• Physical Therapy Korea
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• v.14 no.3
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• pp.23-31
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• 2007

The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 $kg/m^2$) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.

• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.2
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• pp.39-46
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• 2015

Background: The purpose of this study was to investigate the influence of short-term treadmill walking with high-heeled shoes on electromyography activities of the medial gastrocnemius, lateral gastrocnemius and tibialis anterior in healthy young females. Methods: Fifteen healthy females were recruited for this study. To measure muscle activation, the subjects were asked in random order to walk on a treadmill using either high-heeled shoes or barefoot conditions. The shoe heel height for high-heeled walking was 7 cm. The walking speed on the treadmill was 4 km/h, and the inclination rate of the treadmill was 10%. The subjects performed treadmill walking in the barefoot and high-heeled walking conditions for 5 minutes. Electromyography data were collected from the tibialis anterior, medial gastrocnemius, lateral gastrocnemius, and soleus on both firm and foam surfaces and during eyes-open and-closed conditions while standing. Results: Tibialis anterior activity was significantly different before and after the walking task while standing on a foam surface with eyes closed (p<.05). Conclusion: This finding suggests that the activity of the tibialis anterior may be lowered after high-heeled walking. Therefore, high-heeled shoes contribute to harmful effects at the ankle joints, increasing the risks of falling and musculoskeletal injury.

• 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.

• 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.

• 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.

• 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 Convergence for Information Technology
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• v.7 no.5
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• pp.31-38
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• 2017

The purpose of this study was to investigate the effect of training using unstable plate on displacement and dynamic balance ability of ankle joints in women college students wearing high heel shoes. Subjects were randomly divided into experimental group and control group. 3D motion analysis was performed while walking 9cm high-heeled shoes and walking 5m. Dynamic balanced ability evaluation was performed. The intervention program was administered to experimental subjects three times a week for four weeks. They performed balance training using unstable plates. There was no intervention in the control group. The results showed that the displacement of the ankle joints in the experimental group after the intervention was decreased overall and the dynamic balance ability was significantly increased. The control group showed little change. As a result, the training using unstable plate stabilizes the ankle joints and improves the dynamic balance ability of the subjects wearing 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.

• Physical Therapy Korea
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• v.18 no.2
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• pp.1-8
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• 2011

The purpose of this study was to investigate the effect of high heeled shoes with the total contact insert (TCI) on the frontal plane of the joints for the lower extremity during the gait. Ten healthy females voluntarily participated in this study and the height of the high heeled shoes was 7 cm. A three-dimensional motion analysis system (VICON) and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the angle value on the event of the gait cycle in the maximum eversion and inversion of the ankle joint, the varus and valgus of the knee joint, and the adduction and abduction of the hip joint (p>.05). But, there was a significant difference or the range of motion in the ankle joint (p<.05). The value of ankle and knee moment with a TCI was less than the value for no TCI. And there were significant differences for the moment value of the maximum inversion and eversion on the ankle joint and for the maximum varus and valgus on the knee joint (p<.05). Therefore, a TCI would be effective in stabilizing the joints of the lower extremities and increasing the balance of a body to reduce the injure from a fall during the gait.