Optimization of rocker sole footwear
limitation is that we did not compare our group
optimized footwear with fully customized footwear,
incorporating an extra depth upper along with a
customized insole with metatarsal pads and cut outs
etc. However, the aim of this study was to specify a
group-optimized outsole design and the beneficial
effects of other footwear modifications are likely to be
additive. Such customized footwear comes at greater
cost, and perhaps lower adherence, and seems out of
context for the prevention of first ulceration, when
most footwear is still sought via a retail route. However,
our proposed group-optimized design could be used as
a starting point for fully customized footwear if further
reductions in pressure were necessary.
ABBREVIATIONS
MTH: metatarsal head
MTP: metatarsophalangeal
RA: rocker angle
Conclusions
By studying the relationship between footwear design
features and peak plantar pressure, we have been
able to suggest a group-optimized design for plantar
pressure reducing footwear. Our data demonstrate
that this design can reduce pressures below the 200
kPa threshold in the majority of people with elevated
plantar pressure but otherwise at low risk of first
ulceration. The results also show that personalized
selection of footwear based on collection of plantar
pressure data may offer only marginal gains in this
population.
•
PB – Conceived the original idea, designed the
study and contributed towards writing of the final
manuscript.
CJ – Conceived the original idea, designed the study
and co-wrote the final manuscript. All authors read
and approved the final manuscript.
Acknowledgements
We acknowledge the support we received from the
UK Primary Care Research Network who assisted
with participant recruitment for this study.
Ethics approval and consent to participate
This research was carried out with funding from
the European Community’s Seventh Framework
Programme (FP7/2007–2013), Grant Agreement no.
NMP2-SE-2009-229,261. The following statement relating to ethical approval
was provided at the start of the methods section
“All subjects provided written consent to participate
in the study after appropriate ethical approval
had been obtained (UK NRES 10/H1013/32).” This
statement includes the committee name and
reference number. This statement also makes it
clear that all subjects provided informed consent.
Availability of data and materials Author details
The data will not be shared since no informed
consent was taken for data sharing other than
within the research team. 1 Centre for Health Sciences Research, University of
Salford, Salford, Manchester M6 6PU, UK. 2Institute
of Biomechanics and Orthopaedics, German Sport
University Cologne, Am Sportpark Muengersdorf 6,
50933 Cologne, Germany. 3German Research Centre
for Elite Sport, German Sport University Cologne,
Am Sportpark Muengersdorf 6, 50933 Cologne,
Germany. 4Centre for Health and Integrative
Physiology in Space, German Sports University
Cologne, Am Sportpark Muengersdorf 6, 50933
Cologne, Germany.
Funding
Authors’ contributions
SP – Designed the study, carried out data analysis
and co-wrote the final manuscript.
JD and BB – Carried out experimental data
collection, data analysis and contributed towards
writing of the final manuscript.
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