Shiroshita T.1, Naka T.1, Takahashi M.1
1Gumma Paz College, School of Physiotherapy Faculty of Heath Science, Gunma, Japan
Background: The centre-of-gravity is displaced posteriorly in high-heeled gait because of increased pelvic posterior tilting and knee flexion (Opila-Correia, 1990), or increased knee extensor-moment (Esenyel, 2003). However, unexpectedly, the centre-of-gravity was not displaced anteriorly even with high heel position. An earlier study did not directly calculate centre-of-gravity movement.
Purpose: The purpose of this study was to clarify the dynamic strategy mainly for the centre-of-gravity movement on the sagittal plane of the high-heeled gait.
Methods: The subjects were 14 participants (14 women; 14 feet) whose mean (SD) age was 20.8 (0.7) years; height, 160.0 (4.0) cm; and weight, 53.9 (5.2) kg and who had no foot or ankle injury in the past 6 months. The participants were divided into the custom group (>3 times a week of high-heeled gait: n=7) and non-custom group (n=7). All subjects were measured using 6-cm-high-heeled shoes.
Data were collected with a 7-camera Vicon MX motion capture system (100 Hz) using a Plug-in Gait Full Body Marker set and three force plates (AMTI, 100 Hz). The participants performed barefoot and high-heeled gaits five times, respectively. Kinematic and kinetic data were normalised to 100% of the gait cycle. The centre-of-gravity movement was calculated as the distance from the knee joint marker to the centre-of-gravity-line on the sagittal plane. Measurements were made for 12%, 31%, and 50% of the gait cycle on the sagittal plane. For statistical analysis, the custom and non-custom groups were compared by using the Mann-Whitney test; and barefoot and high-heeled gaits, by using the Wilcoxon signed-rank test with IBM SPSS Statistics 20. The results were considered significant at p 0.05.
Results: In the comparison between the two groups, none of the parameters showed statistical significance.
For the knee angle of high-heeled gait, flexion angles significantly increased at 12% and 31% of gait cycle. The knee extension-moment of high-heeled gait significantly increased at 31%. Centre-of-gravity movement significantly increased posteriorly at 12% and 30% of the gait cycle.
By contrast, at 50% of the gait cycle in high-heeled gait, the knee-extension-angle significantly increased, the knee extension-moment was unchanged, and the centre-of-gravity movement was significantly changed anteriorly.
The changes in center-of-gravity movement in the high-heeled, and barefoot gaits were as follows (unit: mm, *p 0.05):, 12%* (134.3, 104.2), 30%* (-38.3, -67.5), and 50%* (-178.7, -174.3), in this order.
Conclusion(s): In the first-half of the stance phase of high-heeled gait, the knee joint was in the flexion position, the extension-moment increased, and the centre-of-gravity was displaced posteriorly.
However, in the last-half of the stance phase, the knee joint was in the extension position, the knee extension-moment was similar to that in barefoot gait, and the centre-of-gravity was displaced anteriorly.
Hence, between the first-half and last-half of the stance phase in high-heeled gait showed wide contrast.
Implications: Whether symptoms are a phenomenon of the first-half or last-half of the stance phase should be clarified, and symptoms should be interpreted clinically.
Funding acknowledgements: I would like to thank Gumma Paz College for a grant that made it possible to complete this study.
Topic: Human movement analysis
Ethics approval: This study was performed with the consent of the Ethics Committee for Human Research of Gumma-Paz College.(the approval number :PAZ13-1)
All authors, affiliations and abstracts have been published as submitted.
