Immediate Repercussions of High Heels on Spine Posture
Condition: Healthy
Study type: Interventional

Summary: 
      The goal of this cross-sectional study is to evaluate the immediate effect of heels elevation
      on the spine posture in a group of 100 healthy subjects (50 males, 50 females). The main
      question it aims to answer is weather high heels immediately affects spinal posture and
      pelvic position in the sagittal plane.

      Participants will undergo an elevation of 3cm and then 7cm of both heels, while their spine
      posture will be examined by means of a rasterstereography device.
    

Detailed description: 
      The data collected by the rasterstereography device will be:

        1. pelvic tilt angle (PI), the angle determined by the vertical and the tangent to
           lumbosacral junction (ILS);

        2. ITL-ILS lordotic angle, measured between the tangents of the thoracolumbar junction
           (ITL) and the lumbosacral junction (ILS);

        3. ICT-ITL kyphotic angle, measured between the tangents of the cervicothoracic junction
           (ICT) and the thoracolumbar junction (ITL); see fig. 1;

        4. lumbar arrow (FL) horizontal distance in millimeters from the vertical line that passes
           through the kyphotic apex in the lumbar spine;

        5. cervical arrow (FC) (horizontal distance in millimeters from the virtual vertical plumb
           line that passes through the kyphotic apex in the cervical spine);

        6. antero-posterior flexion of the trunk (Trunk Inclination-TI) measured as the angle
           between the vertical line and the line passing through the prominent cervical vertebra
           (VP) to the line connecting the two dimples (DM); see fig. 2.

      Participants will provide information on age, height and weight. A questionnaire will be
      administered to standardize the types of high-heeled shoes used and to verify their frequency
      of use.

      Evaluation Protocol

        1. sample 1: barefoot neutral position;

        2. sample 2: barefoot neutral position;

        3. sample 3: 3 cm rise under both heels;

        4. sample 4: 7 cm rise under both heels.

      The positioning with respect to the measurement system will be carried out according to the
      indications provided by the supplier.

      To standardize the position subjects will be prepared for analysis as follows:

        1. standing, back to the detection system, in a relaxed posture with the knees fully
           extended with bare feet on the floor (neutral position);

        2. bare trunk with pants and briefs lowered to half of the glutei

        3. in the case of long hair, it will be required to tie it with suitable means (cap, hair
           clips, hair bands, etc.) so that the neck is visible up to the hairline;

        4. rings, watches and necklaces will be removed to avoid any interference with light lines
           (necklaces in particular increase this probability).

      In the third survey, the heel will be raised by inserting a plastic bar symmetrically under
      both heels, as proposed in previous studies in which wood was used, by 3 cm; for the fourth
      evaluation it will be 7 cm.

      After the first evaluation in the neutral position, before the evaluation with the heel lift,
      a second evaluation will be performed under the same conditions to evaluate the
      reproducibility of the data. The time between the two assessments will be less than 1 minute
      and the subject will not change position.
    

Intervention name(s): Elevated heels
Intervention type(s): Other
Intervention description(s): Each subject will undergo the following evaluations:
neutral barefoot position;
neutral barefoot position (re-test);
3 cm rise of both heels, made with plastic spacer;
7 cm rise of both heels, made with plastic spacer.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other