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Open AccessArticle

Importance of Footwear Outsole Rigidity in Improving Spatiotemporal Parameters in Patients with Diabetes and Previous Forefoot Ulcerations

1
Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
2
Diabetic Foot Unit, Department Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
3
Infectious Diseases Department, Gustave Dron Hospital, 59200 Tourcoing, France
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 907; https://doi.org/10.3390/jcm9040907 (registering DOI)
Received: 4 February 2020 / Revised: 7 March 2020 / Accepted: 24 March 2020 / Published: 25 March 2020
(This article belongs to the Special Issue Diabetic Foot Complications: Current Challenges and Future Prospects)
We aimed to identify if any differences existed in spatiotemporal parameters during gait among different densities of rocker soles in patients with a history of neuropathic ulcerations and the differences in comfort between shoe conditions. This study was a cross-sectional study of 24 patients with diabetes and a history of neuropathic diabetic foot ulcers (DFUs). Spatiotemporal parameters (duration of stance phase (ms), stride length (cm), and step velocity (m/s)) were analyzed in barefoot, semirigid outsole, and rigid outsole footwear conditions. A dynamic pressure measurement system (Footscan® system, RSscan International, Belgium) was used to assess shoe conditions. We also analyzed differences in comfort between the shoe conditions using a visual analog scale. A Wilcoxon test for paired samples was used to assess gait differences. Result showed that a rigid outsole causes changes in the subphases of the stance phase (p < 0.001; Cohen d = 0.6) compared to a semirigid outsole. Stride length (p < 0.001; Cohen d = 0.66) and step velocity were significantly longer (p < 0.001; Cohen d = 2.03) with the use of rigid outsole footwear. A rigid rocker sole reduces the time of the stance phase, in addition to increasing the stride length and velocity of step in patients with a previous history of DFUs.
Keywords: rigid rocker sole; diabetic polyneuropathy; ulcer prevention; spatiotemporal parameters rigid rocker sole; diabetic polyneuropathy; ulcer prevention; spatiotemporal parameters
MDPI and ACS Style

López-Moral, M.; Molines-Barroso, R.; Álvaro-Afonso, F.; Uccioli, L.; Senneville, E.; Lázaro-Martínez, J. Importance of Footwear Outsole Rigidity in Improving Spatiotemporal Parameters in Patients with Diabetes and Previous Forefoot Ulcerations. J. Clin. Med. 2020, 9, 907.

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