BackgroundIt has been proposed that high-heeled shoes may contribute to the development and progression of knee pain. However, surprisingly little research has been carried out on how shoe heel height affects muscle activity around the knee joint. The purpose of this study was to investigate the effect of differing heel height on the electromyographic (EMG) activity in vastus medialis (VM) and vastus lateralis (VL) during a sit to stand activity. This was an exploratory study to inform future research.MethodsA repeated measures design was used. Twenty five healthy females carried out a standardised sit to stand activity under 4 conditions; barefoot, and with heel wedges of 1, 3, and 5 cm in height. EMG activity was recorded from VM and VL during the activity. Data were analysed using 1 × 4 repeated measures ANOVA.ResultsAverage rectified EMG activity differed with heel height in both VM (F2.2, 51.7 = 5.24, p < 0.01), and VL (F3, 72 = 5.32, p < 0.01). However the VM: VL EMG ratio was not significantly different between conditions (F3, 72 = 0.61, p = 0.609).ConclusionWe found that as heel height increased, there was an increase in EMG activity in both VM and VL, but no change in the relative EMG intensity of VM and VL as measured by the VM: VL ratio. This showed that no VM: VL imbalance was elicited. This study provides information that will inform future research on how heel height affects muscle activity around the knee joint.

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Objective The aim of this systematic review was to investigate the efficacy of sensory discrimination training (SDT) on sensorimotor performance in individuals with a neurological condition affecting the central nervous system. Methods MEDLINE, CINAHL, EMBASE, AMED, CENTRAL, PsychINFO, Scopus, OT Seeker, PEDro, ETHOS, Web of Science and OpenGrey were systematically searched for appropriate randomised controlled trials (RCTs). Included studies were assessed for risk of bias, and the quality of the evidence was rated using the GRADE approach. The protocol was registered on PROSPERO (CRD42017055237). Results Six RCTs met the inclusion/exclusion criteria. All studies used manual tactile discrimination to retrain somatosensation. Somatosensory effect sizes (0.12–0.92) and motor function effect sizes (0.12–10.39) ranged from trivial to large with narrative analysis revealing some between-group difference in favour of the intervention group. However, the total sample size ( n = 220) was relatively small, and the quality of the included studies was low. Conclusions SDT may have potential to be an efficacious treatment option for improving sensorimotor performance in individuals with neurological disease. However, at present there is limited evidence on which to base any firm clinical recommendations.

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