• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.593-601
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• 2009

The goal of this study was to investigate the lower extremity's coordination determined by temporal relations with increasing high-heel (3, 7, 9cm) while walking on a treadmill. Twelve healthy women who walked on a treadmill under three conditionswearing 3cm high-heel shoes, 7cm, and 9cm-while kinematic data were collected using a six-cameras (240Hz) Qualisys ProReflex System. From these data, knee flexion, tibia internal rotation, and foot eversion were calculated in Euler technique and found the time for occurring the maximum angle of these movements. The maximum angle of these movements occurred almost simultaneously in 3cm high-heel walking, but not in 7cm and 9cm. The ratio of time for maximum angle of the foot eversion to tibia internal rotation converged to 1 in 3cm high-heel walking, but were less than 1 in 7cm and 9cm. In conclusion, it was indicated that 3cm high-heel walking had better the lower extremity's coordination compared with 7, 9cm high-heel walking.

• Physical Therapy Korea
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• v.26 no.2
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• pp.16-23
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• 2019

Background: High-heeled shoes can change spinal alignment and feet movement, which leads to muscle fatigue and discomfort in lumbopelvic region, legs, and feet while walking. Objects: This study aimed to identify the effects of different shoe heel heights on the walking velocity and electromyographic (EMG) activities of the lower leg muscles during short- and long-distance walking in young females. Methods: Fifteen young females were recruited in this study. The experiments were performed with the following two different shoe heel heights: 0 cm and 7 cm. All participants underwent an electromyographic procedure to measure the activities and fatigue levels of the tibialis anterior (TA), medial gastrocnemius (MG), rectus femoris (RF), and hamstring muscles with each heel height during both short- and long-distance walking. The walking velocities were measured using the short-distance (10-m walk) and long-distance (6-min walk) walking tests. Results: Significant interaction effects were found between heel height and walking distance conditions for the EMG activities and fatigue levels of TA and MG muscles, and walking velocity (p<.05). The walking velocity and activities of the TA, MG, and RF muscles appeared to be significantly different between the 0 cm and 7 cm heel heights during both short- and long-distance walking (p<.05). Significant difference in the fatigue level of the MG muscle were found between the 0 cm and 7 cm heel heights during long-distance walking. In addition, walking velocity and the fatigue level of the MG muscle at the 7 cm heel height revealed significant differences in the comparison of short- and long-distance walking (p<.05). Conclusion: These findings indicate that higher shoe heel height leads to a decrease in the walking velocity and an increase in the activity and fatigue level of the lower leg muscles, particularly during long-distance walking.

• Journal of the Ergonomics Society of Korea
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• v.35 no.1
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• pp.39-52
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• 2016

Objective: This paper investigates gait changes according to different heel heights and speeds, and the interaction between the effects of the heel height and the speed during walking on stride parameters and joint angles. Furthermore, the relationship among heel height, speed and gait variables is investigated using linear regression. Background: Gait changes by heel height or speed have been studied respectively, but has not been reported whether there is an interaction effect between heel height and speed. It would be necessary to understand how gait changes when a person wears heels in different heights at various speeds, for example, high-heeled walking at fast speed, since it may cause unusual gait patterns and musculoskeletal disorders. Method: Ten females were asked to walk at five fixed cadences (94, 106, 118, 130 and 142 steps/min.) wearing three shoes with different heel heights (1, 5.4 and 9.8cm). Nineteen gait variables were analyzed for stride parameters and joint angles using two-way repeated measure analysis of variance and regression analysis. Results: Both heel height and speed affect movement of ankle, knee, spine and elbow joint, as well as stride length and Double/Single support time ratio. However, there is no significant interaction effect between heel height and speed. The regression result shows linear relationships of gait variables with heel height and speed. Conclusion: Heel height and speed independently affect stride parameters and joint angles without a significant interaction, so the gait variables are linearly amplified or diminished by the two factors. Application: Walking in high heels at fast speed should be careful for musculoskeletal disorders, since the amplified movement of knee and spine joint can lead to increased moment. Also, the result might give insight for animators or engineers to generate walking motion with high heels at various speeds.

• Journal of International Academy of Physical Therapy Research
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• v.2 no.2
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• pp.324-328
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• 2011

The purpose of this study is to measure the effect of change in heel height on lower extremities activity of young women on high-heeled shoes that young women prefer from more kinetic and realistic perspective as this study changes the degree of slope on a treadmill. The study subjects are 15 young and healthy women who do not have any external injuries or problem with walking and understand the purpose of this study clearly. They wore three different height of heels(1cm, 7cm, 12cm) and walked on a treadmill at a constant speed of 3km/h. EMG value of four muscles (anterior tibial muscle, gastrocnemius muscle, straight muscle of thigh, and biceps muscle of thigh) were collected when walking and the change according to the height of heels were analyzed using one-way ANOVA. Multiple comparison analysis on anterior tibial muscle and heel height showed that the group with 12cm heel showed significantly high muscle activation compared to the groups with 1cm and 7cm heels. The result of this study can be used for various perspectives from inferring and mediating problems caused by wearing high heels on different ground slopes for a long time.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.379-385
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• 2013

Purpose: The purpose of this study is to compare kinematics on lower limbs between stair walking with high heel and barefoot in healthy adult women. Methods: 18 healthy adult women were recruited in this study. The subjects performed stair ascent and descent with high heels and barefoot. The experiment was conducted in random order and repeated three times for each stair walking with high heels and barefoot. The movements of lower limb joints were measured and analyzed using a three-dimensional analysis system. Results: The ankle, knee, and hip flexion angles on the sagittal plane exhibited statistically significant differences between stair ascent and descent with high heels and barefoot. The pelvic forward tilt angles showed statistically significant differences only during stair ascent. The ankle inversion, hip abduction and pelvic lateral tilt angles on the frontal plane showed statistically significant differences between stair walking with high heels and barefoot. On the transverse plane, the hip rotation angles showed statistically significant differences between the high-heeled and barefoot gait during stair ascent and descent. However, the pelvic rotation angles showed no statistically significant differences. Conclusion: Therefore, wearing high-heeled shoes during stair walking in daily life is considered to influence lower limb kinematics due to the high heel, and thus poses the risks of pain, and low stability and joint damage caused by changes in the movement of lower limb joints.

• International Journal of Contents
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• v.6 no.1
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• pp.41-46
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• 2010

The aim of this study was to investigate the effect of different shoe-heel heights on the surface electromyographic (EMG) activity of vastus medialis (VM) and vastus lateralis (VL) during treadmill walking in female patients with patellofemoral pain (PFP). Nineteen women with PFP participated in this research. EMG signals were recorded from the VM and VL of both sides and were compared during the treadmill walking. The subjects walked on a treadmill wearing shoes of three different heel heights: 1 cm, 3 cm and 7 cm. Each subject walked on a treadmill for five minutes at a speed of 2 km/hour with three minutes resting intervals between consecutive trials. The data were analyzed by one-way repeated-measures analysis of variance. The results of the present study indicate that EMG data of the VM and VL of female patients with PFP did improve with an increase in the height of the shoe heel, which were statistically significant. Additionally, the EMG activity of VM increased more dramatically than that of VL associated with the task of walking with high-heeled shoes on the treadmill. This study suggests that the type of high-heeled shoes is related to the VM and VL muscle activation patterns contributing to knee joint pathologies in female patients with PFP.

• Physical Therapy Korea
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• v.15 no.4
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• pp.1-9
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• 2008

The purpose of this study was to assess the peak plantar pressure distribution under foot areas according to the height of heel lifts in obese adults and non-obese adults during walking. Thirty-one participants volunteered for this experiment. The average body mass index (BMI) value of the fourteen subjects in the obese group was $26.5{\pm}1.4kg/m^2$ (from 25.1 to 29.3 $kg/m^2$), and of seventeen subjects in the non-obese group was $20.0{\pm}1.1kg/m^2$ (from 18.7 to 22.7 $kg/m^2$). The subject ambulated while walking in the sneakers, walking with 2 cm heel lifts, and walking with 4 cm heel lifts in the shoes. We measured the peak plantar pressure under the hallux, 1st, 2nd, 3~4th, and 5th metatarsal head (MTH), mi foot, and heel using F-scan system. The obese group had significantly higher peak plantar pressure under all foot areas than the non-obese group regardless of the height of heel lifts (p<.05). The peak plantar pressure under the 5th MTH and heel was significantly decreased, also the peak plantar pressure under hallux, 1st, and 2nd MTH was significantly increased according to the height of heel lifts in the obese group and non-obese group (p<.05), We proposed that individuals with heel lifts in shoes should be careful, as there is high plantar pressure under the forefoot.

• Korean Journal of Applied Biomechanics
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• v.26 no.1
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• pp.135-142
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• 2016

Objective: The purpose of this study was to investigate the acute effect of walking on high heels on the behavior of fascicle length and activation of the lower limb muscles. Methods: Twelve healthy inexperienced high heel wearers (age: $23.1{\pm}2.0yr$, height: $162.4{\pm}4.9cm$, weight: $54.4{\pm}8.5kg$) participated in this study. They walked in high heels (7 cm) and barefoot on a treadmill at their preferred speed. During the gait analysis, the lower limb joint kinematics were obtained using a motion analysis system. In addition, the changes in fascicle length and the level of activation of the medial gastrocnemius (MG) were simultaneously monitored using a real-time ultrasound imaging technique and surface electromyography, respectively. Results: The results of this study show that the MG fascicle operates at a significantly shorter length in high heel walking ($37.64{\pm}8.59mm$ to $43.99{\pm}8.66mm$) in comparison with barefoot walking ($48.26{\pm}9.02mm$ to $53.99{\pm}8.54mm$) (p < .05). In addition, the MG fascicle underwent lengthening during high heel walking with relatively low muscle activation while it remained isometric during barefoot walking with relatively high muscle activation. Conclusion: Wearing high heels alters the operating range of the MG fascicle length and the pattern of muscle activation, suggesting that prolonged wearing of high heels might induce structural alterations of the MG that, in turn, hinder normal functioning of the MG muscle during walking.

• Journal of Biomedical Engineering Research
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• v.31 no.2
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• pp.106-113
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• 2010

The aim of this study was to evaluate effects of the balance ability on the heel height (flat, low heel[3cm], and high heel[7cm]) and high heeled habituation (group A is used to a low heeled shoes (<7cm) and group B is used to a high heeled shoes (${\geq}7cm$). Thirty-five subjects participated in this study. In this study, the static balance with opened eyes and closed eyes and dynamic balance were measured. Also functional reach test was tested. The results found that the static balance ability was the best in a 7cm heeled shoes with open eyes and closed eyes, but there was not significant difference between group A and Group B. Dynamic balance ability with walking velocity and cadence were significant difference between Group A and B. In the walking velocity, a flat was the fastest, followed by 7cm heel and 3cm heel with Group A while 3cm and 7cm, then a flat with Group B. Also Cadence pattern was similar. Functional balance ability was the highest with a flat, but it was not difference significantly between Group A and B. Therefore, this study demonstrated that the habituation to the high heel altered gait velocity and cadence of dynamic balance ability.

• Journal of the Ergonomics Society of Korea
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• v.32 no.3
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• pp.245-252
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• 2013

Objective: This paper analyzes the changes on stride parameters, joint angles, and trajectories of the body parts due to high heels during walking and explains the causal relationship between the changes and high heels. Background: This study aims to indicate the comprehensive gait changes by high heels on the whole body for women wearing high heels and researchers interested in high-heeled walking. Method: The experiment was designed in which two different shoe heel heights were used for walking (1cm, 9.8cm), and twelve women participated in the test. In the experiment, 35 points on the body were tracked to extract the stride parameters, joint angles, and trajectories of the body parts. Results: Double support time increased, but stride length decreased in high-heeled walking. The knee inflexed more at stance phase and the spine rotation became more severe. The trajectories of the pelvis, the trunk and the head presented outstanding fluctuations in the vertical direction. Conclusion: The double support time and the spine rotation were changed to compensate instability by high heels. Reduced range of motion of the ankle joint influenced on the stride length, the knee flexion, and fluctuations of the body parts. Application: This study can provide an insight of the gait changes by high heels through the entire body.