The effects of high heeled shoes walking in on energy expenditure and oxygen consumption in healthy young female

Background: Walking in high-heeled shoes is widespread dress behavior of women of modern society. It increases lower limb muscles activity and energy cost. The need to generate larger muscular forces during walking increases the metabolic demand, thus oxygen consumption (VO2) is increased when wearing high heels. Aims and Objectives: To access effect of high-heeled shoes on Energy Expenditure (EE) and VO2 in Healthy Young female. Materials and Methods: This cross-sectional study was conducted among fifty apparently healthy female students between the ages of 20 and 26 yrs. Resting arterial blood pressure and heart rate (HR), VO2, heat production, and EE were recorded. Then, subjects walked barefooted a distance of 76.5 meters in 2 min. Following the barefooted walk, cardiac and metabolic parameter were recorded again. The subjects walked 76.5 meters in high-heeled shoes of 2, 4, and 6 inches. These parameters were recorded immediately after 76.5 meters of walking in high-heeled shoes. Results: The results from the present study indicate that walking a distance of 76.5 meters barefooted resulted in a significant increase only in mean arterial pressure, HR and rate pressure product. The EE and VO2 after walking a distance of 76.5 meters in high-heeled shoes of 2, 4, and 6 inches heel heights was significantly higher than walking a distance of 76.5 meters barefooted. Conclusion: Walking barefooted required lesser effort than walking in high-heeled shoes of different heel heights. Effort should therefore be made to encourage women to reconsider the habitual use of high-heeled shoes.

Finite element analysis on relationship between wearing high-heeled shoes and stresses in intermetatarsal region of foot / 医用生物力学

Objective To study stress changes in forefoot intermetatarsal region when wearing high-heeled shoes, so as to provide references for quantitative analysis on inducement mechanism of intermetatarsal neuroma and corresponding treatment strategy. Methods Based on the validated foot-ankle-shoe finite element platform, changes of stress levels and tendency in intermetatarsal region were analyzed for both in balanced standing when wearing 0-3 inch (0, 2.54, 5.08, 7.62 cm) high-heeled shoes and walking when wearing 5.08 cm high-heeled shoes in a gait cycle. Results With the increase of heel height, the stresses in intermetatarsal region were significantly increased, and the stress in the third web space of toes when wearing 7.62 cm high-heeled shoes reached 312% of that when wearing flat shoes (0 cm high-heeled shoes). When walking with 5.08 cm high-heeled shoes, the third web space of toes at push-off instance had the largest stress, reaching 90 kPa, which agreed with the most commonly pathogenic site of intermetatarsal neuroma in clinic. Conclusions Wearing high-heeled shoes can obviously increase the stress in intermetatarsal region. Squeezing by upper extrusion of shoes can result in the largest stresses in the third web space of toes region, which is most likely to cause the development of intermetatarsal neuroma.

The influence of heel height on gait of young females during stair descent / 医用生物力学

Objective To investigate the effects of heel heights on gait of young women when going downstairs, and analyze the injury risk of women wearing high-heeled shoes during stair descent. Methods The gait from 17 young women wearing shoes with 4 different heel heights during their stair descent was measured by infrared high-speed motion capture system. The subjects’temporal parameters of gait and 3D joint angles of lower extremity were calculated and analyzed. Results Compared with flat shoes, the gait cycle increased when wearing 3 cm, 5 cm, 7 cm high-heeled shoes during stair descent, and the stance phase proportion and double-support stance phase proportion decreased, while the step width also decreased evidently. For 5 cm, 7 cm high-heeled shoes, the ankle range of motion (ROM) in the sagittal plane would reduce significantly, and for all the 3 cm, 5 cm, 7 cm high-heeled shoes, the ankle ROM in transverse plane would increase during stair descent. Wearing 3 cm, 5 cm high-heeled shoes could make the knee ROM in the sagittal plane significantly reduce, while wearing 3 cm, 5 cm, 7 cm high-heeled shoes, the knee ROM in the transverse plane would increase evidently. Wearing 5 cm, 7 cm high-heeled shoes, the maximum hip flexion angle was greater than that of wearing flat shoes, and the minimum hip flexion angle would be also greater when wearing 3 cm, 5 cm, 7 cm high-heeled shoes. Conclusions During stair descent, with the increase of heel heights, the gait cycle and swing phase proportion increase, while the stance phase proportion, double-support stance phase proportion and step width decrease, which will raise the risk of falling. Meanwhile, the knee and ankle ROMs in sagittal plane decrease gradually, while those in transverse plane come to increase. The research findings can help to further understand the influence of heel heights on gait characteristics and patterns during stair descent and provide reference for possible injury risk analysis.

The Path of Center of Pressure(COP) of the Foot during Walking

Variations in the distribution and the magnitude of the forces in the foot may reflect painful conditions and abnormalities of structure or function. By tracking the path of the instantaneous COP(center of pressure) during stance phase, the balance and pattern of progression can be determined, but parameters on COP have not been standardized nor widely applied to clinical settings yet. To quantify the COP parameters and to evaluate the clinical applicability of COP, within subject experimental design was used. Twenty six subjects with age of sixties who had no history of foot problems were recruited. Foot contact and COP parameters were measured and compared between flat foot, low heel and high heel shod walking. 1) Gait cycle parameters, 2) foot contact parameters such as total contact area, contact length, contact width, and 3) COP parameters such as initial contact COP, mean COP, anteroposterior and mediolateral displacement of COP, slope of COP, velocity of COP during each functional rocker were measured with F-scan pressure sensitive insole system. In normal flat foot walking, COP of initial contact and mean COP were anatomically correspond to the center of the heel and to the center of the sole respectively. COP displacements corresponded to 83% of foot contact length anteroposteriorly and 18% of forefoot contact width mediolaterally. Slope of COP was about 6 degrees inwardly directed. Velocities of the COP during each functional rocker action were even and about 22-27 cm/sec around. In high heel shod walking, COP of initial contact was displaced 1.73 cm anteriorly and mean COP was displaced 0.31 cm medially and 1.89 cm anteriorly. Anteroposterior displacement of COP was also reduced. Velocity of the COP during heel rocker was faster and velocity during ankle rocker was slower compared to flat foot walking, which suggests excessive heel rocker and reduced ankle rocker action in high heel shod walking. In conclusion, COP parameters measured by pressure sensitive insole system may reflect the biomechanical alteration of the foot quantitatively and may be useful in assessing the biomechanical function of the foot.

Comparison of Gait Analysis Using High-heeled Shoes and High-forefoot Shoes

Previous studies proved that, the high-heeled shoes caused postural changes, a loss of foot function, and deformities of foot. However the lumbar lordosis in gait is rarely measured. The purposes of this study were to compare kinematics and kinetics between high-heeled and high-forefoot gait by skin markers, and to find the influence of heel height to lumbar vertebral alignment. We used the Vicon 370 three-dimension Gait Analysis System. In the present study, the lower extremity biomechanics in high-heeled and high-forefoot shoes were examined in 20 Korean female subjects. Results showed that the double support phase increased in high-forefoot gait in linear parameters. In sagittal plane kinematics, the lumbar lordosis slightly increased in high-forefoot gait, but that did not increase in high-heeled gait. The knee flexion and ankle plantarflexion increased in high-heeled gait, but ankle pantar flexion reduced in high-forefoot gait. Clinically the change of ankle motion was not significantly influenced to the lumbar lordosis. However, high-heeled shoe users with low back pain are probably influenced by the overstress of paraspinal muscles and vertebral ligments. Further studies are required for more precise analysis of high-heeled and high-forefoot gaits.