ideal postural alignment is maintained not only by muscle activity but also by muscular 
 forces interacting with the force of gravity while standing1 . biomechanically , joint positioning while standing requires dynamic 
 postural muscle activity to stabilize body posture against the line of gravity2 . therefore , the foot pressure distribution associated with joint positioning may reflect the 
 overall postural alignment required to stabilize body posture within the base of support . high - heeled shoes ( hhs ) disturb the natural function and position of the ankle joint by 
 forcing the foot into plantar flexion , with excessive vertical and shear stress on the 
 medial forefoot3 . recently , many studies 
 have examined the consequences of this positional change in terms of balance , gait , and 
 general well - being . compared to standard hhs , a preliminary study indicated that the revised 
 hhs placed 9.5% less weight on the forefoot and 10.5% more weight on the rearfoot while 
 standing . about 10% of the rearward weight shift while standing was due to lowering of the 
 heel angle by 1015 in the revised hhs design4 . they are intended 
 to normalize physiologic standing posture and walking pattern compared to standard hhs by 
 making use of tunnel technology with excellent shock absorption and a rearward decrease in 
 the wedge angle4 . however , it is not clear 
 how much the revised hhs affect foot pressure distribution in response to altered postural 
 alignment , with an approximate 10% rearward weight shift while standing4 . therefore , this study aimed to investigate the effects of 
 revised hhs on the distribution of foot pressure and center of pressure ( cop ) distance 
 during standing in adult females . twelve adult females ( age : 1825  years ; height : 165.0  4.8  cm ; weight 56.7  5.6  kg ) were 
 examined under 3 conditions : ( 1 ) barefoot , ( 2 ) in standard hhs with 7-cm heels , and ( 3 ) in 
 revised hhs with 7-cm heels . all subjects gave informed consent as required by the 
 institutional review board . in 
 addition , pregnant women or women who had any psychological disorder were excluded . revised 
 hhs were made using tunnel technology with excellent shock absorption and a rearward 
 decrease of the wedge angle . the measured variables were cop distance 
 from the heel end , and the distribution of left rearfoot , left forefoot , right rearfoot , and 
 right forefoot pressures . one way repeated analysis of variance ( anova ) was performed to compare the 3 different 
 conditions for each measurement using the statistical package for the social sciences 
 version 21.0 ( spss inc . , bonferroni adjustment was used for multiple 
 comparisons under the 3 conditions , and p < 0.05 was set to indicate the level of 
 statistical significance . the left rearfoot pressure was 70.50% when barefoot , 29.50% when wearing revised hhs , and 
 24.00% when wearing standard hhs ; there were significant differences between the 3 
 conditions . the left forefoot pressure was 29.50% when barefoot , 70.50% in revised hhs , and 
 76.00% in standard hhs , with significant differences observed between the 3 conditions . the 
 right rearfoot pressure was 69.75% when barefoot , 28.50% when wearing revised hhs , and 
 23.00% when wearing standard hhs ; there were significant differences between the 3 
 conditions . the right forefoot pressure was 30.25% when barefoot , 71.50% in revised hhs , and 
 77.00% in standard hhs , with significant differences present between the 3 conditions . the cop distance was 5.28  0.53  cm when barefoot , 10.43  1.75  cm when wearing revised 
 hhs , and 12.23  1.03  cm when wearing standard hhs ; there were significant differences 
 between the 3 conditions in the results of one - way repeated measures anova for the change of 
 cop distance ( sum of squares = 329.07 , degree of freedom = 2 , f = 2749.45 , p < 0.01 ) . wearing hhs results in an anterior and medial shift of forces within the foot ; forefoot 
 forces increase , and the force concentration , shear stress , and loading rate at the first 
 metatarsal head dramatically increase , while those over the fifth metatarsal head 
 decrease3 , 5,6,7,8 . this change in force 
 distribution ( as well as the often tight - fitting toe box of hhs ) has been linked to forefoot 
 deformities such as hallux valgus3 , 6,7,8,9,10 , and a correlation between heel height and 
 hallux valgus prevalence has been inferred11 . other foot conditions linked to hhs include corns and calluses , 
 metatarsalgia , achilles tendon tightness , plantar fasciitis , and haglund s deformity , a 
 protrusion on the back of the calcaneus due to increased calcaneal pressure12 . in this study , we aimed to investigate 
 the effects of revised hhs on the distribution of foot pressure and cop distance during 
 standing in adult females . hhs induce greater plantar flexion , whereas flat heels induce greater dorsiflexion of the 
 ankle . therefore , compared to women wearing hhs , those wearing flat shoes use specific 
 muscles more and shift their bodies anteriorly . the distribution of foot pressure moved from 
 the rearfoot to the forefoot as the heel height increased . the peak pressures on the 
 forefoot were 2.32.5 times greater than those on the rearfoot in subjects wearing hhs . increasing the heel height shifted the distribution of foot pressure toward the forefoot and 
 altered the biomechanics5 . our study 
 showed significant differences in the distribution of foot pressure between the 3 
 conditions , and wearing revised hhs was associated with less pronounced changes than wearing 
 standard hhs . in particular , it seems that the excellent shock absorption and rearward 
 decrease of the wedge angle achieved by using tunnel technology resulted in a more normal , 
 physiologic standing posture and static balance when wearing revised hhs , compared to 
 wearing standard hhs4 . thus , the pressure 
 on the rearfoot was higher in the current study , whereas the pressure on the forefoot was 
 lower . our study showed significant differences in cop distance changes 
 between the 3 conditions , and these changes were less for revised hhs than for standard hhs . our 
 findings support the premise that wearing revised hhs seems to normalize physiologic 
 standing posture more than standard hhs . further research should be conducted , and the 
 effect of revised hhs on posture should be examined in a larger number of subjects , using 
 kinetics and kinematic methods . the location of cop between the two lower limbs and the fore - rear distribution of foot 
 pressure were significantly different under the 3 conditions . our findings support the 
 premise that wearing revised hhs seems to provide enhanced physiologic standing posture 
 compared to standard hhs .
[ purpose ] revised high - heeled shoes were developed to minimize foot deformities by 
 reducing excessive load on the forefoot during walking or standing in adult females , who 
 frequently wear standard high - heeled shoes . 
 specifically , this study aimed to investigate 
 the effects of revised high - heeled shoes on foot pressure distribution and center of 
 pressure distance during standing in adult females . [ subjects and methods ] twelve healthy 
 adult females were recruited to participate in this study . 
 foot pressures were obtained 
 under 3 conditions : barefoot , in revised high - heeled shoes , and in standard 7-cm 
 high - heeled shoes . 
 foot pressure was measured using the tekscan hr mat scan system . 
 one - way repeated analysis of variance was used to compare the foot pressure distribution 
 and center of pressure distance under these 3 conditions . 
 [ results ] the center of pressure 
 distance between the two lower limbs and the fore - rear distribution of foot pressure were 
 significantly different for the 3 conditions . 
 [ conclusion ] our findings support the 
 premise that wearing revised high - heeled shoes seems to provide enhanced physiologic 
 standing posture compared to wearing standard high - heeled shoes .