146 m, respectively) or absolute (373 m vs 406 m, respectively) claudication distances. In response to IC pain, similar adaptations in temporal-spatial parameters and the sagittal kinematics were observed between the shoe types.

Significance
The three-curved rocker shoes, in their current design, do not augment gait sufficiently to enhance walking distance, when compared with control shoes, and therefore cannot be recommended for the intermittent claudication population.
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