SLR - November 2012 - Eoin Gorman(2)
Reference: Filho WT, Dezzotti NRA, Joviliano EE, Moriya T, Piccinato CE. Influence of high-heeled shoes on venous function in young women. J Vasc Surg 2012; 56: 1039-44.
Scientific Literature Review
Reviewed by: Eoin Gorman, DPM
Residency Program: Columbia – St. Mary’s Milwaukee, WI
Podiatric Relevance:
Podiatric physicians are experts in all aspects of the lower extremity including shoe gear concerns. Often, certain types of shoe gear present specific risk factors that can have an effect on lower extremity health and overall quality of life. This study presents a potential mechanism for venous hypertension and complications that may be related to the persistent use of high-heeled shoes. The information presented is valuable for patient education, risk factor awareness and prevention.
Methods:
This study utilized air plethysmography (APG) to measure venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) in 30 asymptomatic women. These women had an average age of 26.4 and a BMI of less than or equal to 25 kg/m2. These measurements were taken during standing heel raises in four situations: barefoot, medium heels (3.5 cm), stiletto high heels (seven cm), and platform high heels (seven cm). The measured values were analyzed and compared among the different groups.
Results:
Residual volume fraction (RVF) was found to be significantly higher in the stiletto, platform and medium heel height groups compared to barefoot. The RVF of the medium heel group was lower than in the stiletto and platform groups, but the result was not significant. The ejection fraction was found to be significantly higher for the barefoot group compared to the three high-heel groups. The venous filling index showed no statistical difference among the groups.
Conclusions:
The results of this study indicate that high-heels produce higher values for residual volume fraction and lower values for venous ejection fraction. These two findings show that increased heel height correlates with reduced effectiveness of the calf-pump mechanism secondary to restrained motion of the ankle and may result in venous hypertension. Venous hypertension is related to consequences such as varicose veins, leg pain and fatigue. This study provides evidence that high-heels may increase the risk for venous complications in the legs.