Effect of Different Placement of Heel Rockers on Lower-Limb Joint Biomechanics in Healthy Individuals

Abstract

Results showed that forward and backward shifting of the heel rocker apex could change the knee moment and ankle joint range of motion in the stance phase of gait. Therefore, placement of the heel rocker in a rocker-bottom shoe can be manipulated to promote the desired lower-limb motion, at least in healthy individuals.

Do biomechanical foot-based interventions reduce patellofemoral joint loads in adults with and without patellofemoral pain or osteoarthritis? A systematic review and meta-analysis

“…There is very low certainty evidence to suggest rocker-soled shoes do not alter peak patellofemoral joint loads during walking and running combined (SMD (95% CI) = 0.37) (−0.06 to 0.79), p=0.09) with low heterogeneity (I 2 =2%). After subgrouping by task, the effect estimates in two studies43 44 for walking were non-significant. In contrast, the effect estimate during running showed patellofemoral joint loads were increased in rocker-soled footwear (SMD (95% CI) = 0.78 (0.06 to 1.50)), although this was based on one study 45…”

“…Thirty-three studies were included in the final review. Of these, 2236–57 (n=371 participants) investigated the effect of footwear and 1130 58–67 (n=207 participants) the effect of shoe insoles on patellofemoral joint loads. We did not identify any studies that investigated effects of taping or bracing.…”

“…The populations in the included studies were apparently healthy (30 studies,37–62 64–67 n=496 participants) and people diagnosed with patellofemoral pain (3 studies,30 36 59 n=61 participants) or osteoarthritis (1 study,63 n=21 participants). Measurement outcomes included peak external flexion/internal extension knee moment (18 studies,37 40 42–45 47 49–53 55–57 59 60 63 peak patellofemoral joint pressure (14 studies30 36 38 39 41 46 48 54 58 61 62 64 65 67 and peak patellofemoral joint reaction force (1 study 66. Study outcomes are outlined in table 1 (footwear interventions) and table 2 (insole interventions).…”

“…We rated 31 outcomes as ‘some concerns’30 36–42 45–55 57–59 61–67 and 443 44 56 60 as ‘high risk’ of bias (figure 2). The risk of bias was largely consistent between the studies and was mostly due to a lack of randomisation, a lack of information regarding the randomisation process (when randomisation was used), and/or did not report sufficient rest time for carryover effects to disappear.…”

“…Three studies43–45 (n=44 participants) compared rocker-soled footwear with non-rocker footwear in healthy people only (figure 3B). There is very low certainty evidence to suggest rocker-soled shoes do not alter peak patellofemoral joint loads during walking and running combined (SMD (95% CI) = 0.37) (−0.06 to 0.79), p=0.09) with low heterogeneity (I 2 =2%).…”