RESPONSES 9-16: AFO & Skechers "Shape-Ups" Shoes

Description

Title:

RESPONSES 9-16: AFO & Skechers "Shape-Ups" Shoes

Date:

10/15/2010

Text:

Dear List Members:
 
Below, following my original question posted to OANDP-L, you will find the responses to my post. As you will read the opinions and experiences are rather varied, much of which I concur with. Sketchers actually provides a good deal of information regarding the shoes when they are purchased, including an informational video, which supports what you will find on their web site and can be viewed as educational or just marketing info. Although I feel I fully understand the concept behind the shoes, I plan to monitor my patient closely, given my own concerns and unknowns of their use with AFO's.
 
Many thanks to all who responded!
 

John N. Billock, CPO/L

Orthotics & Prosthetics Rehabilitation Engineering Centre
Warren, Ohio 44484 USA
 

Original Questions:
I would be interested in hearing your input and/or opinions, positive or negative, regarding experiences you may have had with individuals using any type of Custom Molded AFO in conjunction with Skechers Shape-Ups Shoes?

Responses 9-16:


Had 1 experience recently w/ a pt who was transitioned from CROW to solid AFO and that rocker sole was good for the missing ankle ROM.

We have a podiatrist that has us rocker sole fore and aft when fitting solid ankle AFO's or suggests they get the shape up style shoes. Pt's
initially report a slight instability to just stand still. Less problems in gait. But they adjust quickly and seem to do well.

I've seen several individuals bennefit from the rocker bottom on these shoes. They can reduce foot/ankle motion for patients with painful conditions. They also help restore a normal roll over for people with ankle fusions and/or wearing solid ankle AFOs.
One negative I have seen is some of these shoes are built with a very soft midsole and they offer poor M/L stability. Obvioulsy not good if you are
putting an AFO or FO inside.
In general I think they are great for most patients that would bennefit from a traditional rocker bottom shoe modification.

At the VA in Houston we are doing a study on Skechers feet and amputees. One of our Therapists has put it on a pt using an AFO with success, and now the orthotist is going to add a rocker bottom to one of his pair of shoes.
With Amputees, everyone has stated that walking is improved. However, there are other factors involved to include the different profiles in Skechers and other rocker bottom shoes that are coming out on themarket. We suspect that it is not the rocker bottom alone that is responsible. I think this will be an important study because more and more of these type of shoes are entering the market and prosthetists and orthotists should be aware of these factors. We are directing our study to amputees only.
A resident is working with me and will be writing a paper. Our study has a few metrics involved and should be very interesting. More detailed info to follow in about a month.

I have several patients that tried the Skechers shoes and also one similar to them with solid ankle AFOs and they did not work well. The patients could not get a balance point to stand and the shoe made it difficult to walk. I don't know what the affects would be if it was a hinged AFO.
I will be eager to read the other responses.


Hyperextension of the knee on heel strike with a solid ankle AFO. Bad news.


The MBT technology to broken in very very slowly, build up the use gradually.
The standing position not to lock the knees to obtain balance; I have had some negative feed back with non pathology, active population; exhibiting some irritation in the sciatic area, different muscle groups in hip and upper thigh area get a good work out so slowly slowly catchee monkey.
People with balance issues are sometimes improved sometimes worse, The best indication is doing an extensive gait eval with the shoes.
My co worker has an LLD approx 1cm no compensation was needed in the shoes she has and some knee pain. The MBT once broken in gave good results, knee pain minimal.



It has been interesting to critique in the past few months - looking at that shoe. The shoes have positive and negative design to them. In regard to
bracing I think the Sketcher shoe works well on unilateral patient with simple foot drop. When I have a patient who has balance issues I shy away from them. Some people have a mild foot drop and the rocker sole design can work to advantage.
For patients treated bilaterally with braces, I shy away from that. If you have a patient with unstable subtalar joint and rolls medially or laterally I shy away from them.
On a separate note patients who have metatarsal issues and one their feet a lot, they either love or hate them. It is a judgment call. I have a patient who is adamant to take them home and try at the house. They can then decide. Most of the time patients will use a cane for 3-point balance.


                          

Citation

“RESPONSES 9-16: AFO & Skechers "Shape-Ups" Shoes,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/231931.