The Mechanically Destabilizing Effect of Increased Heel Height in Women Is Not Enhanced by Dual-Task Interference

Postural balance deteriorates as heel height increases, but the dual-task interference effect has not been investigated. This study investigated the influence of two concurrent cognitive tasks on balance performance while wearing shoes with different heel heights. We hypothesized that the concurrent cognitive demands’ effect on balance deterioration would be more pronounced in shoes with increased heel height. Twenty-one women (21-54 years) were assessed for quiet stance balance performance while wearing shoes with low-, medium-and high-heel height. Cognitive interference on balance performance was investigated by a dual task condition using a short memory (COGN_A) and verbal fluency (COGN_B) task. Balance performance was quantified by measuring centre of pressure (CoP) path length and sway range, while errors made and scores in COGN_A and COGN_B assessed cognitive performance. Postural balance decreased as heel height increased with greater CoP path length and anteroposterior sway for the medium and high heeled shoes (p<0.001). Cognitive load did not affect balance performance, nor was there an interaction between cognitive load and balance with increasing heel height. The results suggest that cognitive load does not limit postural balance with increasing heel height, and that balance is more affected by the increased mechanical demands of heel height.