A 59-year-old man with a functionally fused ankle due to prior arthritic changes; which shoe modification would be MOST beneficial?

Cushioned heel

Metatarsal bar

Heel lift

Rocker bar

When the ankle is fused, normal ankle motion during gait can’t occur, so the shoe should help the foot roll through the stance phase without needing ankle motion. A rocker bar provides a curved sole that acts like a pivot near the forefoot, allowing the foot to roll from heel strike to toe-off smoothly. This reduces the need for dorsiflexion or plantarflexion at the ankle and makes forward progression easier and more energy-efficient for someone with a fused ankle.

Other options don’t address rollover as effectively. A cushioned heel mainly softens landings but doesn’t assist the rollover sequence. A metatarsal bar shifts pressure under the forefoot but doesn’t facilitate the smooth transition through the foot. A heel lift changes heel height and can alter gait mechanics without improving the rollover needed when the ankle is immobile.

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