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Title: The effectiveness of rocker sole shoes in chronic low back pain
Author: MacRae, Catharine Sian
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2013
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Shoes with a rocker sole are marketed as reducing low back pain. There is minimal evidence to support these claims. This investigation compared rocker sole shoes to flat sole shoes in people with chronic low back pain (CLBP). The thesis reports findings of a randomised clinical trial and a series of biomechanical experiments. Following preparatory pilot and reliability studies, 115 people with CLBP were randomised to wear rocker sole shoes or flat sole shoes; all participants attended an exercise and education programme. Participants were assessed without knowledge of group allocation pre-randomisation, at six weeks, six months, and one year (main outcome point). Primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Analysis was by intention-to-treat. Biomechanical experiments recruited 20 participants from the main study and investigated effects of wearing rocker sole and flat sole shoes on standing balance and gait, immediately and after 6 months of shoe wear, using centre of pressure and motion-analysis derived kinetic, kinematic and spatio-temporal measures. Balance and gait in people with and age-and gender-matched controls without CLBP were compared. Rocker sole shoes were no more beneficial than flat sole shoes for CLBP patients; flat sole shoes were more beneficial in a sub-group of CLBP aggravated by standing or walking. Biomechanical studies found rocker sole shoes introduced immediately greater postural instability than flat sole shoes but neither shoe had long-term training effects on postural control. Furthermore, although both shoes resulted in small immediate changes in kinetic, kinematic and spatio-temporal parameters of shod gait, neither shoe had long-term training effects on these parameters in barefoot gait. Finally, in contrast to some previous research, postural control during standing, and kinetics, kinematic, and spatio-temporal parameters during gait were similar between people with and without CLBP.
Supervisor: Critchley, Duncan; Morrissey, Matt; Shortland, Adam Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available