Authors (including presenting author) :
HO CYH(1), Au-Yang ACK(2), Mok KM(3)
Affiliation :
(1)Prosthetics and Orthotics Department, Alice Ho Miu Ling Nethersole Hospital (2)Prosthetics and Orthotics Department, Prince of Wales Hospital (3)Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong
Introduction :
Partial first ray amputation is one of the clinical pathway of diabetic foot ulceration. The missing first ray disrupts the foot structures, causing deformities and excessive plantar pressure. Without comprehensive care, reulceration may occur and possibly lead to higher level amputation. Previous study has suggested that rocker bottom shoes could reduce risk of ulceration in partial first ray amputation. However, it lacked quantitative evidence to support the statement. In this study, we aimed to investigate the effect of toe-only rocker sole with the use of total contact insole in reduction of peak plantar pressure in partial first ray amputation.
Objectives :
1) To investigate the effect of toe-only rocker sole with the use of total contact insole in peak plantar pressure reduction in partial first ray amputation 2) To compare the effect of peak plantar pressures reduction between rocker sole and control shoe (both with total contact insole)
Methodology :
Seven subjects (mean age: 68.7 mean BMI: 23.1) with unilateral partial first ray amputation were recruited. Toe-only rocker sole was modified from control shoe and total contact insole was fabricated from direct casting from subjects’ feet. Peak plantar pressure data were collected using Pedar® Insole in three tested conditions (control shoe, total contact insole in control shoe (TC) and toe-only rocker sole with total contact insole (rocker sole)) during gait cycle. Peak plantar pressures over 6 regions (total, heel, midfoot, metatarsal, hallux and lesser toes) were collected and compared among different tested conditions.
Result & Outcome :
Peak plantar pressures were reduced significantly (p<0.05) in total, heel and metatarsal regions in both TC and rocker sole compared with control shoe. No significant difference (p<0.05) was found in peak plantar pressure in all regions between TC and rocker sole. Mean peak plantar pressures in rocker sole were reduced in all regions compared with control shoe, and in all regions except heel compared with TC. It was suggested that toe-only rocker sole with total contact insole could reduce peak plantar pressures and serve as a preventive measure in ulceration occurrence.
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