The Result of Mid-High-Heeled Footwear on Young Adult Women
of the whole body taken using a biplanar low-dose radiographic imaging system ( EOS Imaging , Paris , France ). Comparing radiological methods and surface topography is a big challenge due to the differences in the imaged structures [ 25 , 26 , 27 ] . The unified interpretation of the results for various methods remains difficult . An additional barrier for the comparability of the results is the presence of moderate statistical relations of the studied parameters .
Recently , the reduction of radiation exposure has become a severe concern for researchers
[ 28,29,30,31,32,33,34,35 ]
. The most crucial argument in favor of the development of surface topography methods is the reduction of the cumulative X-ray effect during systematic diagnostic tests of patients with scoliosis [ 28 , 2
9,31,32,34,36,37,38,39,40,41 ]
. There is a noted preference in the use of non-radiation dependent measurements [ 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ] . However , even radiographs using a biplanar low-dose radiographic imaging system ( EOS Imaging ) may produce a total radiation dose as low as 0.1 – 0.7 mSv per participant [ 54 ] .
Repeatability of the experiment also depends on the measurement uncertainty of the devices used to deliver image data and algorithms used to extract parameters and indices from that data . The majority of the studies do not take these factors into account .
A more rigorous investigation is necessary to confirm the significant factors . The aim of this study was to investigate the effect of high-heeled footwear on static posture parameters in a homogenous sample of young adult women while standing . Surface topography ( ST ) was selected as the investigation tool to facilitate comparison of results , but also for its moderate availability , non-invasive character , and amount of delivered information about the body shape
[ 18 ]
. The experiment was performed while controlling all its core components : the geometry of the heel , the data acquisition process ( including hardware ), and the data analysis and parameter extraction stage . In this way , we intended to remove most of the uncontrolled variables , which should contribute to more reliable and repeatable results . All the steps are described in detail to provide a basis to reproduce the results in similar experiments in the future .
2 . Material and Methods
2.1 Design
The experiment followed a repeated measures design , two conditions were examined , the initial state being barefoot , and the modified state wearing high-heeled shoes . The initial state was measured multiple times to test repeatability . No randomization was applied in order to follow the posture changes in each subject .
2.2 . Subjects
A group of seventy-six healthy volunteers , students of the Physiotherapy Department of the Medical University in Warsaw , was initially enrolled in the study . Body mass index ( BMI ) was used to determine subjects at ranges reliable for surface topography measurements . The high body mass index may prevent the surface topography from detecting the severity of the curves . The reproducibility of surface topography has been found to be accurate in patients with BMI up to 29 [ 55 ] . The healthy normal BMI range ( 18.5 – 24.9 ) applies the same for men and women .
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