This study is sponsored by the National Natural Science Foundation of China (81301600), K. C. Wong Magna Fund in Ningbo University, National Social Science Foundation of China (16BTY085), the Zhejiang Social Science Program "Zhi Jiang youth project" (16ZJQN021YB), Loctek Ergonomic Technology Corp, and Anta Sports Products Limited.

This study has been approved by the Human Ethics Committee of Ningbo University (ARGH20150356). All subjects gave their informed consent for inclusion in the study, and they were informed of the goal, requirements, and experimental procedures of the study.
1. Gait Laboratory Preparation
<ol>
	<li>Switch off any incandescent lights and leave a reasonable fluorescent lighting level in the laboratory. Remove all markers and unwanted objects of reflection that may be misinterpreted as passive re...

<ol>
	<li>Barkema, D. D., Derrick, T. R., Martin, P. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heel+height+affects+lower+extremity+frontal+plane+joint+moments+during+walking.">Heel height affects lower extremity frontal plane joint moments during walking.</a> Gait Posture. 35 (3), 483-488 (2012).</li><li>Hong, W. H., Lee, Y. H., Chen, H. C., Pei, Y. C., Wu, C. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+heel+height+and+shoe+insert+on+comfort+perception+and+biomechanical+performance+of+young+female+adults+during+walking.">Influence of heel height and shoe insert on comfort perception and biomechanical performance of young female adults during walking.</a> Foot Ankle Int. 26 (12), 1042-1048 (2005).</li><li>Baker, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gait+analysis+methods+in+rehabilitation.">Gait analysis methods in rehabilitation.</a> J Neuroeng Rehabil. 3 (1), (2006).</li><li>Galna, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+the+Microsoft+Kinect+sensor+for+measuring+movement+in+people+with+Parkinson's+disease.">Accuracy of the Microsoft Kinect sensor for measuring movement in people with Parkinson's disease.</a> Gait Posture. 39 (4), 1062-1068 (2014).</li><li>Esenyel, M., Walsh, K., Walden, J. G., Gitter, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kinetics+of+high-heeled+gait.">Kinetics of high-heeled gait.</a> J Am Podiatri Med Assocn. 93 (1), 27-32 (2003).</li><li>Cronin, N. J., Barrett, R. S., Carty, C. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+use+of+high-heeled+shoes+alters+the+neuromechanics+of+human+walking.">Long-term use of high-heeled shoes alters the neuromechanics of human walking.</a> J Appl Physiol. 112 (6), 1054-1058 (2012).</li><li>Mika, A., Oleksy, &. #. 3. 2. 1. ;., Mika, P., Marchewka, A., Clark, B. 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E., Kuhl, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=On+high+heels+and+short+muscles:+A+multiscale+model+for+sarcomere+loss+in+the+gastrocnemius+muscle.">On high heels and short muscles: A multiscale model for sarcomere loss in the gastrocnemius muscle.</a> J Theor Biol. 365, 301-310 (2015).</li><li>Opila-Correia, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kinematics+of+high-heeled+gait+with+consideration+for+age+and+experience+of+wearers.">Kinematics of high-heeled gait with consideration for age and experience of wearers.</a> Arch Phys Med Rehabil. 71 (11), 905-909 (1990).</li><li>Cronin, N. 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L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lower+extremity+biomechanics+and+self-reported+foot-strike+patterns+among+runners+in+traditional+and+minimalist+shoes.">Lower extremity biomechanics and self-reported foot-strike patterns among runners in traditional and minimalist shoes.</a> J Athl Train. 50 (6), 603-611 (2015).</li><li>Chien, H. L., Lu, T. W., Liu, M. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+long-term+wearing+of+high-heeled+shoes+on+the+control+of+the+body's+center+of+mass+motion+in+relation+to+the+center+of+pressure+during+walking.">Effects of long-term wearing of high-heeled shoes on the control of the body's center of mass motion in relation to the center of pressure during walking.</a> Gait Posture. 39 (4), 1045-1050 (2014).</li><li>Chien, H. L., Lu, T. W., Liu, M. W., Hong, S. W., Kuo, C. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kinematic+and+Kinetic+Adaptations+in+the+Lower+Extremities+of+Experienced+Wearers+during+High-Heeled+Gait.">Kinematic and Kinetic Adaptations in the Lower Extremities of Experienced Wearers during High-Heeled Gait.</a> BME. 26 (3), 1450042 (2014).</li><li>Novacheck, T. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+biomechanics+of+running.">The biomechanics of running.</a> Gait Posture. 7 (1), 77-95 (1998).</li><li>Powell, D. W., Williams, D. B., Windsor, B., Butler, R. J., Zhang, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ankle+work+and+dynamic+joint+stiffness+in+high-compared+to+low-arched+athletes+during+a+barefoot+running+task.">Ankle work and dynamic joint stiffness in high-compared to low-arched athletes during a barefoot running task.</a> Hum Mov Sci. 34, 147-156 (2014).</li><li>Robbins, S. E., Gouw, G. J., Hanna, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Running-related+injury+prevention+through+innate+impact-moderating+behavior.">Running-related injury prevention through innate impact-moderating behavior.</a> Med Sci Sports Exerc. 21 (2), 130-139 (1989).</li><li>Simonsen, E. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Walking+on+high+heels+changes+muscle+activity+and+the+dynamics+of+human+walking+significantly.">Walking on high heels changes muscle activity and the dynamics of human walking significantly.</a> J Appl Biomech. 28 (1), 20-28 (2012).</li><li>Stefanyshyn, D. J., Nigg, B. M., Fisher, V., O'Flynn, B., Liu, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+influence+of+high+heeled+shoes+on+kinematics,+kinetics,+and+muscle+EMG+of+normal+female+gait.">The influence of high heeled shoes on kinematics, kinetics, and muscle EMG of normal female gait.</a> J Appl Biomech. 16 (3), 309-319 (2000).</li><li>Kerrigan, D. C., Lelas, J. L., Karvosky, M. 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D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+strain+behavior+of+the+anterior+cruciate+ligament+during+squatting+and+active+flexion-extension+a+comparison+of+an+open+and+a+closed+kinetic+chain+exercise.">The strain behavior of the anterior cruciate ligament during squatting and active flexion-extension a comparison of an open and a closed kinetic chain exercise.</a> Am J Sports. 25 (6), 823-829 (1997).</li><li>Fleming, B. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+gastrocnemius+muscle+is+an+antagonist+of+the+anterior+cruciate+ligament.">The gastrocnemius muscle is an antagonist of the anterior cruciate ligament.</a> J Orthop Res. 19 (6), 1178-1184 (2001).</li><li>Schipplein, O., Andriacchi, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interaction+between+active+and+passive+knee+stabilizers+during+level+walking.">Interaction between active and passive knee stabilizers during level walking.</a> J Orthop Res. 9 (1), 113-119 (1991).</li><li>Baliunas, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+knee+joint+loads+during+walking+are+present+in+subjects+with+knee+osteoarthritis.">Increased knee joint loads during walking are present in subjects with knee osteoarthritis.</a> Osteoarthr Cartil. 10 (7), 573-579 (2002).</li><li>Payne, C., Munteanu, S., Miller, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Position+of+the+subtalar+joint+axis+and+resistance+of+the+rearfoot+to+supination.">Position of the subtalar joint axis and resistance of the rearfoot to supination.</a> J Am Podiatr Med Assoc. 93 (2), 131-135 (2014).</li><li>Cheung, R. 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One defect of most studies that analyze high-heeled gait biomechanics is ignoring the possible importance of experience wearing high heels12. This study divided subjects into groups of regular and occasional wearers to explore the effects of high-heeled shoe wearing experience on lower-limb kinematics and GRF during moderate high-heeled jogging and running.
EW and IEW showed comparable jogging/running speeds. Compared with EW, IEW adopted a higher stride frequency and a...

High-heel design has always been one of the popular features of women&#39;s footwear. Forcing the ankle into a passive plantar-flexed state, high-heeled shoes considerably alter walking kinematics and kinetics. Despite reported adverse effects on the musculoskeletal system1, social and fashion customs encourage the continued use of high-heeled shoes2.
Optical tracking systems, currently used in the majority of gait-analysis laboratories for both clinical and research purposes, give accurate and reliable measurement of 3D lower-limb joint motions3. This technology provides a &#34;gold standard&#34; for gait analysis4. Consistent results based on the technique have revealed that higher heel heights lead to larger knee flexion and ankle inversion when compared with flat shoes5,6,7. GRF is another commonly used parameter in gait analysis. The shift of GRF toward the medial forefoot, reduced GRF during mid-stance, increased vertical GRF at heel-strike, and increased peak anterior-posterior GRF have also been observed in high-heeled walking1,6,7,8.
Previous studies referenced above use methods based mainly on level walking. In modern society, running for a bus, darting across a busy street, or dashing to catch the last train push more and more women to use higher speeds every now and then. There are limited studies concerning lower-limb biomechanics during high-heeled jogging and running. Gu et al. noted that the joint motion range of knee abduction-adduction and hip flexion-extension increased significantly as the heel height increased during jogging9. The limitation of this study is that they only recruited habitual high-heel wearers. The frequent use of high-heeled shoes can potentially induce structural adaptions in lower-limb muscles. Z&#246;llner et al. created a multiscale computational model revealing that muscle is able to gradually adjust to its new functional length due to the use of high heels after a chronic loss of sarcomeres in series10. Evidence also demonstrates that kinematic accommodations in gait caused by high-heeled shoes vary between experienced and inexperienced wearers11. Data collected from both experienced and inexperienced subjects may mask statistical results12. It is important to explore whether the biomechanical changes are similarly obvious in inexperienced and experienced users.
The purpose of this study was to investigate the differences in lower-limb kinematics and vertical GRF between experienced wearers (EW) and inexperienced wearers (IEW) during moderate high-heeled jogging and running. It was hypothesized that EW would show faster self-preferred jogging and running speeds, less joint motion, and larger vertical GRF during jogging and running.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Motion Tracking Cameras</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>MX cameras</td>
			<td>n= 8</td>
		</tr>
		<tr>
			<td>Vicon Nexus&#160;</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>Version 1.4.116</td>
			<td>Proprietary tracking software (PlugInGait template)</td>
		</tr>
		<tr>
			<td>Dongle</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>-</td>
			<td>-</td>
		</tr>
		<tr>
			<td>MX Ultranet HD</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>-</td>
			<td>-</td>
		</tr>
		<tr>
			<td>Vicon Datastation ADC&#160;</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>-</td>
			<td>External ADC</td>
		</tr>
		<tr>
			<td>Passive Retro-reflective Marker</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>-</td>
			<td>n=16; Diametre=14 mm&#160;</td>
		</tr>
		<tr>
			<td>Force Platform Amplifier</td>
			<td>Kistler, Switzerland</td>
			<td>5165A</td>
			<td>n=1</td>
		</tr>
		<tr>
			<td>Force Platform</td>
			<td>Kistler, Switzerland</td>
			<td>9287C</td>
			<td>n=1</td>
		</tr>
		<tr>
			<td>T-Frame</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>-</td>
			<td>-</td>
		</tr>
		<tr>
			<td>Double Adhesive Tape</td>
			<td>Oxford Metrics Ltd., Oxford, UK</td>
			<td>-</td>
			<td>For fixing markers to skin</td>
		</tr>
		<tr>
			<td>moderate high-heeled shoe</td>
			<td>Daphne, Hong Kong</td>
			<td>13085015</td>
			<td>Heel height: 4.5cm; Size:37EURO</td>
		</tr>
		<tr>
			<td>Microsoft Excel&#160;</td>
			<td>Microsoft Corporation, United States</td>
			<td>Version 2010</td>
			<td>For low pass filtering data and calculations; Add-in:Butterworth.xla</td>
		</tr>
		<tr>
			<td>Origin&#160;</td>
			<td>OriginLab Corporation, United States</td>
			<td>Version 9.0</td>
			<td>Plot GRF-time curve</td>
		</tr>
		<tr>
			<td>Stata&#160;</td>
			<td>Stata Corp, College station, TX</td>
			<td>Version 12.0</td>
			<td>Statistical analysis</td>
		</tr>
	</tbody>
</table>

using gold-standard gait analysis methods to assess experience effects on lower-limb mechanics during moderate high-heeled jogging and running

A limited number of studies have explored lower-limb biomechanics during high-heeled jogging and running, and most studies have failed to clarify the wearing experience of subjects. This protocol describes the differences in lower-limb kinematics and ground reaction force (GRF) between experienced wearers (EW) and inexperienced wearers (IEW) during moderate high-heeled jogging and running. A three-dimensional (3D) motion analysis system with a configured force platform was used to synchronously capture lower-limb joint movements and GRF. 36 young females volunteered to participate in this study and were asked about high-heeled shoe-wearing experience, including frequency, duration, heel types, and heel heights. Eleven who had the experience of 3 to 6 cm heels for a minimum of three days per week (6 h per day) for at least two years and eleven who wore high heels less than twice per month participated. Subjects performed jogging and running at comfortable low and high speeds, respectively, with the right foot completely stepping onto a force platform when passing by along a 10 m walkway. EW and IEW adopted different biomechanical adaptations while jogging and running. IEW exhibited a generally larger range of joint movement, while EW showed a dramatically larger loading rate of GRF during running. Hence, further studies on the lower-limb biomechanics of high-heeled gait should strictly control the wearing experience of the subjects.

All results are presented here as the mean &#177; standard deviation. The running speed was significantly greater than the jogging speed, regardless of wearing experience (EW: Jog vs. Run: 2.50 &#177; 0.14 vs. 3.05 &#177; 0.14, p = 0.010; IEW: Jog vs. Run: 2.24 &#177; 0.26 vs. 2.84 &#177; 0.29, p = 0.028; in m/s) (Table 1). No significant difference in the corresponding jogging/running speeds between EW and IEW was fou...

Watch this Scientific Journal Video about Using Gold-standard Gait Analysis Methods to Assess Experience Effects on Lower-limb Mechanics During Moderate High-heeled Jogging and Running at JoVE.com

Using Gold-standard Gait Analysis Methods to Assess Experience Effects on Lower-limb Mechanics During Moderate High-heeled Jogging and Running

This study investigated lower-limb kinematics and ground reaction force (GRF) during moderate high-heeled jogging and running. Subjects were divided into groups of experienced wearers and inexperienced wearers. A three-dimensional motion analysis system with a configured force platform captured lower-limb joint movements and GRF.

A limited number of studies have explored lower-limb biomechanics during high-heeled jogging and running, and most studies have failed to clarify the ...

The overall goal of this experiment is to observe the effects of high-heeled shoes on lower limb mechanics during moderate high-heeled jogging and running. This method can answer the key question that in high-heel exercise, interference, such as the elevation that the heel has, may not be the single main factor causing the attenuators of the low limb mechanics. The one feature of this protocol is that with the variety of participants as experienced and inexperienced subjects, which has been readily considered in previous high heeled studies using their guardist and their method.Begin by measuring the subject's standing height and body mass. Measure the distance between the superior iliac spine and the ankle internal condyle, the distance between the medial and lateral knee condyles, and the distance between the medial and lateral ankle condyles using measuring calipers. Next, palpate to identify anatomical landmarks.Label each landmark on the skin using a marking pen and then attach the 16 passive retro-reflective markers on the landmarks of both sides of the lower limbs with double-sided adhesive tape. Ask the subject to change into the experimental shoe. Then have them walk, jog, and run freely along the runway until they are physiologically and psychologically comfortable with the cameras and markers on their lower limbs, and they feel like they are moving naturally.Next, ask the subject to practice jogging along the runway at a comfortable low speed until they are able to jog steadily. Instruct them to make an effort to jog at a progressively increasing speed on a treadmill within a safe and comfortable range, known as Progressive Training. Then, have them practice running on the ground along the runway at a comfortable high speed until they are able to run steadily at this speed.Finally, instruct the subject to try to start jogging from different starting lines within the starting area several times, to find an appropriate starting position, ensuring that the right foot naturally strikes and completely contacts the force platform when passing by. Begin by asking the subject to stand in a stationary, neutral pose in the center of the capture volume to capture the static data. Click the start button in the subject capture section to capture approximately 150 frames.Then, click the stop button. Next, select static in the pipeline pull-down list in the subject calibration section. Check the left foot and the right foot options in the static settings pane.Click the start button in the subject calibration section. Then, ask the subject to stand at the appropriate starting position. Click the start button in the capture section to begin capturing and then immediately give the subject the oral instruction to go jogging.Ensure that the right foot naturally strikes and completely contacts the force platform when passing by. For jogging trials, ask the subjects to jog at the comfortable low speed that they were familiar with during preparation. For running trials, ask the subjects to run at the comfortable high speed that they had been familiar with during preparation.Allow for a two minute rest between two trials. Finally, after the subject comes to the end of the runway, click the stop button. These results indicated that, except for the knee and hip motions in the sagittal plane, all three joint range of motion of IEW was generally greater than that of EW.Significant speed effect on joint range of motion only existed in the hip-flexion extension.The GRF time curve of EW is characterized by an initial peak immediately followed by a small wave during the shock absorption period, particularly during running. In contrast, that of IEW is relatively fluent after the initial peak. There is no significant difference in the impact force between EW and IEW, but the loading rate of EW was significantly higher during running.While attempting this procedure, it's important to remember to recalibrate the cameras reading the capture volume and to calibrate the first parameter to their own level before starting each and every trial to ensure the capture accuracy. Following this procedure, other parameters, such as joint momentum, can be calculated in order to answer additional questions, like whether wearing high-heeled shoes would factor in other accuracy and measurements of only other accuators. Of these, the value meant that this math ought to emphasize the importance of the allocating their subjects wearing experience of the high-heeled shoes to provide more specific information and reducing the inferring to target the population.After watching this video, you should understand how to use or understand the math or to perform the experiment with the high heel and get the accuracy as well as criteria suggests based on the different wearing experience.

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Research

JoVE Journal

Behavior

9.0K visualizações.  Ningbo University. The overall goal of this experiment is to observe the effects of high-heeled shoes on lower limb mechanics during moderate high-heeled jogging and running. This method can answer the key question that in high-heel exercise, interference, such as the elevation that the heel has, may not be the single main factor causing the attenuators of the low limb mechanics. The one feature of this protocol is that with the variety of participants as experienced and inexperienced subjects, which has been r...