Changes in lower limb muscle synchronisation during walking on high‐heeled shoes

Pratihast, Manisha; Al-Ani, Ahmed; Chai, Rifai; Su, Steven W.; Naik, Ganesh R.

doi:10.1049/htl.2018.5032

Cited by 4 publications

(2 citation statements)

References 26 publications

(47 reference statements)

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“…A number of studies have shown that walking in HHS may affect neuromechanics and kinematics of the lower limbs when HH increased to 4 cm HH (Naik et al, 2017). When walking in 4 and 10 cm HHS compared with flat shoes, the postural stability may be decreased on the account of high joint stiffness evaluated by muscle pair synchronization around the knee joint (Pratihast et al, 2018). Accordingly, the TUGT completion time was longer for impaired postural stability and reduced perceived stability, consistent with previous findings (Arnadottir & Mercer, 2000).…”

Section: Discussionsupporting

confidence: 84%

Peer Review #1 of "Influences of heel height on human postural stability and functional mobility between inexperienced and experienced high heel shoe wearers (v0.1)"

2020

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Background. High heel shoes (HHS) can affect human postural control because elevated heel height (HH) may result in plantar flexed foot and limit ankle joint range of motion during walking. Effects of HH and HHS wearing experience on postural stability during selfinitiated and externally triggered perturbations are less examined in the literature. Hence, the objective of the present study is to investigate the influences of HH on human postural stability during dynamic perturbations, perceived stability, and functional mobility between inexperienced and experienced HHS wearers. Methods. A total of 41 female participants were recruited (21 inexperienced HHS wearers and 20 experienced HHS wearers). Sensory organization test (SOT), motor control test (MCT), and limits of stability (LOS) were conducted to measure participant's postural stability by using computerized dynamic posturography. Functional reach test and timed up and go test were performed to measure functional mobility. The participants' self-perceived stability was assessed by visual analog scale. Four pairs of shoes with different HH (i.e., 0.8, 3.9, 7.0, and 10.1 cm) were applied to participants randomly. Repeated measures analysis of variance was conducted to detect the effects of HH and HHS wearing experience on each variable. Results. During selfinitiated perturbations, equilibrium score remarkably decreased when wearing 10.1 cm compared with flat shoes and 3.9 cm HHS. The contribution of vision to postural stability was larger in 10.1 cm HHS than in flat shoes. The use of ankle strategy worsened when HH increased to 7 cm. Similarly, the directional control of the center of gravity (COG) decreased for 7 cm HHS in LOS. Experienced wearers showed significantly higher percentage of ankle strategy and COG directional control than novices. Under externally triggered perturbations, postural stability was substantially decreased when HH reached 3.9 cm in MCT. No significant difference was found in experienced wearers compared with novices in MCT. Experienced wearers exhibited considerably better functional mobility and perceived stability with increased HH. Conclusions. The use of HHS may worsen dynamic

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Section: Discussionsupporting

confidence: 84%

Peer Review #1 of "Influences of heel height on human postural stability and functional mobility between inexperienced and experienced high heel shoe wearers (v0.1)"

2020

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“…A number of studies have shown that walking in HHS may affect neuromechanics and kinematics of the lower limbs when HH increased to four cm HH ( Naik et al, 2017 ). When walking in 4 and 10 cm HHS compared with flat shoes, the postural stability may be decreased on the account of high joint stiffness evaluated by muscle pair synchronization around the knee joint ( Pratihast et al, 2018 ). Accordingly, the TUGT completion time was longer for impaired postural stability and reduced perceived stability, consistent with previous findings ( Arnadottir & Mercer, 2000 ).…”

Section: Discussionmentioning

confidence: 99%

Influences of heel height on human postural stability and functional mobility between inexperienced and experienced high heel shoe wearers

Chen

Wang

2020

PeerJ

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Background High heel shoes (HHS) can affect human postural control because elevated heel height (HH) may result in plantar flexed foot and limit ankle joint range of motion during walking. Effects of HH and HHS wearing experience on postural stability during self-initiated and externally triggered perturbations are less examined in the literature. Hence, the objective of the present study is to investigate the influences of HH on human postural stability during dynamic perturbations, perceived stability, and functional mobility between inexperienced and experienced HHS wearers. Methods A total of 41 female participants were recruited (21 inexperienced HHS wearers and 20 experienced HHS wearers). Sensory organization test (SOT), motor control test (MCT), and limits of stability (LOS) were conducted to measure participant’s postural stability by using computerized dynamic posturography. Functional reach test and timed up and go test were performed to measure functional mobility. The participants’ self-perceived stability was assessed by visual analog scale. Four pairs of shoes with different HH (i.e., 0.8, 3.9, 7.0, and 10.1 cm) were applied to participants randomly. Repeated measures analysis of variance was conducted to detect the effects of HH and HHS wearing experience on each variable. Results During self-initiated perturbations, equilibrium score remarkably decreased when wearing 10.1 cm compared with flat shoes and 3.9 cm HHS. The contribution of vision to postural stability was larger in 10.1 cm HHS than in flat shoes. The use of ankle strategy worsened when HH increased to 7 cm. Similarly, the directional control of the center of gravity (COG) decreased for 7 cm HHS in LOS. Experienced wearers showed significantly higher percentage of ankle strategy and COG directional control than novices. Under externally triggered perturbations, postural stability was substantially decreased when HH reached 3.9 cm in MCT. No significant difference was found in experienced wearers compared with novices in MCT. Experienced wearers exhibited considerably better functional mobility and perceived stability with increased HH. Conclusions The use of HHS may worsen dynamic postural control and functional mobility when HH increases to 3.9 cm. Although experienced HHS wearers exhibit higher proportion of ankle strategy and COG directional control, the experience may not influence overall human postural control. Sensory organization ability, ankle strategy and COG directional control might provide useful information in developing a safety system and prevent HHS wearers from falling.

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Effects of high-heeled shoes on lower extremity biomechanics and balance in females: a systematic review and meta-analysis

Zeng

Liu

et al. 2023

BMC Public Health

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Background High-heeled shoes (HHS) are widely worn by women in daily life. Limited quantitative studies have been conducted to investigate the biomechanical performance between wearing HHS and wearing flat shoes or barefoot. This study aimed to compare spatiotemporal parameters, kinematics, kinetics and muscle function during walking and balance between wearing HHS and flat shoes or barefoot. Methods According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, PubMed Medline, Cochrane, EMBASE, CINAHL Complete and Web of Science databases were searched from the earliest record to December 2021. A modified quality index was applied to evaluate the risk of bias, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences (SMD). Potential publication bias was evaluated graphically using funnel plot and the robustness of the overall results was assessed using sensitivity analyses. Results Eighty-one studies (n = 1501 participants) were included in this study. The reduced area of support requires the body to establish a safer and more stable gait pattern by changing gait characteristics when walking in HHS compared with walking in flats shoes or barefoot. Walking in HHS has a slight effect on hip kinematics, with biomechanical changes and adaptations concentrated in the knee and foot–ankle complex. Females wearing HHS performed greater ground reaction forces earlier, accompanied by an anterior shift in plantar pressure compared with those wearing flat shoes/barefoot. Furthermore, large effect sizes indicate that wearing HHS resulted in poor static and dynamic balance. Conclusion Spatiotemporal, kinematic, kinetic and balance variables are affected by wearing HHS. The effect of specific heel heights on women’s biomechanics would benefit from further research.

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Changes in lower limb muscle synchronisation during walking on high‐heeled shoes

Cited by 4 publications

References 26 publications

Peer Review #1 of "Influences of heel height on human postural stability and functional mobility between inexperienced and experienced high heel shoe wearers (v0.1)"

Peer Review #1 of "Influences of heel height on human postural stability and functional mobility between inexperienced and experienced high heel shoe wearers (v0.1)"

Influences of heel height on human postural stability and functional mobility between inexperienced and experienced high heel shoe wearers

Effects of high-heeled shoes on lower extremity biomechanics and balance in females: a systematic review and meta-analysis

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