The efficacy of rocker bottom shoes and orthotic insoles in redistributing foot plantar pressure among diabetic patients a scoping review

Foot ulceration is a severe complication for diabetic patients (DPs), leading to amputation and decreased quality of life. Effective prevention through plantar peak pressure (PPP) redistribution is crucial. This scoping review evaluates the offloading effectiveness of rocker bottom shoes (RBS) and orthotic insoles (OI) in type 1 and type 2 DPs. Thirteen studies met the inclusion criteria. Both RBS and OI significantly reduce PPP under the metatarsal heads (P<0.05), however RBS were more effective than OI in reducing PPP below the threshold of 200kPa. Few studies found statistically significant PPP reduction under the hallux. All studies showed increased PPP under the midfoot (P<0.05), which remained below 200kPa. Findings shows that RBS and OI are reliable tools for primary and secondary prevention of foot ulcerations in DPs. Future investigations should include analysis of adherence, walking comfort and material deterioration.