Evaluation of dynamic posture control when wearing high-heeled shoes using star excursion balance test

Abstract

High-heeled shoes increase the difficulty of maintaining balance. The aim of this study was to evaluate the dynamic posture control when wearing high-heeled shoes using star excursion balance test (SEBT) in combination of plantar pressure measurement. 20 healthy young females volunteered to participate in the test. Participants completed the modified three directions including anterior, posteromedial, and posterolateral in the SEBT. Three different types of shoes were used: Flat (0.8 cm), Low (4.0 cm), High (6.6 cm). A Novel Pedar insole system was used to measure peak pressure, contact area and pressure-time integral of the stance limb. Results showed that normalized excursion distance decreased significantly as heel height increased. The changes of plantar pressure in the SEBT as heel height increased were more obvious in MF, MM, MR and ML areas. Plantar loading of stance limb shifted to medial forefoot to reduce posture instability. Knowledge of this study identified dynamic posture control deficits when wearing high-heeled shoes and the critical role of medial forefoot in posture control, providing a basis for further research of improving the ability of dynamic balance.