ArticleHeliyon2023
Effects of heel apex position, apex angle and rocker radius on plantar pressure in the heel region.
Article in Heliyon, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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0 citing papers in PubMed, 5 citations in OpenAlex.
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Rocker shoes and insoles are used to prevent diabetic foot ulcers in persons with diabetes mellitus and loss of protective sensation, by reducing the plantar pressure in regions with high pressure values (>200 kPa) (e.g., hallux, metatarsal heads and heel). However, forefoot rocker shoes that reduce pressure in the forefoot inadvertently increase pressure in the heel. No studies focused on mitigating the negative effects on heel pressure by optimizing the heel rocker midsole, yet. Therefore, we analyze the effect of different heel rocker parameters on the heel plantar pressure. Methods: In-shoe pressure was measured, while 10 healthy participants walked with control shoe and 10 different heel rocker settings. Peak pressure was determined in 7 heel masks, for all shoes. Generalized estimating equations was performed to test the effect of the different shoes on the peak pressure in the different heel masks. Results: In the proximal heel, a rocker shoe with distal apex position, small rocker radius and large apex angle (100°), shows the largest significant decrease in peak pressure compared to rocker shoes with more proximally located apex positions. In the midheel and distal heel, the same rocker shoes or any other rocker shoes, analyzed in this study, do not reduce the PP more than 2 % compared to the control shoe. For the midheel and distal heel region with high pressure values (>200 kPa), rocker shoes alone are not the correct option to reduce the pressure to below 200 kPa. Conclusion: When using rocker shoes to reduce the pressure in the forefoot, a heel rocker midsole with a distal apex position, small rocker radius and apex angle of 100°, mitigates the negative effects on proximal heel pressure. For the midheel and distal heel, other footwear options as an addition or instead of rocker shoes are needed to reduce the pressure.
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