The Result of Mid-High-Heeled Footwear on Young Adult Women
high-heeled shoes . However , in the literature , high-heeled shoes were not always found as the factor that increases the forward inclination of the body , its asymmetry [ 11 ] , and pelvic anteversions [ 15 ] that may lead to an uneconomic body position [ 8 , 9 ] . Some studies [ 1 , 9 , 20 , 106 ] have suggested that high heels induce a vertical integration in the sacrum , pelvic tilt and lumbar adjustment due to increased activity of the hamstring muscles to counteract the abnormal gravity line . A small to moderate effect of high-heeled shoes was observed on static and dynamic pelvic positions ( sagittal pelvic tilt and axial pelvic rotation ) in females habituated to the use of high-heeled footwear [ 4 ] . The wearing of high-heeled shoes may cause a “ chain reaction ” of postural alteration superior to the ankle , where the pelvis , rather than the lumbar spine that is involved in postural compensatory strategies [ 4 ] . The statistically significant gradual increase of the trunk forward inclination angle with the increasing height of the heels [ 11 ] was explained as the reaction in the body ’ s center of gravity and the attempt to maintain postural stability . The cervical spine may show increased lordosis due to the forward displacement of the head [ 18 ] as an additional mechanism to shift the center of gravity backward . Most of the high heels related adaptive responses to the antero-cranial shift of the center of gravity occur in the lower extremity , especially the knees [ 8 ] .
4.2 . Influence of Precision of Fiducial Marker Placement
The markers were placed once for all the measurements , did not change their position on the skin , and thus provided a good base for comparison . Additional tests were conducted for the statistically significant parameters that showed at least a small effect size : the vertical balance and pelvic incidence angles . Tests were performed according to the described procedure .
The pelvic incidence angle and vertical balance angle can be considered reliable measurements . All ten random tests showed statistically significant results for the parameters , and the effect size did not decline .
In the case of pelvic incidence angle , the area around the left and right dimple of Venus markers used for calculation of the angle was large and was related closely to the orientation of the pelvis . For the vertical balance angle , the distance between the two markers used for calculation was considerable compared to possible inaccuracy in placing the markers . Additionally , possible inaccuracy in the frontal plane was small due to the location of the markers along the spine line , and the inaccuracy vector in the sagittal plane was almost parallel to the line connecting the two markers , thus did not have much influence on the angle value .
4.3 . Limitations of the Study
The general limitations of this study concern the acquisition of the 3D image that can only document a short moment of a body ’ s position . However , this limitation appears equally in static examinations regardless of the measurement method used for image acquisition : radiogram , moiré photogrammetry , rasterstereography , 3D structured light . None of the methods adjust to the dynamic process of balancing . The repeatability of three subsequent barefoot measurements was high , which implies that the captured differences between the barefoot and high-heeled conditions were significant at that moment in time .
A limitation of this study is also the inability
28 Pedorthic Footcare Association | www . pedorthics . org