Effects of the Twin Shoe (Darco) to compensate height differences in normal gait.

Background: After foot surgery or in diseases such as diabetes, orthopaedic shoes with an elevated sole construction are used to off-load the affected foot. The height difference between the shoes results in a leg length discrepancy and an abnormal gait pattern arises which can cause long-term discomfort in the joints of the lower extremity and the lower back. To compensate for this discrepancy and to ensure a symmetrical gait pattern a Twin Shoe (Darco) has been designed.

Aim: To investigate the effect of wearing orthopaedic shoes in combination with the Twin Shoe on normal gait biomechanics.

Study Design: Cross-sectional study in a laboratory setting.

Methods: Normal gait was recorded in 15 healthy subjects with a gait analysis system. Four different shoe conditions were measured. Selected biomechanical parameters were calculated and compared between the shoe conditions.

Results: Walking in orthopaedic shoes with an elevated sole without compensation on the contralateral side leads to significant asymmetrical joint movements and higher loads in feet, knees, hips and the lower back during gait. By using the Twin Shoe these abnormal patterns were improved but not entirely compensated.

Conclusions: Using the Twin Shoe as a partner to orthopaedic shoes with an elevated sole construction improves gait asymmetry and increased loading of joints induced by functional leg length discrepancy.