The biomechanics and clinical efficacy of footwear adapted with rocker profiles--evidence in the literature.

BACKGROUND Rocker profiles are the most commonly prescribed external therapeutic shoe modification. However, the prescription criteria for rocker profiles have historically been based on theoretical considerations with minimal scientific study and validation. OBJECTIVE Rocker profiles are used to afford pressure relief for the plantar surface of the foot, to limit the need for sagittal plane motion in the joints of the foot and to alter gait kinetics and kinematics in proximal joints. This paper reviews the literature relating to biomechanical and clinical efficacy. METHOD A literature search was undertaken in Medline, PubMed, Recal, Cochrane database and Scopus. RESULTS AND CONCLUSIONS Efficacy is demonstrated with regards to relief of forefoot plantar pressures. However, the definitive profile shape has not been demonstrated. The effectiveness of rocker-soled shoes in restricting sagittal plane motion in individual joints of the foot is unclear. Rocker profiles have minimal effect on the kinetics and kinematics of the more proximal joints of the lower limb, but more significant effects are seen at the ankle. Further research is warranted on the effects of rocker profiles on individual joints of the foot and the manner in which they effect lower limb muscle activity and gait patterns.

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