Influence of heel design in an orthopedic shoe on ground reaction forces during walking.

ABSTRACT

BACKGROUND: One of the treatments prescribed for musculoskeletal patients is orthopedic shoe. The use of an orthopedic shoe is thought to produce a more typical ground reactive force pattern. OBJECTIVES: This study was designed to determine the influence of three heel designs of an orthopedic shoe on the ground reaction forces during walking in healthy subjects. STUDY DESIGN: Quasi-experimental. METHOD: In total, 30 healthy adults (12 males, 18 females) walked at a self-selected pace for six trials in each of the three shoe conditions having three different heels which included the following standard heel, beveled heel, and positive posterior heel flare. For each trial, ground reaction force parameters were recorded using a force plate. RESULTS: Repeated measures analysis of variance indicated that the impact force was significantly reduced for the positive posterior heel flare condition by 8% and 13% compared with standard and beveled heels, respectively (p < 0.001). The first peak of vertical force showed a significant reduction in the beveled heel by 5% and 4% compared with the standard heel and the positive posterior heel flare, respectively (p < 0.001). Loading rate was significantly reduced in the beveled heel and the positive posterior heel flare conditions (p < 0.05). CONCLUSION: Positive posterior heel flare reduced impact force due to its geometry flexibility, while a beveled heel reduced first peak of vertical force. The findings of this study show that the shape of the heel therefore has the potential to modify impact loads during walking. CLINICAL RELEVANCE This study provides new evidence that by changing shape in the heel of orthopedic shoe impact loads are reduced during walking. Thus, these findings indicate that use of heel design may be beneficial for various musculoskeletal disorders, including key public health problems.