Predictors of walking speed and stride length in high- and low-heeled footwear

摘要

Background: Footwear has a profound effect on walking speed, and lower extremity kinematics and kinetics. The purpose of this study is to identify possible predictors of walking speed and stride length in high- and low- heeled footwear. Methods: Thirty-one female subjects, each of whom were screened for lower extremity pain or dysfunction, and were determined not to be regular users of high-heeled shoes, participated in this study. Standardised, appropriately sized low- and high- heeled footwear were provided for all subjects. Euler angles were used to calculate the motion of the distal segment relative to the proximal segment. An inverse dynamics approach was used to calculate the net joint moment and power at the ankle, knee and hip joint. A paired t-test was used to assess the effect of footwear, and stepwise linear regression was performed to identify possible kinematic and kinetic predictors of walking speed and stride length. Results: Use of high-heeled footwear resulted in slower walking speed and shorter stride length. Regression analyses indicated that the most significant predictors of self-selected walking speed in high-heeled footwear were sagittal power generation at the knee, hip flexion, and sagittal power absorption at the ankle. Determinants of stride length when walking in high-heeled footwear included ankle sagittal power generation, hip sagittal range and the hip extension moment. Conclusion: A relatively simple model (three predictors or less) was able to explain 30-60% of the variance in walking speed and stride length. The key findings of our study underscore that altering heel height results in a change in motor strategy and attendant joint contribution used to maintain walking speed and stride length.