Chien Hui-Lien, Lu Tung-Wu, Liu Ming-Wei
Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC.
Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC; Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taiwan, ROC.
Gait Posture. 2014 Apr;39(4):1045-50. doi: 10.1016/j.gaitpost.2014.01.007. Epub 2014 Jan 19.
High-heeled shoes are associated with instability and falling, leading to injuries such as fracture and ankle sprain. This study investigated the effects of habitual wearing of high-heeled shoes on the body's center of mass (COM) motion relative to the center of pressure (COP) during gait. Fifteen female experienced wearers and 15 matched controls walked with high-heeled shoes (7.3cm) while kinematic and ground reaction force data were measured and used to calculate temporal-distance parameters, joint moments, COM-COP inclination angles (IA) and the rate of IA changes (RCIA). Compared with inexperienced wearers, experienced subjects showed significantly reduced frontal IA with increased ankle pronator moments during single-limb support (p<0.05). During double-limb support (DLS), they showed significantly increased magnitudes of the frontal RCIA at toe-off and contralateral heel-strike, and reduced DLS time (p<0.05) but unaltered mean RCIA over DLS. In the sagittal plane experienced wearers showed significantly increased mean RCIA (p<0.05) and significant differences in the RCIA at toe-off and contralateral heel-strike (p<0.05). Significantly increased hip flexor moments and knee extensor moments at toe-off (p<0.05) were needed for forward motion of the trailing limb. The current results identified the change in the balance control in females after long-term use of high-heeled shoes, providing a basis for future design of strategies to minimize the risk of falling during high-heeled gait.
高跟鞋与身体不稳和摔倒相关，会导致骨折和脚踝扭伤等损伤。本研究调查了习惯性穿着高跟鞋对步态期间身体重心（COM）相对于压力中心（COP）运动的影响。15名有经验的女性穿着者和15名匹配的对照组穿着高跟鞋（7.3厘米）行走，同时测量运动学和地面反作用力数据，并用于计算时间-距离参数、关节力矩、COM-COP倾斜角（IA）和IA变化率（RCIA）。与无经验的穿着者相比，有经验的受试者在单腿支撑期间，随着踝内旋力矩增加，额状面IA显著降低（p<0.05）。在双腿支撑（DLS）期间，她们在足尖离地和对侧足跟触地时额状面RCIA的幅度显著增加，DLS时间缩短（p<0.05），但DLS期间平均RCIA未改变。在矢状面，有经验的穿着者平均RCIA显著增加（p<0.05）以及在足尖离地和对侧足跟触地时RCIA存在显著差异（p<0.05）。为了后肢向前运动，在足尖离地时需要显著增加髋屈肌力矩和膝伸肌力矩（p<0.05）。目前的结果确定了长期穿着高跟鞋后女性平衡控制的变化，为未来设计策略以最小化高跟鞋步态期间摔倒风险提供了依据。
