Current Pedorthics | July-August 2019 | Vol.51, Issue 4 | Page 51

Optimization of rocker sole footwear Table 3: The proportion of participants with a peak pressure below 200 kPa in the control shoe, the group- optimized design (52% apex) and the personalized design (individually selected apex) for both the 15° and 20° rocker angles (RA), in each of the three anatomical regions. Participants with Diabetes Healthy Individuals Apex position Rocker angle =15° Rocker angle = 20° Rocker angle =15° Rocker angle = 20° 52% 42% 46% 39% 56% 57% 30% 26% 39% 32% 62% 20% 23% 14% 9% 67% 8% 5% 8% 3% 52% 75% 87% 68% 88% 57% 19% 13% 23% 8% 62% 2% 0% 6% 5% 67% 5% 0% 3% 0% 52% 25% 45% 33% 35% 57% 38% 25% 32% 41% 62% 30% 21% 27% 15% 67% 75% 9% 8% 9% 1st MTP 2-4 MTH Hallux Data are reported on all diabetes participants (n = 102) and also participants with diabetes and peripheral neuropathy (n = 17). for the 1st MTP and 2–4 MTH regions and small in these studies supports the idea that increasing rocker the hallux region (5%). We therefore suggest that, if angle will decrease plantar pressures. However, there individuals are unwilling to wear a shoe with a 20° appears to be a complex relationship between apex rocker angle, then a 15° could be prescribed as an angle and apex position. Whereas in our first study, acceptable alternative. we investigated the effect of varying apex position when apex angle was fixed at 80° [16] , in this current Through a series of two studies (this current study study apex angle was fixed at 95°. Interestingly, it and a previously published study was not possible to specify a group-optimized apex ), we have [16] attempted to understand the combined effect of the position in the previous study because of considerable three design features of curved rocker footwear: apex inter-subject variability. However, the use of a 95° apex angle, apex position and rocker angle. Data from both angle led to a much more consistent response in this Current Pedorthics | July/August 2019 49