Rocker shoe as walking aid in multiple sclerosis

Area of Science:

• Biomechanics
• Rehabilitation Medicine
• Neurology

Background:

• Multiple sclerosis (MS) often impairs walking ability, leading to increased energy expenditure and fatigue.
• Rocker shoes are a potential assistive device to mitigate gait abnormalities in MS patients.

Purpose of the Study:

• To evaluate the efficacy of rocker shoes as a walking aid for individuals with multiple sclerosis.
• To establish criteria for patient selection and assess the impact on gait mechanics and energy cost.

Main Methods:

• Mechanical analysis of rocker shoe function.
• Development of clinical criteria for patient selection, focusing on roll point placement and fit.
• Laboratory gait analysis of MS patients with and without rocker shoes.

Main Results:

• Optimal rocker shoe function requires a specific roll point (2cm proximal to 1st metatarsal head) and secure fit.
• Rocker shoes were beneficial for patients with independent walking ability and sufficient hip/calf strength.
• Significant improvements in gait, including reduced knee hypertension, forward trunk lean, and toe drag, were observed.
• A mean energy saving of 150% was achieved, with notable reductions in net energy cost.

Conclusions:

• Rocker shoes can be an effective walking aid for select multiple sclerosis patients with specific gait deficits.
• Patient selection criteria, including retained ambulation and muscle strength, are crucial for optimal outcomes.
• Rocker shoe use significantly reduces the metabolic cost of walking in eligible MS patients.