2. METHODS

METHODS

To perform gait analysis, we recruited two females who were both familiar with walking in heels. The two subjects needed to be similar in height to compare the affect and influence of high heels on their gait cycle. Subject 1 is currently 21 years old, 5'6", 149 lb, and is moderately active. Subject 2 is 21 years old, 5'5", 146 lb, and is also moderately active. Before testing, informed consent was obtained and both participants were free of any notable gait abnormalities. Before recording their strides, neon green markers (stickers) were placed on both individuals' anatomical landmarks on the side closest to the camera (the right side) as they were later used for drawing angles in digitization. The following landmarks were marked: lateral head of the 5th metatarsal of the foot, lateral malleolus of the ankle, lateral epicondyle of the knee, and greater trochanter of the hip.

The footage was recorded in front of Wait Chapel on Wake Forest University's campus. A 2021 iPhone 12, model number MWKV2LL/A was used to record the footage. The phone rested on a 3-foot armrest of a bench approximately 10 ft from the subjects. The camera was leveled using “Bubble Level”, an app from the Apple App Store. The subjects were evaluated through kinematic analysis using videography in the sagittal plane. The participants were asked to perform two trials for each condition. The three conditions consisted of walking barefoot, walking in low high heels (2"), and walking in tall high heels (4"). Both pairs of high heels were Steve Madden Carson block heels, the first pair being 2’’ tall, and the second pair being 4’’ tall. The video analysis software used to analyze the joint angles and their gait was PowerChalk (Raleigh, NC). Using the known height of the subject and a pixel scale provided by PowerChalk, we were able to calculate the step and stride length of the subjects in inches.

Step length was defined by the heel strike of foot 1 to the heel strike of foot 2, while stride length was defined as heel strike of foot 1 to the next heel strike of foot 1. The ankle angle was formed by the lateral head of the 5th metatarsal of the foot, lateral malleolus of the ankle, and lateral epicondyle of the knee. The knee angle was drawn from the lateral malleolus of the ankle, lateral epicondyle of the knee, and greater trochanter of the hip. We compared these joint angles between the different types of footwear and graphed the difference between them to better visualize how high heels affect gait kinematics.

Subject 1 with ankle (1) and knee (2) angle drawn in 4 inch heels.

Subject 2 with ankle (3) and knee (4) angle drawn in 4 inch heels.