Impact of high-heeled and sport shoes on multi-joint external load profile during walking

BACKGROUND: Previous studies have analysed the effect of wearing high-heeled shoes (HHS) on gait analysis, balance and its relation to health. However, further research is needed to study its effect on the difference of chain reactions in the transfer of body impacts from the lower to the upper limbs. OBJECTIVES: The aims of the present research were: (a) to compare the effects of wearing HHS on impacts across body joints during walking with sport shoes (SS) as a reference, and (b) to examine such effects at different speeds. METHODS: Seven well-trained women completed this study. Incremental treadmill walking test were performed with two different footwear: SS and HHS. Inertial devices were used to quantify the chain reactions at selected anatomical lower limbs and trunk locations. Statistical analysis included the Wilcoxon test with ranges and Cohen's d effect size with percentage of differences. RESULTS: The highest values were found at the heel in both footwear and in both legs (SS: right =0.76 +/- 0.27, left = 0.79 +/- 0.27; HHS: right = 1.07 +/- 0.38, left = 1.11 +/- 0.41), while the lowest values were registered at lower and upper back. Furthermore, significant differences were found with the HHS load being higher at all locations (p < 0.05; %(diff) = 12.20-36.36%), influenced by the walking speed. In addition, a strong influence of footwear in the change of the laterality profile was found (p < 0.05). CONCLUSIONS: These findings suggest that the use of HHS increase the load on the lower limb and the trunk. Until reaching 5 km/h during walking, no significant differences were found between wearing HHS or SS in accelerometer load, producing exponential differences from this speed. The great between-subject variability implies that within-subject analysis is recommended, as it is more related to real clinical practice.