• Journal of the Ergonomics Society of Korea
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• v.29 no.5
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• pp.789-795
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• 2010

This study aimed to investigate the effect of differing heel height on static balance and muscle activation of ankle joint during standing. Twenty-one young females volunteered to participate in this study. To measure balance function and EMG activity of tibialis anterior and gastrocnemius muscles, the subjects were asked to perform 1-min standing with eyes open and closed state under 3 different heel heights: barefoot, 3cm, and 7cm each. During the standing, postural sway distance and area, and EMG activity of tibialis anterior and gastrocnemius muscles were significantly augmented with increasing heel height (p<0.05). For comparison between eyes open and closed in terms of postural sway area and EMG activity of tibialis anterior muscle, barefoot and 7cm height conditions respectively showed significant differences as well. The findings indicate that high-heeled shoes may have disadvantages in maintaining balance function because of extra-muscular effort of ankle joint. This study provides useful information that will inform future studies on how heel height affects muscle activity around the ankle joint in aspects of static and dynamic balance.

• Physical Therapy Korea
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• v.21 no.2
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• pp.28-36
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• 2014

The purpose of this study was to evaluate the changes in the electromyographic (EMG) activity of the trunk and the lower limb muscles during quiet standing on an unstable surface while wearing low-heeled shoes (3 cm), high-heeled shoes (7 cm) and without footwear (0 cm) in 20 young healthy women. The subjects stood on an unstable surface for 30 seconds. We examined the differences in the EMG data of the erector spinae, rectus abdominis, biceps femoris, rectus femoris, tibialis anterior, and the gastrocnemius medialis muscle. A one-way repeated analysis of variance was used to compare the effects of shoe heel height on the EMG activity with the level of significance set at ${\alpha}=.05$. The EMG activity of the erector spinae and the rectus femoris were significantly increased (p<.05) in the subjects who wore elevated heel height, while the tibialis anterior and the gastrocnemius medialis were significantly decreased (p<.05). However, the rectus abdominis and the biceps femoris exhibited no significant difference among the three conditions. The above results indicate that wearing high-heeled shoes may change the postural strategy. The findings of this study suggest that excessive heel height could contribute to an increased fall risk during quiet standing.

• International Journal of Contents
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• v.6 no.1
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• pp.41-46
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• 2010

The aim of this study was to investigate the effect of different shoe-heel heights on the surface electromyographic (EMG) activity of vastus medialis (VM) and vastus lateralis (VL) during treadmill walking in female patients with patellofemoral pain (PFP). Nineteen women with PFP participated in this research. EMG signals were recorded from the VM and VL of both sides and were compared during the treadmill walking. The subjects walked on a treadmill wearing shoes of three different heel heights: 1 cm, 3 cm and 7 cm. Each subject walked on a treadmill for five minutes at a speed of 2 km/hour with three minutes resting intervals between consecutive trials. The data were analyzed by one-way repeated-measures analysis of variance. The results of the present study indicate that EMG data of the VM and VL of female patients with PFP did improve with an increase in the height of the shoe heel, which were statistically significant. Additionally, the EMG activity of VM increased more dramatically than that of VL associated with the task of walking with high-heeled shoes on the treadmill. This study suggests that the type of high-heeled shoes is related to the VM and VL muscle activation patterns contributing to knee joint pathologies in female patients with PFP.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.55-60
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• 2000

Purpose: To investigate the effect of heel elevation on the radiographic parameters of the forefoot. Materials and Methods: Forty feet in twenty-one adults were studied. Weight bearing dorsoplantar radiograph was taken with the foot on a flat surface and with the heel of the foot elevated by 5cm. Various parameters were measured and compared between the results with and without heel elevation. Result: The hallux valgus angle was increased by $5.0{\pm}3.5$ degrees with heel elevation and the change was statistically significant(p<0.01). There was no statistically significant changes in the other parameters. Conclusion: The results of this study suggest that high-heeled shoes might contribute in causing or aggravating the degrees of the hallux valgus.

• Physical Therapy Korea
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• v.16 no.3
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• pp.24-31
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• 2009

This study aimed to investigate the effect of differing heel heights on the electromyographic (EMG) activity in vastus medialis (VM) and vastus lateralis (VL) during stair ascending and descending activities. A total of 26 healthy women volunteered to perform stair-ascending and stair-descending tasks with 3 heel heights: barefoot, 3 cm, and 7 cm. The EMG activities of the VM and VL were recorded during the tasks. During the stair ascending and descending tasks, the EMG activities of both VM and VL significantly changed with differing the heel heights (p<.05). Moreover, the EMG activities of VM and VL during the stair ascending task were significantly higher than the corresponding values during the stair-descending task (p<.05). However, there were no significant differences between the VM:VL EMG ratios for the 3 heel heights (p>.05). The VM:VL EMG ratios between the 2 tasks differed significantly in the 7 cm high heel condition (p<.05). Despite an increase in the EMG activities in both VM and VL during stair ascending and descending tasks, there was no change in the relative EMG intensities of VM and VL, which was measured by calculating the VM:VL ratio this result indicates that no VM:VL imbalances were elicited. The relative EMG intensities of VM and VL during stair descent were lower than the corresponding values during the ascent, suggesting that VM and VL may show an imbalance in the eccentric activation during the weight-acceptance phase. This study provides useful information that will facilitate future research on how heel height affects muscle activity around the knee joint.

• Physical Therapy Korea
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• v.20 no.3
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• pp.36-44
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• 2013

This study aimed to investigate the influence of shoe heel height and muscle fatigue on static and dynamic balance in young women. Thirty women who were used to wearing high heels volunteered to participate in this study. The shoe heel heights were 0 cm and 7 cm. And ankle plantar flexor fatigue was experimentally induced. Static and dynamic balance were measured using the one leg standing test (OLST) and the star excursion balance test (SEBT) in anterior, posteromedial, and posterolateral directions, respectively. Values in the OLST (shoe heel height 0 cm, $28.83{\pm}3.24$ sec to $26.12{\pm}6.13$ sec; and 7 cm, $24.75{\pm}7.09$ sec to $16.86{\pm}9.32$ sec) and the SEBT in anterior (shoe heel height 0 cm, $71.02{\pm}4.57%$ to $69.50{\pm}3.66%$; and 7 cm, $64.17{\pm}3.53%$ to $59.61{\pm}4.06%$) and posteromedial (shoe heel height 0 cm, $92.01{\pm}5.61%$ to $90.38{\pm}7.10%$; and 7 cm, $83.09{\pm}7.29%$ to $76.83{\pm}9.28%$) directions were significantly reduced when fatigue-inducing exercise was performed (p<.05). Furthermore, within these parameters, there were significant interaction effects between shoe heel height and fatigue condition (p<.05). These findings suggest that shoe heel height and muscle fatigue contribute to some changes in static and dynamic balance in young women, probably leading to negative effects on physical function during a variety of activities of daily living.

• Journal of Korean Physical Therapy Science
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• v.20 no.1
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• pp.17-25
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• 2013

The purpose of this research is to provide right information about deformation and to relieve fatigue of high-heels lovers. The research data includes 15 tests and survey on 71 female students. The result follows 1. Age of surveys is mostly 22, consisting 43.7% of all. The most frequently worn shoe kind is high heels that 45.1% of surveys wear 2. Female students those are 155~160cm high wear high heels most frequently, 40.8%. 3. The fatigue condition classified by hours of wearing: Surveys wearing high heels over 7 hours and 5~7 hours state starting to feel fatigue by 40.8%, 38.0% each, and the result was stastically significant 4. The appearance of pain on calf classified by hours of wearing: 35.2% of surveys answered they start to feel pain when worn high heels over 7 hours, and 33.8% of students answered 5~7 hours 5. The fatigue condition classified by kinds of shoes worn: 45.0% of the surveys felt tired when wearing high heels, 40.8% answered wearing heel inserted running shoes, and 14.0% for flat shoes. 6. The fatigue condition classified by heel height: 69.0% of survey answered they feel fatigue after wearing shoes with 5~9cm high heels, 21.1% answered under 3cm high heels, and 9.9% answered over 10cm heels(p<0.05) 7. The experience of cramp in calf cramp muscle classified by heel height: 69.0% of surveys experienced cramp when wearing 5~9cm high heels, 21.1% answered under 3cm high heels, 9.9% for over 10cm heels.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.379-385
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• 2013

Purpose: The purpose of this study is to compare kinematics on lower limbs between stair walking with high heel and barefoot in healthy adult women. Methods: 18 healthy adult women were recruited in this study. The subjects performed stair ascent and descent with high heels and barefoot. The experiment was conducted in random order and repeated three times for each stair walking with high heels and barefoot. The movements of lower limb joints were measured and analyzed using a three-dimensional analysis system. Results: The ankle, knee, and hip flexion angles on the sagittal plane exhibited statistically significant differences between stair ascent and descent with high heels and barefoot. The pelvic forward tilt angles showed statistically significant differences only during stair ascent. The ankle inversion, hip abduction and pelvic lateral tilt angles on the frontal plane showed statistically significant differences between stair walking with high heels and barefoot. On the transverse plane, the hip rotation angles showed statistically significant differences between the high-heeled and barefoot gait during stair ascent and descent. However, the pelvic rotation angles showed no statistically significant differences. Conclusion: Therefore, wearing high-heeled shoes during stair walking in daily life is considered to influence lower limb kinematics due to the high heel, and thus poses the risks of pain, and low stability and joint damage caused by changes in the movement of lower limb joints.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.407-413
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• 2014

PURPOSE: We investigated the influence of heel insole and visual control on body sway index with high-heeled shoes. METHODS: The subjects of this study were 61 healthy students. None of the participants had any orthopedic or neurologic alterations. C90 area, C90 angle, trace length, sway average velocity were measured using a force plate by BT4. The variables were measured both with insole and without insole when wearing high-heeled shoes under the conditions of eyes open and eyes closed. The collected data were analyzed using the Kolmogorov-Smirnov test and paired t-test. RESULTS: When wearing high-heeled shoes with insole under the conditions of eyes open, trace length, C90 area, velocity were significantly more decreased than without insole (p<.01). When wearing high-heeled shoes with insole under the conditions of eyes closed, only C90 area was significantly more decreased than without insole (p<.05). When wearing high-heeled shoes with insole under the conditions of eyes open, trace length, C90 area, velocity were significantly more decreased than under the conditions of eyes closed (p<.01). CONCLUSION: The present study demonstrates that the use of high-heeled shoes with insole supported from heel to midfoot more increased static balance than without insole under the conditions of eyes open.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2010.05a
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• pp.1413-1414
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• 2010