High heeled shoes: their effect on center of mass position, posture, three-dimensional kinematics, rearfoot motion, and ground reaction forces.

This study investigated changes in center of mass position, forefoot loading, lumbar curvature, and pelvic tilt during standing and ground reaction forces, rearfoot motion, sagittal lower extremity kinematics, and shoulder and pelvic rotations of women walking at 1.4 m.s-1 in different heights of high heeled shoes. Three different heel heights (1.91, 3.81, 7.62cm) were worn by each of 11 women. Vertical forces applied to the forefoot during standing increased with increased heel height. No significant differences in average lumbar curvature or pelvic tilt among shoe heights were found. Significant increases in vertical and anteroposterior forces during walking were found with increased heel height, and foot abduction angle during support showed significant less abduction with higher heels. With an increase in heel height the minimum vertical force (at midstance) and the maximum vertical force during the second half of support both occurred later in the support phase, whereas the maximum and minimum anteroposterior forces occurred earlier in support. Rearfoot angle measures obtained from high-speed video analysis showed a significantly greater angle of supination at footstrike and a smaller angle of maximum pronation in the high compared with the low heeled shoes. Ankle angles throughout the gait cycle showed a significant increase in plantarflexion with increased heel height. Maximum knee angle during swing and knee extension velocity decreased with increased heel height. Other sagittal plane kinematic measures and measures to hip and shoulder rotation derived from three-dimensional (3-D) cine data showed few consistent effects of heel height.(ABSTRACT TRUNCATED AT 250 WORDS)