title: Rocker outsole shoe is not a threat to postural stability in patients with diabetic neuropathy.
abstract: BACKGROUND
  Rocker outsole shoes are commonly prescribed to patients with diabetic neuropathy to offload a particular area of the foot sole, thereby decreasing the risk of foot ulceration. Contrary to this, some evidence has reported a postural destabilising effect of these shoes in healthy adults.
  
  
  OBJECTIVE
  To explore the postural stability of patients with diabetic neuropathy who wear a rocker outsole shoe.
  
  
  METHODS
  Quasi-experimental.
  
  
  METHODS
  In total, 17 patients with diabetic neuropathy (aged 49.29 ± 7.48 years; 7 female, 10 males) participated in this study. A Motor Control Test measuring centre of force displacement, response strength scale and response latency in medium and large perturbations was conducted using the EquiTest system to evaluate postural stability while wearing a baseline shoe (without a rocker outsole) or a rocker outsole shoe (with a toe-only rocker sole).
  
  
  RESULTS
  No significant difference was observed between the shoe conditions in centre of force displacement and response latency of the participants (p > 0.05). The results indicated a significant increase in the response strength scale of participants by the rocker outsole, for medium forward and backward and large forward perturbations (p = 0.014, p = 0.001 and p = 0.027, respectively).
  
  
  CONCLUSIONS
  When the immediate effect is a concern, the rocker outsole shoe did not negatively affect postural stability in patients with diabetic neuropathy.
  
  
  CONCLUSIONS
  This article will provide objective evidence about the effect of rocker outsole on postural balance in diabetic patients. In prescription of rocker outsole to prevent plantar ulceration of diabetic foot, immediate postural destabilising is not a concern.
authors: Department of Orthotics and Prosthetics, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran banafshe.ghomian@gmail.com.
authors: Banafshe
authors: B
authors: Ghomian
authors: Department of Orthotics and Prosthetics, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors: Mojtaba
authors: M
authors: Kamyab
authors: KU Leuven - University of Leuven, Health Psychology, Leuven, Belgium.
authors: Hassan
authors: H
authors: Jafari
authors: Endocrine Research Centre (Firouzgar Hospital), Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
authors: Mohammadebrahim
authors: M
authors: Khamseh
authors: Faculty of Health Sciences, Staffordshire University, Staffordshire, UK.
authors: Aoife
authors: A
authors: Healy
mesh_terms: D000328:Adult; D003929:Diabetic Neuropathies / Q000150:complications / Q000503:physiopathology*; D004867:Equipment Design; D005260:Female; D016523:Foot Ulcer / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D012775:Shoes; D016474:Weight-Bearing / Q000502:physiology
keywords: Diabetic neuropathy; postural balance; rocker outsole