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Comparative Analysis of Strap-Induced Pressure at the Toe Hold Area: Assessing the Impact of Rolled Inner Seam Flip Flops in Healthy Volunteers

Shreya Rao

Footwear-induced dorsal foot ulcers, particularly those caused by straps, can have devastating consequences,
especially in individuals with diabetes and leprosy. However, there is limited literature specifically investigating strap-
induced pressure on the dorsal foot. This study aimed to compare the pressure at the toe hold area between Rolled
Inner Seam (RIS) and traditional strap designs in flip flops. Healthy female volunteers (n=5, for a total of 10 measures
with 5 Right and 5 Left) participated in a 5-step walk trial wearing both types of flip flops. Pressure at the toe hold was
measured using portable pressure sensors. Paired t-tests revealed a significant difference in pressure between RIS
and traditional strap flip flops (p=0.0014). The RIS design exerted significantly lower pressure (-40.90) compared to the
traditional strap. These findings have far-reaching implications, particularly in developing nations where flip flops are
commonly worn and healthcare access is limited. RIS flip flops may offer a practical solution to reduce strap-induced
pressure, potentially preventing dorsal foot ulcers. Further research is warranted to validate and extend these findings,
particularly in populations with chronic conditions such as diabetes.