title: Heel lifts and the stance phase of gait in subjects with limited ankle dorsiflexion.
abstract: BACKGROUND
  Heel lifts are often prescribed as part of the treatment program for patients with overuse injuries associated with limited ankle dorsiflexion. However, little is known about how joint kinematics and temporal variables are affected by heel lifts.
  
  
  OBJECTIVE
  To determine the effects of heel lifts on selected lower extremity kinematic and temporal variables during the stance phase of gait in subjects with limited ankle dorsiflexion.
  
  
  METHODS
  Two-way, fully repeated-measures design. The 2 factors were side (right or left) and walking condition (shoes alone, 6-mm heel lifts in shoes, 9-mm heel lifts in shoes).
  
  
  METHODS
  University biomechanics laboratory.
  
  
  METHODS
  Twenty-six volunteers (21 females, 5 males) with no more than 5 degrees of ankle joint dorsiflexion.
  
  
  METHODS
  Subjects were tested in shoes alone and in shoes with 6-mm and 9-mm heel lifts.
  
  
  METHODS
  We used the Qualisys Motion Analysis System to measure ankle dorsiflexion excursion, maximal knee extension, and time to heel off during the stance phase of gait under the 3 walking conditions.
  
  
  RESULTS
  On the right side, ankle dorsiflexion excursion increased significantly with the 6-mm and 9-mm heel lifts compared with shoes alone (P < .05). On the left side, ankle dorsiflexion increased significantly with the 9-mm heels lifts over shoes alone and with the 9-mm heel lifts compared with the 6-mm heel lifts (P < .05). Time to heel off increased significantly for walking with the 9-mm heel lifts compared with shoes alone (P < .05). No differences were noted for maximal knee extension (P > .05).
  
  
  CONCLUSIONS
  Clinicians may consider prescribing heel lifts for patients with limited dorsiflexion range of motion if increasing ankle dorsiflexion excursion and time to heel off during the stance phase of gait may be beneficial.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA. majohan@emory.edu
authors.forename: Marie A
authors.initials: MA
authors.lastname: Johanson
authors.forename: Alanna
authors.initials: A
authors.lastname: Cooksey
authors.forename: Caroline
authors.initials: C
authors.lastname: Hillier
authors.forename: Heather
authors.initials: H
authors.lastname: Kobbeman
authors.forename: Amy
authors.initials: A
authors.lastname: Stambaugh