KINEMATIC AND KINETIC ADAPTATIONS IN THE LOWER EXTREMITIES OF EXPERIENCED WEARERS DURING HIGH-HEELED GAIT

Abstract

High-heeled shoes are associated with falling, leading to injuries such as fracture and ankle sprain. The study aimed to investigate the kinematic and kinetic adaptations in the lower extremities resulting from habitual use of high-heeled shoes. A total of 15 female experienced wearers and 15 matched controls walked with high-heeled shoes (7.3 cm) while kinematic and ground reaction force data were measured and used to calculate the joint angles and moments, as well as the temporal-distance parameters. Compared with inexperienced wearers, experienced wearers appeared to adopt a specific control strategy to improve the stability of the support ankle and knee while preventing excessive loading at the knee and hip. Increased hip abduction during early stance phase and increased pelvis rotation toward the ipsilateral side at contralateral heel-strike appeared to contribute toward the reduced step width for a better adjustment of the medio-lateral motion of the body's center of mass in order to maintain stability. At the hip, increased abductor moments may help to increase the pelvis stability and prevent excessive loading at the knee, and reduced internal rotator moments may reduce the torsional loading at the hip. At the knee, reduced ranges of flexion-extension and adduction-abduction motions may increase its stability. At the ankle, increased external rotation angles, together with increased pronator and external rotator moments through increased ground reaction force, may enhance the ankle stability. The current results identified the changes in the kinematics and kinetics of the lower extremities in females after long-term use of high-heeled shoes, providing a basis for future development of training programs and design of new high-heeled shoes to help those who have higher risks of falling and injuries during high-heeled gait.