Do rocker-sole shoes influence postural stability in chronic low back pain? A randomised trial. Issue 1 (19th October 2016)

• Record Type: Journal Article
• Authors: MacRae, C Sian; Critchley, Duncan; Morrissey, Matthew; Shortland, Adam; Lewis, Jeremy S
• Is Part Of: BMJ open sport & exercise medicine. Volume 2:Issue 1(2016)
• Publication Date: 2016-10-19
• Subjects: Biomechanics -- Exercise rehabilitation -- Lumbar spine -- Randomised controlled trial; Sports medicine -- Periodicals; Exercise therapy -- Periodicals; 617.102705
• DOI: 10.1136/bmjsem-2016-000170
• Languages: English
• ISSNs: 2055-7647

Abstract

Abstract : Background: People with chronic low back pain (CLBP) demonstrate greater postural instability compared with asymptomatic individuals. Rocker-sole shoes are inherently unstable and may serve as an effective balance training device. This study hypothesised that wearing rocker-sole shoes would result in long-term improvement in barefoot postural stability in people with CLBP. Methods: 20 participants with CLBP were randomised to wear rocker-sole or flat-sole shoes for a minimum of 2 hours each day. Participants were assessed barefoot and shod, over three 40 s trials, under 4 posture challenging standing conditions. The primary outcome was postural stability assessed by root mean squared error of centre of pressure (CoP) displacement (CoPRMSE AP ) and mean CoP velocity (CoPVELAP ), both in the anteroposterior direction, using force plates. Participants' were assessed without knowledge of group allocation at baseline, 6 weeks and 6 months (main outcome point). Analyses were by intention-to-treat. Results: At 6 months, data from 11 of 13 (84.6%) of the rocker-sole and 5 of 7 (71.4%) of the flat-sole group were available for analysis. At baseline, there was a mean increase in CoPRMSE AP (6.41 (2.97) mm, p<0.01) and CoPVELAP (4.10 (2.97) mm, p<0.01) in the rocker-sole group when shod compared with barefoot; there was no difference in the flat-sole group. There were no within-group or between-group differences in change in CoP parameters at any time point compared with baseline (1) for any barefoot standing condition (2) when assessed shod eyes-open on firm ground. Conclusions: Although wearing rocker-sole shoes results in greater postural instability than flat-sole shoes, long-term use of rocker-sole shoes did not appear to influence postural stability in people with CLBP.