Effect of Modified High-heels on Metatarsal Stress in Female Workers

Objective: The purpose of this study was to identify the effect of high-heels (HH) modification on metatarsal stress in female workers. Method: Seven females who work in clothing stores ($heights=160.4{\pm}3.9cm$; $weights=47.4{\pm}4.1kg$; $age=31.3{\pm}11.1yrs$; $HH\;wear\;career=8{\pm}6.5yrs$) wore two types of HH (original and modified). The modified HH had been grooved with 1.5 cm radius and 0.2 cm depth around the first metatarsal area inside of the shoes using the modified shoe-last. Participants were asked to walk for 15 minutes on a treadmill and to stand for 10 minutes with original and modified HH, respectively. Kinetics data were collected by the F-scan in-shoe system. After each test, participants were asked to rate their perceived exertion using the Borg's 15-grade RPE scale and interviewed about their feeling of HH. Nonparametric Wilcoxon signed-rank test and effect size (Cohen's d) were used to determine the difference of the variables of interest between the original and modified HH. Results: In the present study, modified HH of the peak contact pressure of 1st metatarsal (PCP) left, PCP right, pressure time integral (PTI) left, peak pressure gradient (PPG) left during standing and PPG right during walking are greater than original HH. And even it didn't show statistically significant, the average in all pressure values of modified HH showed bigger than original HH. It surmised to be related to awkward with modified HH. Even though they said to feel the comfortable cause of big space inside of HH in the interview, they seemed to be not enough time to adapt with new HH. So their walking and standing postures were unstable. Conclusion: Modified the fore-medial part of HH can reduce the stress in the first metatarsal head and big toe area during standing and walking.