Article

There is still conflicting evidence about the effect of high-heeled footwear on
posture, especially if methodological confounders are taken into account. The
purpose of this study was to investigate the effect of high-heeled footwear on
lumbopelvic parameters in experienced younger and middle-aged women while
standing and walking. Thirty-seven experienced younger (n=19:18-25 years) and
middle-aged (n=18:26-56 years) women were included in this randomized crossover
study. Using a non-invasive back shape reconstruction device
(rasterstereography), static (pelvic tilt and lumbar lordosis angle) and dynamic
(pelvic rotation, median lumbar lordosis angle and range of motion) parameters
representing pelvis position and lumbar curvature were measured. In order to
analyse standing and walking on a treadmill (0.83m/s), the effects of high-heels
(7-11cm) were compared to standard control shoes. There were no effects on the
lumbar lordosis angle or range of motion under static or dynamic conditions
(p>0.05, d</=0.06). But there was a small effect for a reduced pelvic tilt
(p=0.003, d=0.24) and a moderate effect for an increased transversal pelvic
rotation (p=0.001, d=0.63) due to high heel shoed standing or walking,
respectively. There were no significant age-group or interaction effects
(p>0.05). Altered pelvic parameters may be interpreted as compensatory
adaptations to high-heeled footwear rather than lumbar lordosis adaptations in
experienced wearers. The impact of these findings on back complaints should be
revisited carefully, because muscular overuse as well as postural load relieving
may contribute to chronic consequences. Further research is necessary to examine
clinically relevant outcomes corresponding to postural alterations.
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