[논문]The Effect of Shoe Heel Types and Gait Speeds on Knee Joint Angle in Healthy Young Women - A Preliminary Study

Chhoeum, Vantha; Wang, Changwon; Jang, Seungwan; Min, Se Dong; Kim, Young; Choi, Min-Hyung

doi:10.7472/jksii.2020.21.6.41

The Effect of Shoe Heel Types and Gait Speeds on Knee Joint Angle in Healthy Young Women - A Preliminary Study 원문보기

Journal of Internet Computing and Services = 인터넷정보학회논문지, v.21 no.6, 2020년, pp.41 - 50

Chhoeum, Vantha (Dept. of Software Convergence, Soonchunhyang University) , Wang, Changwon (Dept. of Software Convergence, Soonchunhyang University) , Jang, Seungwan (Dept. of Software Convergence, Soonchunhyang University) , Min, Se Dong (Dept. of Software Convergence, Soonchunhyang University) , Kim, Young (Institute of Wellness Convergence Technology, Soonchunhyang University) , Choi, Min-Hyung (Dept. of Computer Science and Engineering, University of Colorado Denver)

Abstract ▼ AI-Helper

The consequences of wearing high heels can be different according to the heel height, gait speed, shoe design, heel base area, and shoe size. This study aimed to focus on the knee extension and flexion range of motion (ROM) during gait, which were challenged by wearing five different shoe heel types and two different self-selected gait speeds (comfortable and fast) as experimental conditions. Measurement standards of knee extension and flexion ROM were individually calibrated at the time of heel strike, mid-stance, toe-off, and stance phase based on the 2-minute video recordings of each gait condition. Seven healthy young women (20.7 ± 0.8 years) participated and they were asked to walk on a treadmill wearing the five given shoes at a self-selected comfortable speed (average of 2.4 ± 0.3 km/h) and a fast speed (average of 5.1 ± 0.2 km/h) in a random order. All of the shoes were in size 23.5 cm. Three of the given shoes were 9.0 cm in height, the other two were flat shoes and sneakers. A motion capture software (Kinovea 0.8.27) was used to measure the kinematic data; changes in the knee angles during each gait. During fast speed gait, the knee extension angles at heel strike and mid-stance were significantly decreased in all of the 3 high heels (p<0.05). The results revealed that fast gait speed causes knee flexion angle to significantly increase at toe-off in all five types of shoes. However, there was a significant difference in both the knee flexion and extension angles when the gait in stiletto heels and flat shoes were compared in fast gait condition (p<0.05). This showed that walking fast in high heels leads to abnormal knee ROM and thus can cause damages to the knee joints. The findings in this preliminary study can be a basis for future studies on the kinematic changes in the lower extremity during gait and for the analysis of causes and preventive methods for musculoskeletal injuries related to wearing high heels.

주제어

표/그림 (8)

그림 (Figure 1) Example of the shoe heel design and size measurement standards
그림 (Figure 2) Lateral view of the shoe types
그림 (Figure 3) Sample image of knee flexion angle (θ) measurement at the time of heel strike
표 (Table 1) Characteristics of the testing shoes
표 (Table 2) Result of knee ROM comparison between conditions (n = 7)
그림 (Figure 4) Result of knee flexion at heel strike, *statistically significant between speeds, C: comfortable speed, F: fast speed, S1: flat, S2: sneaker, S3: chunky heel, S4: classic pump heel, S5: stiletto heel
그림 (Figure 5) Result of knee flexion at toe-off, *statistically significant between speeds, **statistically significant between shoes, C: comfortable speed, F: fast speed, S1: flat, S2: sneakers, S3: chunky heel, S4: classic pump heel, S5: stiletto heel
표 (Table 3) Result of between-shoe comparison in fast speed condition (n = 7)

AI 본문요약
AI-Helper

제안 방법

For this study, a total of 10 experimental conditions were performed by each participant; shoe 1: flat (S1), shoe 2: sneakers (S2), shoe 3: chunky heel (S3), shoe 4: classic pump heel (S4), shoe 5: stiletto heel (S5), gait 1: at a comfortable speed (C), and gait 2: at a fast speed (F)
Although there have been various studies on womens’ gait and high-heeled shoes, not many studies have defined the correlation between different outsole designs and their effects on knee joint angle during gait in different gait speeds. Therefore, this study aimed to analyze the knee ROM changes affected by wearing five different shoe heel types in two self-selected gait speeds.

대상 데이터

Seven young, healthy women were recruited for this research. The participants had an average age of 20.

데이터처리

ANOVA was performed to analyze on the statistical difference of shoe types and Bonferroni Post hoc was used to reveal the affected knee flexion by each of the 5 shoes in fast gait. By comparing S5 to that of S1, knee flexion angle was significantly increased (11.
, Chicago, IL, USA) was used. One-way ANOVA was performed to identify the statistical difference between the shoe types. Paired t-test was implemented to compare the speed effect with a significance level of p<0.
Paired t-test was implemented to compare the speed effect with a significance level of p<0.05.

성능/효과

Figures 4 and 5 depicted the results of knee extension ROM at the time of heel strike and knee flexion ROM at toe-off, comparing the two gait speeds while wearing the same shoe. For all three high heels, knee extension angle was decreased at heel strike and knee flexion angle was detected lower at toe-off compared to wearing S1 and S2 in both gait speed. In our research for all three high heels, knee flexion angles during the stance phase were significantly greater than those of S1 and S2 at fast walking speed.
From all participants, we obtained the average walking speed of 2.4 ± 0.3 km/h and 5.1 ± 0.2 km/h for comfortable and fast gait speed, respectively.
The results revealed that wearing high heels for faster gait speed decreases the knee extension at heel strike but increases the knee flexion at toe-off which leads to an altered gait pattern. Hence, increasing the gait speed and decreasing the base area of the heels could affect the kinematics in the knee and the gait patterns. The findings of our work can be used as a fundamental information for future studies which could identify the cause of injuries in the leg and the methods to injury prevention for high heel wearers.
For all three high heels, knee extension angle was decreased at heel strike and knee flexion angle was detected lower at toe-off compared to wearing S1 and S2 in both gait speed. In our research for all three high heels, knee flexion angles during the stance phase were significantly greater than those of S1 and S2 at fast walking speed. At toe-off, both comfortable and fast gait speeds, knee flexion angles were consistently smaller in all three high heels compared to those in S1 and S2.
Our research observed the effect of five different shoes and two different gait speeds on the changes in knee extension and flexion range of motion. The results revealed that wearing high heels for faster gait speed decreases the knee extension at heel strike but increases the knee flexion at toe-off which leads to an altered gait pattern.
The result from One-way ANOVA which applied for comparison between 5 shoes during comfortable gait walking, showed that there was no significant difference in the knee joint angles. However in fast gait walking, knee flexion angle was significantly increased in S3 (22.
Our research observed the effect of five different shoes and two different gait speeds on the changes in knee extension and flexion range of motion. The results revealed that wearing high heels for faster gait speed decreases the knee extension at heel strike but increases the knee flexion at toe-off which leads to an altered gait pattern. Hence, increasing the gait speed and decreasing the base area of the heels could affect the kinematics in the knee and the gait patterns.

후속연구

Hence, increasing the gait speed and decreasing the base area of the heels could affect the kinematics in the knee and the gait patterns. The findings of our work can be used as a fundamental information for future studies which could identify the cause of injuries in the leg and the methods to injury prevention for high heel wearers.
Four, this study was conducted as a pilot test with a small number of participants, aiming to preliminarily examine how different types of high-heeled outersoles affect womens’ gait, especially on the knee joint angle movements. The findings of this study can be the basis for our future study, which will be done with a larger number of subjects in different age groups and more types of footwear.

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