The influence of shoe heel height on the muscular activity of the thigh during walking

Amputees are often restricted to wearing shoes that have a fixed heel height and, if using shoes with different heel heights, require adjustments to the alignment of the prosthetic device. In order to gain insight into the differences in muscular activity that transtibial amputee patients experience when using shoes with different heel heights, a virtual model, close to the physical characteristics of a transtibial amputee, was obtained by modifying an existing musculoskeletal model. The muscular activity obtained from the muscles attached to the thigh was higher in the case of the residual limb than in the case of the intact leg. A compensatory mechanism, similar to the one described in the literature [10], was obtained by using the amputee musculoskeletal model. Small differences related to the intensity of the muscular activity were obtained when a higher heel was used. The differences were mostly due to the increased use of the muscles needed for balancing the body, and less to the use of muscles needed for body propulsion.