• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.155-161
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• 2024

Purpose : Wearing high-heeled shoes leads to foot and ankle instability, which requires leg muscles to remain in constant contraction. In order to adapt to the instability of the feet and ankles caused by wearing high heels, the muscles of the legs continuously repeat contraction and relaxation. Previous studies of the impact of stair climbing in high-heeled shoes have involved placing the entire stepping area of the shoe on the stair. However, high-heeled shoe wearers sometimes unconsciously contact the stair using only half of the stepping area. Therefore, the objective of this study was to examine differences in leg and ankle muscle activation according to stepping area during stair climbing in high-heeled shoes. Methods : Twenty young women in their early 20s voluntarily agreed to participate in this study. We used surface electromyography to measure gastrocnemius and tibialis anterior activation in the right leg during stair climbing under three conditions: barefoot, using half of high-heeled shoe stepping area, and using the total of high-heeled shoe stepping area. Barefoot, half of high heeled shoe, and total of high-heeled shoe were used to evaluate the effects of different areas of the foot or high heels touching the stairs. Results : Both muscles showed significant activity differences among the three stair climbing conditions. Gastrocnemius activity was significantly different between the high-heeled shoe conditions (p= .032), and tibialis anterior activity was significantly different between barefoot stair climbing and climbing with half of the high-heeled shoe stepping area (p= .021). Conclusion : The stepping area increased as heel size increased, thus increasing excessive gastrocnemius and tibialis anterior activity to control excessive ankle joint movement. We infer that using half of the high-heeled shoe stepping area prevents muscle fatigue by reducing excessive leg and ankle muscle activation.

• Korean Journal of Applied Biomechanics
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• v.20 no.4
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• pp.479-486
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• 2010

The purpose of this study was to determine the effects of high-heeled shoe on the quiet standing and gait balance. Twenty women (mean height: $161.6{\pm}3.3\;cm$, mean body mass: $53.8{\pm}6.3\;kg$, mean age: $23.8{\pm}2.7$ yrs..) who were without history or complain of lower limb pain took part in this study. They were asked to stand quietly on a force platform for 30 sec and walk on it at their preferred walking speed (mean speed $3.14{\pm}0.5\;km/hr$.) with wearing three different high-heeled shoe, 3, 7, 9 cm high for collecting data. Data were randomly recorded to collect two trials for quiet standing and five trials for walking The parameters to have been analyzed for comparison between three conditions of the height of high-heeled shoe were COP(Center of Pressure) range, COP velocity, sway area, and free moment on the static balance and COP range, COP velocity, and free moment on the dynamic balance. In this study, high-heel height affected on the COP range and velocity in the ante-posterior direction during walking, dynamic balance, but didn't affect on the quiet standing, static balance.

• Physical Therapy Korea
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• v.4 no.2
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• pp.10-17
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• 1997

The purpose of this study were to compare light touch, two-point discrimination, position sense, and static balance ability and to examine the relationship of static balance ability and different senses in those who are wearing various heights of high-heeled shoes. Each 29 women was classified two different heights (below 3 cm, above 7 cm) by experience in wearing shoes. A t-test was used to determine the differences between low- and high-heeled shoe in light touch, two-point discrimination, position sense, and static balance ability. Pearson correlation was used to examine the relationship of static balance ability to these sensation. The results were as follows: 1) No significant differences in average light touch, position sense between two groups were found(p>0.05). But significant differences in average two-point discrimination, static balance ability were found(p<0.05). 2) Static balance ability was not significantly correlated with light touch, position sense, two-point discrimination(p>0.05). The results suggest that long time experience in wearing high-heeled shoe may be caused local sensory change and decreased static balance ability. Even though, static balance ability was not significantly affected but correlated with two-point discrimination, position sense, and light touch in order.

• Physical Therapy Korea
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• v.15 no.1
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• pp.38-45
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• 2008

This study investigated gait characteristics, kinematics, and kinetics in the lower extremities between two different shoe conditions (high heeled shoes (7 cm), and high heeled shoes with a total contact insert (TCI)) after lower extremity muscle fatigue. Although TCI shave been applied in high heeled shoes to increase comfort and to decrease foot pressure, no study has attempted to identify the effects of TCI in fatigue conditions. The purpose of this study was to determine the effects of walking in high heeled shoes with TCI after lower extremity muscle fatigue was induced. This study was carried out in a motion analysis laboratory at Hanseo University. A volunteer sample of 14 healthy female subjects participated. All in fatigue conditions, the subjects were divided into two groups. The muscle fatigue was induced by 40 voluntary dorsi- and plantar-flexion exercises and 40 heel-rise exercises of the dominant foot. Surface electromyography was used to confirm the localized muscle fatigue using power spectral analysis of three muscles (tibialis anterior, gastrocnemius medialis and lateralis). The results were as follows: (1) In muscle fatigue conditions, the use of TCI decreased the peak flexion angle of the hip joint significantly in the early stance phase (p<.05) and increased the peak hip flexion moment in the terminal stance phase (p<.05). (2) In muscle fatigue conditions, the application of TCI also increased peak hip power generation in the early stance phase and peak hip power absorption in the terminal stance phase (p<.05). (3) In muscle fatigue conditions, the use of TCI reduced the impact force significantly and increased the secondary peak vertical GRF. These findings suggest that the TCI may provide beneficial effects when muscle fatigue occurs for a high heeled shoe gait. Future research employing the patient population and various types of TCI materials are required to clarify the effects of TCI.

• The Korean Journal of Community Living Science
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• v.22 no.3
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• pp.365-377
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• 2011

The dual purposes of this study were to investigate footwear worn by college students who have become spoilt for choice in apparel & shoes, and point out the problems of their shoe-wearing habbits. The survey was administered in October, 2010 to 600 college residents in Kwangju-Jeonnam area and the results are as follows. Firstly, the most frequently worn footware by males were sneakers, followed by dress shoes and oxford shoes. Females followed a similar trend with sneakers being the most frequently worn, followed by high heeled shoes, flat shoes, wedge high heeled shoes and chucker boots. Secondly, both male and female students thought that the most comfortable and favorable shoes for them were sneakers and the most uncomfortable ones were high-heeled shoes and sandals. They thought chucker boots were both fashionable and comfortable. Thirdly, the degree of unsatisfaction for shoes was relatively high and the influencing factors for unsatisfaction were uncomfortable soles, aches around the toes and a frontward leaning posture of the body, etc. Finally, 87% of the female subjects who had experience wearing high-heeled(over 7cm height) shoes showed a significant increase in foot disorders than those who had never worn high-heeled shoes. According to the results, it is necessary to educate proper selection and wearing of footwear in order to prevent foot disorders and maintain overall health of the body.

• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.112-124
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• 2004

Purpose : The purpose of this study is to research the effects of the differences in shoe heel height on balanced performances with a balance master. Method : 40 healthy female adults were divided into 2 groups at random. All the female participants were tested by a balance master system. Differences were analyzed according to high heel shoes and low heel shoes. The ability of static postural balance control was measured by modified CTSIB and unilateral stance test, while that of dynamic postural balance control was measured by LOS (limit of stability) and rhythmic weight shift, among the programs of a balance master. Result : 1. There is no significant correlation between the ability of static and dynamic postural balance control before main test without the shoes. 2. Movement velocity and directional control ability were significant correlation compared result of in high heel shoes and low heel shoes group. Conclusion : In conclusion, the test results of the high heeled shoe group and the low heeled shoe group through a balance master system showed that the former one is inferior to the latter one.

• Fashion & Textile Research Journal
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• v.10 no.2
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• pp.128-137
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• 2008

The purpose of this study is to investigate the characteristic analysis and to date guidance of European high heeled shoes in 18th century. The research was conducted by stylistic analysis of high heeled shoes from literature review and museums resource. 14 comparative study on shoe objects dating from 1600-1790 in the Museum at F.I.T., New York, Museum of Art, Boston and Metropolitan Museum of Art, New York were selected. The result of this study are as follows: (1) The origin and development of high heeled shoes were accomplished by protection, social status and exaggeration of body, decoration and fashion. (2) According to the comparative study of Museum objects and literature, characteristic analysis of high heeled shoes from 1700-20s, 1730-40s, 1750-60s, 1770-89 and 1890-1900 were accomplished. (3) Significant elements of European women's shoes from 18th century that aid dating are identified as the presence of white rand, shape of tongue, heel shape and height, latchat, toe shape, color and materials.

• The Journal of Korean Physical Therapy
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• v.23 no.3
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• pp.49-56
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• 2011

Purpose: To evaluate changes in lower extremity muscle activity caused by high heeled shoe wearing during normal, brisk, and upslope walking. Methods: Twenty healthy young women (age, $23.9{\pm}2.47$) participated in this study. Muscle activities of the tibialis anterior, peroneus longus, gastrocnemius lateralis, gastrocnemius medialis, soleus, hamstring, vastus lateralis, and vastus medialis while walking normally, walking briskly, and walking up a slope. Results: When walking normally, the peroneus longus, gastrocnemius lateralis, soleus, and vastus lateralis evidenced higher activity when high-heeled shoes were worn (p<0.05). During brisk walking, the peroneus longus and gastrocnemius lateralis exhibited higher activity (p<0.05). Although the peroneus longus and vastus lateralis exhibited higher activity when walking up an incline with high-heeled shoes, the activity levels of the tibialis anterior and gastrocnemius medialis were lower (p<0.05). Conclusion: The results of this study demonstrate that increased heel height substantially reduces muscle effort when walking up a slope. From a therapeutic perspective, it is possible that using high heeled shoes over a short period might enhance muscle activity of ankle evertor, although it can cause mediolateral muscle imbalances in the lower extremities.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.85-91
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• 2017

PURPOSE: The purpose of this study was to compare muscle activation of the trunk and lower limbs of subjects wearing high-heeled or flat shoes while crossing over obstacles of different heights. METHODS: Twenty subjects participated in this study. While wearing high-heeled shoes (7 cm) or flat shoes (0 cm), the subjects were asked to cross over obstacles of different heights (10%, 20%, and 30% of their lower-limb length). Muscle activation of the trunk and lower limbs with the supported side while crossing over obstacles of different heights was measured using the electromyogram (Noraxon, DTS, Germany). Two-way repeated ANOVA was used to compare the muscle activation between high-heel shoes and flat shoes while crossing over obstacles of different heights. All statistical analyses were performed using SPSS ver. 21, and p-values less than .05 were used to identify significant differences. RESULTS: As an obstacle's height increased, muscle activation of the trunk and lower limbs with the supported side was increased while wearing either type of shoe, and it was generally higher while wearing high-heeled shoes. However, tibialis anterior muscle activity while wearing high-heeled shoes was lower than while wearing flat shoes. CONCLUSION: This study showed that muscle activation of the trunk and lower limbs was higher when subjects wore high-heeled shoes than when they wore flat shoes while crossing over obstacles of different heights. Therefore, high-heeled shoes can easily cause high muscle fatigue of the trunk and lower limbs, and the TA muscle may weaken in persons who wear high-heeled shoes.

• 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.