Kinetic and Kinematic Differences of Barefoot versus High-Heeled Gait in Healthy, Young Adult Females: A Pilot Study

Background & Purpose: High-heeled shoes (HHSs) are a well known part of women’s footwear repertoire that can influence ankle and foot position during functional activities. Few studies have quantified the impact of HHSs on static standing posture, balance, and gait, leaving numerical values as to why HHSs are unfavorable to be determined. The purpose of this study was to identify the differences in weight distribution, area of sway during gait initiation (GI), and gait parameters between barefoot and HHSs. Methods: 12 healthy young adult female participants ambulated barefoot, then while wearing HHSs in a motion analysis laboratory. Data was collected using a Tekscan Mat (Tekscan Inc., South Boston, MA, USA) and Vicon Motion Analysis system (Vicon, Centennial, CO, USA). Paired t-tests were utilized for statistical analysis. Statistical significance was set at α = 0.05. Results: Weight shifting primarily occurs through the rearfoot in barefoot static standing, whereas in HHSs it occurs primarily through the forefoot. In addition, wearing HHSs anteriorly displaces the center of force (COF) in standing (p < 0.05). During barefoot GI, the area of COF movement was significantly greater (p < 0.05). Cadence and walking speed significantly decreased, and double-support phase of gait significantly increased in HHSs (p < 0.05). Vertical ground reaction forces at initial contact were significantly greater in HHSs (p < 0.05). Conclusion: With the results of this study, it appears that healthy young female adults demonstrate more caution with gait in HHSs as well as a disruption of natural postural alignment, imposing greater stresses on the lower extremities. While HHSs do not have a different motor strategy to execute the first step based on relative time of GI, it does require a compensated motor response to adjust to the altered postural alignment during both gait initiation and walking. This contributes to the theory that long-term use of HHSs could predispose women to lower extremity pathology through chronically altered biomechanics.