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

• A. Cushioned heel
• B. Metatarsal bar
• C. Heel lift
• D. Rocker bar

Answer: (D)

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.