Influence of prefabricated orthopedic footwear with rocker soles on foot loading while walking: A comparative biomechanical investigation of three different types of footwear.

BACKGROUND

Rocker-bottom footwear with increased midsole stiffness is commonly prescribed to reduce painful forefoot loading. However, its combined effects on dorsiflexion-related loading at the metatarsophalangeal joints and plantar pressure distribution during walking remain incompletely understood.

RESEARCH QUESTION: Do prefabricated therapeutic footwear with rocker soles and midsole stiffening reduce dorsiflexion-related loading and alter plantar pressure distribution compared with standard footwear?

METHODS

Thirteen healthy adults walked on a treadmill under three conditions: their own shoes, a prefabricated orthopedic shoe, and a prefabricated therapeutic comfort shoe combining rocker geometry and increased midsole stiffness. Plantar pressure and dorsiflexion-related bending moments were recorded using in-shoe sensor systems. Peak plantar pressures and dorsiflexion moments during late stance were compared across conditions.

RESULTS

Footwear condition significantly affected dorsiflexion moments at the first and fifth metatarsophalangeal regions (p < .001). The therapeutic rocker shoe reduced peak dorsiflexion moments by 25% at MTH1 and 22% at MTH5 compared with participants' own shoes, while the orthopedic shoe showed smaller reductions. Plantar pressure distribution also changed significantly. The rocker shoe reduced forefoot and toe pressures (e.g., T1 - 33%, MT2 -22%), accompanied by increased midfoot loading and reduced rearfoot pressure.

CONCLUSION

Prefabricated stiff rocker footwear substantially reduced dorsiflexion-related loading at the metatarsophalangeal region and shifted plantar loading toward the midfoot. These biomechanical effects support the rationale for rocker-stiff footwear to offload the forefoot and may be clinically relevant for conditions requiring reduced metatarsophalangeal loading.