ROCKER SOLE KINETICS AND KINEMATICS

摇椅鞋底是最常用的外置鞋

The rocker sole is the most commonly prescribed external shoe modification. Use of rocker soles has been based on theoretical considerations and empirical observations with minimal scientific study and validation. With the passage of the therapeutic shoe bill (PL-100- 203sec4072) authorizing Medicare coverage of shoes and shoe modifications for diabetics, it is important to have objective data regarding the effect of rocker soles. The purpose of this proposed research is to study the effect of rocker soles on plantar pressures and gait. Our overall concern is that rocker soles not only affect plantar pressures but also produce kinetic and kinematic suprasegmental changes. The recently completed pilot studies support our hypotheses that plantar pressures and suprasegmental kinetics/kinematics are altered uniquely by each type of rocker and differ from baseline shoes. Our objective is to analyze how the different rocker soles redistribute plantar and suprasegmental forces and affect the timing of these forces. In order to achieve the study objectives, the following specific aims will be accomplished: 1. We will quantitate the effect of toe only rocker, negative heel rocker, and double rocker on plantar pressures. 2. We will determine the effect of toe only rocker, negative heel rocker, and double rocker on gait kinematics and kinetics. Our goals include analyzing whether negative heel rockers unload the forefoot and increase heel loading more than toe only rockers and whether this is accompanied by suprasegmental kinematic/kinetic gait changes. We would also like to determine if double rockers and forefoot rockers unload the forefoot equally but with less increase in heel loading (with the double rocker). We will compare the kinematic/kinetic suprasegmental effects of the toe only rocker, negative heel rocker, and double rocker shoes. We will study 40 sensate and 6 insensate subjects. The practical rehabilitation implication of this study is that a more quantitative understanding of the effects of different rocker shoes will allow scientifically based pedorthotic prescription.