• 1

    William A: Footwear assessment and management. Podiatry Management 26: 165, 2007.

  • 2

    Perry SD, Radtke A, Goodwin CR: Influence of footwear midsole material hardness on dynamic balance control during unexpected gait termination. Gait Posture 25: 94, 2007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Butler RJ, Hamill J, Davis I: Effect of footwear on high and low arched runners' mechanics during a prolonged run. Gait Posture 26: 219, 2007.

  • 4

    Cheung RTH, Ng GY: A systematic review of running shoes and lower leg biomechanics: a possible link with patellofemoral pain syndrome? Int Sportmed J 8: 107, 2007.

    • Search Google Scholar
    • Export Citation
  • 5

    Frey C: Foot health and shoewear for women. Clin Orthop Relat Res 372: 32, 2000.

  • 6

    Butler RJ, Scheuchenzuber HJ: The effect of forefoot midsole hardness on propulsion. Med Sci Sports Exerc 34: S280, 2002.

  • 7

    Barton C, Bonanno D, Menz H: Development and evaluation of a tool for the assessment of footwear characteristics. J Foot Ankle Res 2: 10, 2009.

  • 8

    De Lateur BJ, Giaconi RM, Questad K, et al: Footwear and posture: compensatory strategies for heel height. Am J Phys Med Rehabil 70: 246, 1991.

  • 9

    Hong W, Lee Y, Lin Y, et al: Effect of shoe heel height and total-contact insert on muscle loading and foot stability while walking. Foot Ankle Int 34: 273, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Mika A, Oleksy Ł, Mika P, et al: The influence of heel height on lower extremity kinematics and leg muscle activity during gait in young and middle-aged women. Gait Posture 35: 677, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11

    Guo L, Lin C, Yang C, et al: Effect on plantar pressure distribution with wearing different base size of high-heel shoes during walking and slow running. J Mech Med Biol 12: 1250018, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12

    Luximon Y, Cong Y, Luximon A, et al: Effects of heel base size, walking speed, and slope angle on center of pressure trajectory and plantar pressure when wearing high-heeled shoes. Hum Move Sci 41: 307, 2015.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13

    Branthwaite H, Chockalingam N: The role of footwear in rehabilitation: a review. Internet J Rehabil 1: 1, 2009.

  • 14

    Phillips RD, Reczek DM, Fountain D, et al: Modification of high-heeled shoes to decrease pronation during gait. JAPMA 81: 215, 1991.

  • 15

    Lee GH, Han SJ, Lee SG, et al: The effect of metatarsal pad for foot pressure. J Korean Acad Rehabil Med 28: 94, 2004.

  • 16

    Yung-Hui L, Wei-Hsien H: Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking. Appl Ergon 36: 355, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Light LH, Mclellan GE, Klenerman L: Skeletal transients on heel strike in normal walking with different footwear. J Biomech 13: 477, 1980.

  • 18

    Branthwaite H, Chockalingam N, Greenhalgh A: The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females. J Foot Ankle Res 6: 28, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Arts MLJ, Bus SA: Twelve steps per foot are recommended for valid and reliable in-shoe plantar pressure data in neuropathic diabetic patients wearing custom made footwear. Clin Biomech 26: 880, 2011.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20

    Bonanno DR, Landorf KB, Menz HB: Pressure-relieving properties of various shoe inserts in older people with plantar heel pain. Gait Posture 33: 385, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Konrad P: The ABC of EMG: A Practical Introduction to Kinesiological EMG, Noraxon USA Inc, Scottsdale, AZ, 2005.

  • 22

    Mika A, Clark BC, Oleksy Ł: The influence of high and low heeled shoes on EMG timing characteristics of the lumbar and hip extensor complex during trunk forward flexion and return task. Man Ther 18: 506, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Hermens HJ; Commission of the European Communities, Biomedical and Health Research Programme, S.E.N.I.A.M. Project: European Recommendations for Surface Electromyography: Results of the SENIAM Project, Roessingh Research and Development, Enschede, the Netherlands, 1999.

    • Search Google Scholar
    • Export Citation
  • 24

    Kim MH, Yi CH, Yoo WG, et al: EMG and kinematics analysis of the trunk and lower extremity during the sit-to-stand task while wearing shoes with different heel heights in healthy young women. Hum Mov Sci 30: 596, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Riemann BL, Limbaugh GK, Eitner JD, et al: Medial and lateral gastrocnemius activation differences during heel-raise exercise with three different foot positions. J Strength Cond Res 25: 634, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Héroux ME, Dakin CJ, Luu BL, et al: Absence of lateral gastrocnemius activity and differential motor unit behavior in soleus and medial gastrocnemius during standing balance. J Appl Physiol 116: 140, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Signorile JE, Applegate B, Duque M, et al: Selective recruitment of the triceps surae muscles with changes in knee angle. J Strength Cond Res 16: 433, 2002.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Gefen A, Megido-Ravid M, Itzchak Y, et al: Analysis of muscular fatigue and foot stability during high-heeled gait. Gait Posture 15: 56, 2002.

  • 29

    Kellis E, Arabatzi F, Papadopoulos C: Muscle co-activation around the knee in drop jumping using the co-contraction index. J Electromyogr Kinesiol 13: 229, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Foster A, Blanchette MG, Chou Y, et al: The influence of heel height on frontal plane ankle biomechanics: implications for lateral ankle sprains. Foot Ankle Int 33: 64, 2012.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Falconer K, Winter D: Quantitative assessment of cocontraction at the ankle joint during walking. Electromyogr Clin Neurophysiol 25: 135, 1985.

    • Search Google Scholar
    • Export Citation
  • 32

    Cohen J: Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates, Hillsdale, NJ, 1988.

  • 33

    Cho W, Choi H: Center of pressure (COP) during the postural balance control of high-heeled woman. Conf Proc IEEE Eng Med Biol Soc 3: 2761, 2005.

    • Search Google Scholar
    • Export Citation
  • 34

    Edwards L, Dixon J, Kent JR, et al: Effect of shoe heel height on vastus medialis and vastus lateralis electromyographic activity during sit to stand. J Orthop Surg Res 3: 2, 2008.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Losa Iglesias ME, Becerro de Bengoa Vallejo R, Palacios Peña D: Impact of soft and hard insole density on postural stability in older adults. Geriatr Nurs 33: 264, 2012.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Romkes J, Rudmann C, Brunner R: Changes in gait and EMG when walking with the Masai Barefoot Technique. Clin Biomech 21: 75, 2006.

Effects of In-Shoe Midsole Cushioning on Leg Muscle Balance and Co-Contraction with Increased Heel Height During Walking

Kit-lun Yick PhD1, Ka-lai Yeung BA (Hons)2, Del P. Wong DPhil3, Yee-nee Lam MPhil2, and Sun-pui Ng PhD4
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  • 1 Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong.
  • | 2 Faculty of Design, Technological and Higher Education Institute of Hong Kong (THEi), Hong Kong.
  • | 3 Shangdong Sport University, Sport Science Research Center, China.
  • | 4 Hong Kong Community College, The Hong Kong Polytechnic University, Hong Kong.
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Background:

The midsole is an essential assembly of footwear for retaining the shape of the shoe, delivering support to the foot, and serving as a cushioning and stability device for walking. To improve leg muscle balance and muscle co-contraction, we propose a new midsole design for high heels with different hardness levels at the forefoot region.

Methods:

Five healthy women participated in the study, with a mean ± SD age of 21.80 ± 4.09 years, and duration of high-heeled shoe wear of 5.20 ± 4.09 years. Two midsole conditions, control and multiple-hardness midsole (MHM), with heel heights of 2 (flat), 5, and 8 cm were used. The main outcome measures were to examine the acute effects of MHM by electromyography on muscle activity balance and co-contraction at varying heel heights during shuttle walk.

Results:

Use of the MHM significantly reduced the muscle activity ratio between the medial and lateral gastrocnemius muscles (P = .043) during push-off to heel strike with a heel height of 5 cm (−22.74%) and heel strike to midstance with a heel height of 8 cm (−22.26%). The increased co-contraction indices of the tibialis anterior–peroneus longus muscles (14.35% with an 8-cm heel height) and tibialis anterior–soleus muscles (15.18% with a 5-cm heel height) are significant (P = .043), with a large effect size (d = 0.8).

Conclusions:

These results deliver important implications in advancing the engineering of MHM design without changing the in-shoe volume to enhance leg muscle balance and co-contraction during walking.

Corresponding author: Kit-lun Yick, PhD, ST735, Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong. (E-mail: kit-lun.yick@polyu.edu.hk)