In this study nine different rigid rocker shoe designs were tested in 17 symptom-free male subjects and compared with the control condition of a flexible, non-rockered extra-depth shoe with the same flat insole. Effects of both rocker height and axis location were explored. Peak pressure was reduced at most forefoot locations by rocker shoes, but increased in the midfoot and heel. Axis location was found to have an important effect, particularly on hallux pressures. On average the best axis location for reducing metatarsal head (MTH) pressure was in the region of 55-60% of shoe length, while for the toes it was 65%. There was a mean trend towards optimal reduction of pressure in one of the rocker shoe conditions at each anatomical location, but the axis position for this optimal placement was variable across subjects and anatomical locations. While most configurations of the rocker shoes were superior to the control shoe, no single configuration was optimal for all subjects at all sites or even for all subjects at the same site. Therefore, some form of plantar pressure measurement in conjunction with gait training to ensure correct use of the rocker shoes would appear to be essential if the pressure reducing effect of the rigid rocker bottom shoe is to be optimized.

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Experiments to determine the effects of therapeutic shoe outsole modifications frequently require the examination of many different configurations and typically use in-shoe pressure measurement to determine the optimal design. A method is presented here to allow the foot-shoe interface to remain undisturbed as different outsole designs are used in the same patient. A standard extra-depth (or super extra-depth) shoe is modified to house three receptacles for quarter-turn fasteners in a carbon fiber plate. The fasteners pass through the outsole unit and secure it firmly to the plate. Results from a typical experiment are presented to illustrate the effectiveness of the approach. It is possible that a large clinic could use this approach in complex cases to assist with optimal footwear prescription.

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