Low back pain (LBP) is one of the most common musculoskeletal disorders [1]. Exercise therapy is often advised [2, 3] but requires a significant time commitment, can rely on equipment or health professionals and risks low compliance. As an alternative or adjunct, shoes with a curved sole profile are thought to produce beneficial changes in ankle, knee, hip and back position and posture [4]. Therefore, the aim of this preliminary study was to investigate the effect of rollover footwear on pain, disability and lumbar posture in patients with lumbar pain

Forghany, S

Nester, CJ

pol, F

Rahimi, A

Journal of Foot and Ankle Research

PubMed

University of Salford Institutional Repository

MEETING ABSTRACT Open AccessThe effect of rollover footwear on pain, disabilityand lumbar posture in patients with low backpainAtefe Rahimi1, Saeed Forghany1,2*, Christopher Nester2, Fateme pol1From 4th Congress of the International Foot and Ankle Biomechanics (i-FAB) CommunityBusan, Korea. 8-11 April 2014BackgroundLow back pain (LBP) is one of the most common mus-culoskeletal disorders [1]. Exercise therapy is oftenadvised [2,3] but requires a significant time commit-ment, can rely on equipment or health professionals andrisks low compliance. As an alternative or adjunct, shoeswith a curved sole profile are thought to produce benefi-cial changes in ankle, knee, hip and back position andposture [4]. Therefore, the aim of this preliminary studywas to investigate the effect of rollover footwear onpain, disability and lumbar posture in patients withlumbar pain.Material and method21 patients (age: 35.5±1.4 years) with LBP (pain distal tothe buttocks that centralized with extension) were ran-domly assigned to a rollover footwear and lumbar exten-sion exercise group (n=11) or a lumbar extension exerciseonly group (n=10). Baseline and 4 weeks post interventionmeasures were pain (visual analog scale), disability(Oswestry LBP disability) and lumbar posture when stand-ing barefoot (as described by Forghany et al [4]).Participants attended six appointments of 30 minutesduration over 4 weeks. Exercise consisted of 3 sets of 10repetitions of extension exercises. Participants in the shoeand exercise group walked in rollover footwear [PerfectSteps] as often as possible over the 4 weeks (but at least30 minutes each day).ResultsParticipants in both groups showed significant decreasesin pain levels and disability after four weeks. Participantsin the shoe and exercise group had significantly greaterdecreases in pain (p=0.04) and demonstrated 11.8% greaterreduction in disability, but this did not reach statistical sig-nificance (p>0.05) (Table 1). The radius of lumbar curvewas decreased in both groups when standing barefootafter 4 weeks, but not significantly (p>0.05) and there wasno significant difference in the change in the radius oflumbar curve between two groups (p>0.05) (Table 1).ConclusionThis result suggests that the rollover footwear could bepart of a treatment protocol for greater reduction in* Correspondence: Saeed_forghany@rehab.mui.ac.ir1Musculoskeletal Research Centre, Isfahan University of Medical Sciences, IranFull list of author information is available at the end of the articleTable 1 Mean and amount of change in pain, disability and lumbar posture in exercise only, and exercise and shoegroups.Pain Disability Lumbar Posture (cm)Pretest 4 weeks change Pretest 4 weeks change Pretest 4 weeks changeExercise 7.1±1.6 4.8±2.1a -%31.5 36.9±10.5 26.3±9.5a -%27.8 26.2±13.9 22.2±10.5 -%15.3Exercise + shoe 7.3±1.8 3.0±2.0a -%58.9b 29.8±5.3 18.0±5.9 a -%39.6 20.1±11.9 17.5±5.6 -%12.9a P <0.05 (within group). b P <0.05 (between group).Rahimi et al. Journal of Foot and Ankle Research 2014, 7(Suppl 1):A20http://www.jfootankleres.com/content/7/S1/A20 JOURNAL OF FOOTAND ANKLE RESEARCH© 2014 Rahimi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.pain level in patients with LBP. However, the effects onlumbar biomechanics and association with changes inpain and disability remain unclear and requires furtherinvestigation.Authors’ details1Musculoskeletal Research Centre, Isfahan University of Medical Sciences,Iran. 2Centres for Health Sciences Research, University of Salford, UK.Published: 8 April 2014References1. Dunsford A, Kumar S, Clarke S, et al: Integrating evidence in to practice:use of Mckenzie- based treatment for mechanical low back pain.J Multidiscip Healthc 2011, 4:393-402.2. Peterson T, Larsen K, Jacobsen S: One-year follow-up comparison of theeffectiveness of Mckenzie treatment and strengthening training forpatients with chronic low back pain. J Spine 2007, 32:2948-2956.3. Nigg B, Davis A, Lindsay D, Emery C: The effectiveness of an unstablesandal on low back pain and golf performance. Clin J Sport Med 2009, 19.4. Forghany S, Nester C, Richards B: The relationship between sole curvatureof roll over footwear and changes in gait. Foot Ankle 2012.doi:10.1186/1757-1146-7-S1-A20Cite this article as: Rahimi et al.: The effect of rollover footwear on pain,disability and lumbar posture in patients with low back pain. Journal ofFoot and Ankle Research 2014 7(Suppl 1):A20.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitRahimi et al. Journal of Foot and Ankle Research 2014, 7(Suppl 1):A20http://www.jfootankleres.com/content/7/S1/A20Page 2 of 2

The effect of rollover footwear on pain, disability and lumbar posture in patients with low back pain

Atefe Rahimi

Saeed Forghany

Christopher Nester

Fateme pol

Crossref

Nester, C

Keele Research Repository

Springer - Publisher Connector

MEETING ABSTRACT Open Access
The effect of rollover footwear on pain, disability
and lumbar posture in patients with low back
pain
Atefe Rahimi1, Saeed Forghany1,2*, Christopher Nester2, Fateme pol1
From 4th Congress of the International Foot and Ankle Biomechanics (i-FAB) Community
Busan, Korea. 8-11 April 2014
Background
Low back pain (LBP) is one of the most common mus-
culoskeletal disorders [1]. Exercise therapy is often
advised [2,3] but requires a significant time commit-
ment, can rely on equipment or health professionals and
risks low compliance. As an alternative or adjunct, shoes
with a curved sole profile are thought to produce benefi-
cial changes in ankle, knee, hip and back position and
posture [4]. Therefore, the aim of this preliminary study
was to investigate the effect of rollover footwear on
pain, disability and lumbar posture in patients with
lumbar pain.
Material and method
21 patients (age: 35.5±1.4 years) with LBP (pain distal to
the buttocks that centralized with extension) were ran-
domly assigned to a rollover footwear and lumbar exten-
sion exercise group (n=11) or a lumbar extension exercise
only group (n=10). Baseline and 4 weeks post intervention
measures were pain (visual analog scale), disability
(Oswestry LBP disability) and lumbar posture when stand-
ing barefoot (as described by Forghany et al [4]).
Participants attended six appointments of 30 minutes
duration over 4 weeks. Exercise consisted of 3 sets of 10
repetitions of extension exercises. Participants in the shoe
and exercise group walked in rollover footwear [Perfect
Steps] as often as possible over the 4 weeks (but at least
30 minutes each day).
Results
Participants in both groups showed significant decreases
in pain levels and disability after four weeks. Participants
in the shoe and exercise group had significantly greater
decreases in pain (p=0.04) and demonstrated 11.8% greater
reduction in disability, but this did not reach statistical sig-
nificance (p>0.05) (Table 1). The radius of lumbar curve
was decreased in both groups when standing barefoot
after 4 weeks, but not significantly (p>0.05) and there was
no significant difference in the change in the radius of
lumbar curve between two groups (p>0.05) (Table 1).
Conclusion
This result suggests that the rollover footwear could be
part of a treatment protocol for greater reduction in
* Correspondence: Saeed_forghany@rehab.mui.ac.ir
1Musculoskeletal Research Centre, Isfahan University of Medical Sciences, Iran
Full list of author information is available at the end of the article
Table 1 Mean and amount of change in pain, disability and lumbar posture in exercise only, and exercise and shoe
groups.
Pain Disability Lumbar Posture (cm)
Pretest 4 weeks change Pretest 4 weeks change Pretest 4 weeks change
Exercise 7.1±1.6 4.8±2.1a -%31.5 36.9±10.5 26.3±9.5a -%27.8 26.2±13.9 22.2±10.5 -%15.3
Exercise + shoe 7.3±1.8 3.0±2.0a -%58.9b 29.8±5.3 18.0±5.9 a -%39.6 20.1±11.9 17.5±5.6 -%12.9
a P <0.05 (within group). b P <0.05 (between group).
Rahimi et al. Journal of Foot and Ankle Research 2014, 7(Suppl 1):A20
http://www.jfootankleres.com/content/7/S1/A20 JOURNAL OF FOOT
AND ANKLE RESEARCH
© 2014 Rahimi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://
creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
pain level in patients with LBP. However, the effects on
lumbar biomechanics and association with changes in
pain and disability remain unclear and requires further
investigation.
Authors’ details
1Musculoskeletal Research Centre, Isfahan University of Medical Sciences,
Iran. 2Centres for Health Sciences Research, University of Salford, UK.
Published: 8 April 2014
References
1. Dunsford A, Kumar S, Clarke S, et al: Integrating evidence in to practice:
use of Mckenzie- based treatment for mechanical low back pain.
J Multidiscip Healthc 2011, 4:393-402.
2. Peterson T, Larsen K, Jacobsen S: One-year follow-up comparison of the
effectiveness of Mckenzie treatment and strengthening training for
patients with chronic low back pain. J Spine 2007, 32:2948-2956.
3. Nigg B, Davis A, Lindsay D, Emery C: The effectiveness of an unstable
sandal on low back pain and golf performance. Clin J Sport Med 2009, 19.
4. Forghany S, Nester C, Richards B: The relationship between sole curvature
of roll over footwear and changes in gait. Foot Ankle 2012.
doi:10.1186/1757-1146-7-S1-A20
Cite this article as: Rahimi et al.: The effect of rollover footwear on pain,
disability and lumbar posture in patients with low back pain. Journal of
Foot and Ankle Research 2014 7(Suppl 1):A20.
Submit your next manuscript to BioMed Central
and take full advantage of: 
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at 
www.biomedcentral.com/submit
Rahimi et al. Journal of Foot and Ankle Research 2014, 7(Suppl 1):A20
http://www.jfootankleres.com/content/7/S1/A20
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The effect of rollover footwear on pain, disability and lumbar posture in patients with low back pain

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