Lange GW, Hintermeister RA, Schlegel T, et al: Electromyographic and kinematic analysis of graded treadmill walking and the implications for knee rehabilitation. .J Orthop Sports Phys Ther 23::294. ,1996. .
Stefanyshyn D, Nigg B, Fisher V, et al: The influence of high heeled shoes on kinematics, kinetics, and muscle EMG of normal female gait. .J Appl Biomech 16::309. ,2000. .
Leroux A, Fung J, Barbeau H: Postural adaptation to walking on inclined surfaces: I. Normal strategies. .Gait Posture 15::64. ,2002. .
Prentice SD, Hasler EN, Groves JJ, et al: Locomotor adaptations for changes in the slope of the walking surface. .Gait Posture 20::255. ,2004. .
Kawamura K, Tokuhiro A, Takechi H: Gait analysis of slope walking: a study on step length, stride width, time factors and deviation in the center of pressure. .Acta Med Okayama 45::179. ,1991. .
Sun J, Walters M, Svensson N, et al: The influence of surface slope on human gait characteristics: a study of urban pedestrians walking on an inclined surface. .Ergonomics 39::677. ,1996. .
Leroux A, Fung J, Barbeau H: Adaptation of the walking pattern to uphill walking in normal and spinal-cord injured subjects. .Exp Brain Res 126::359. ,1999. .
Simonsen EB, Dyhre-Poulsen P, Voigt M: Excitability of the soleus H reflex during graded walking in humans. .Acta Physiol Scand 153::21. ,1995. .
Tokuhiro A, Nagashima H, Takechi H: Electromyographic kinesiology of lower extremity muscles during slope walking. .Arch Phys Med Rehabil 66::610. ,1985. .
Opila-Correia KA: Kinematics of high-heeled gait. .Arch Phys Med Rehabil 71::304. ,1990. .
Mann RA, Hagy JL, Schwarzman A: Biomechanics of the Earth shoe. .Orthop Clin North Am 7::999. ,1976. .
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. .
Benz D, Stacoff A, Balmer E, et al: Walking pattern with missing-heel shoes. .J Biomech 31:(suppl):132. ,1998. .
Whittle M: Gait Analysis, Reed Educational and Professional Publishing Ltd, Chicago. ,2002. .
Winter D: The Biomechanics and Motor Control of Human Gait: Normal, Elderly and Pathological, University of Waterloo Press, Waterloo, Ontario. ,1991. .
Valmassy R: Clinical Biomechanics of the Lower Extremities, Mosby Inc, St Louis. ,1996. .
Yamamoto T, Ohkuwa T, Itoh H, et al: Walking at moderate speed with heel-less shoes increases calf blood flow. .Arch Physiol Biochem 108::398. ,2000. .
Mandelbaum B, Gruber J, Zachazewski J: “Achilles Tendon Repair and Rehabilitation,” in Rehabilitation for the Postsurgical Orthopedic Patient, ed by L Maxey, J Magnusson, p 323, Mosby Inc, St Louis. ,2001. .
Brotzman S, Brasel J: “Foot and Ankle Rehabilitation,” in Clinical Orthopaedic Rehabilitation, ed by S Brotzman, p 245, Mosby Inc, St Louis. ,1996. .
Ebbeling C, Hamill J, Crussemeyer J: Lower extremity mechanics and energy cost of walking in high-heel shoes. .J Orthop Sports Phys Ther 19::190. ,1994. .
Thorstensson A, Nilsson J, Carlson H: Trunk movement in human locomotion. .Acta Physiol Scand 121::9. ,1984. .
Vogt L, Banzer W: Measurement of lumbar spine kinematics in incline treadmill walking. .Gait Posture 9::18. ,1999. .
Dubo HI, Peat M, Winter DA, et al: Electromyographic temporal analysis of gait: normal human locomotion. .Arch Phys Med Rehabil 57::415. ,1976. .
Nilsson J, Thorstensson A, Halbertsma J: Changes in leg movements and muscle activity with speed of locomotion and mode of progression in humans. .Acta Physiol Scand 123::457. ,1985. .
Brandell BR: Functional roles of the calf and vastus muscles in locomotion. .Am J Phys Med 56::59. ,1977. .
Palmitier RA, An KN, Scott SG, et al: Kinetic chain exercise in knee rehabilitation. .Sports Med 11::402. ,1991. .
Baratta R, Solomonow M, Zhou BH, et al: Muscular coactivation: the role of the antagonist musculature in maintaining knee stability. .Am J Sports Med 16::113. ,1988. .
Draganich LF, Jaeger RJ, Kralj AR: Coactivation of the hamstrings and quadriceps during extension of the knee. .J Bone Joint Surg Am 71::1075. ,1989. .
Battye CK, Joseph J: An investigation by telemetering of the activity of some muscles in walking. .Med Biol Eng 4::125. ,1966. .
Background: We investigate kinematic adaptation and muscle activities in the trunk and lower extremities of healthy subjects during treadmill walking in negative-heeled sports shoes versus normal sports shoes.
Methods: Thirteen healthy female university students participated in the study. We analyzed sagittal-movement kinematics and electromyographic findings from the erector spinae, rectus abdominus, rectus femoris, biceps femoris, tibialis anterior, and lateral gastrocnemius muscles of the dominant side in two shod conditions.
Results: Negative-heeled gait is characterized by faster cadence, shorter stride length, increased maximal extension angles in the trunk and hip, increased flexion angle in the knee, larger dorsiflexion in the stance phase, and a larger range of motion of the ankle joint. Negative-heeled gait resulted in a significantly larger integrated electromyographic value, a longer duration of electromyographic activity, and a higher mean amplitude of electromyographic activity in the tibialis anterior, lateral gastrocnemius, and biceps femoris muscles.
Conclusions: Negative-heeled gait compared with normal gait places a higher physiologic demand on the tibialis anterior, lateral gastrocnemius, and biceps femoris muscles when walking on a level surface. Thus, negative-heeled shoes could be of value if used in an exercise rehabilitation or training program where inclined walking is not available owing to a flat terrain. (J Am Podiatr Med Assoc 97(6): 447–456, 2007)