Rocker soles, flat sole shoes comparable in reducing disability, lower back pain

Rocker sole shoes were found to be no more effective than flat sole shoes in reducing disability and pain in people with lower back pain, while flat shoes were more beneficial for lower back pain aggravated by standing or walking, according to recent study results published in Spine.

Researchers randomly assigned 115 participants with chronic lower back pain to wear rocker sole shoes or flat sole shoes for a minimum of 2 hours each day while standing and walking. Participants also wore their assigned shoe while attending an exercise and education program once a week for 4 weeks. Primary outcome was results from the Roland Morris Disability Questionnaire (RMDQ).

Researchers assessed participants at 6 weeks, 6 months and 1 year through an intention-to-treat method. Overall, data from the RMDQ revealed greater reduction in disability in the flat sole group compared with the rocker sole group. Flat shoes also provided a minimal clinically important improvement in disability in participants at 6 months.

However, researchers found no significant between-group differences for disability or pain during the study. Among participants who reported pain when standing and walking at baseline, those in the flat sole group reported a greater reduction in disability at 12 months compared with the rocker sole group.

“Rocker sole footwear … manufacturers claim that the unstable curved sole can positively influence mechanisms associated with chronic lower back pain, such as poor balance, substandard muscle function, poor posture and reduced ability to absorb shock while walking. However, there is no evidence in the literature supporting these claims,” Sian MacRae, PhD, of the therapy department at Chelsea and Westminster Hospital NHS Foundation Trust in London, UK, stated. “On the basis of the findings of this randomized clinical trial, clinicians should be confident in advising patients with chronic lower back pain that wearing either rocker sole shoes or trainers may offer similar outcomes in disability and pain. However, if a patient reports lower back pain when standing or walking, it may be more beneficial to wear trainers than rocker sole shoes.”

For more information:

MacRae CS. Spine. 2013;doi:10.1097/brs.0b013e3182a69956.

Disclosure: This study was supported by grants provided by Masai GB Ltd.

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