Name (Optional) : - Age: - 21 - Yo Height: - 5'1'' - FT Weight: - 100 - Kg/lbs

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Good Day!

We are De La Salle University, Industrial Engineering students working on our thesis regarding the effects of high-heeled shoes specifically to front desk officers. We hope you could take some time to answer our simple survey as this would really help our study progress. Your answers are very much appreciated and will solely be used for the study. Thank you! Name (Optional):___________________________ ___ Age: ___21_ yo Height: ___51__ ft Weight: __100__ kg/lbs
1. Have you undergone a back surgery? Yes, pls. specify when: _____________ 2. Do you have musculoskeletal abnormalities? Yes, pls. specify what: ____________ No No

ASSUMING YOU WORK AS A FRONT DESK OFFICER. You work for 8 hours (exc. breaks) Required to wear at least 2 in closed high-heeled shoes You stand 75%-100% of the time Sit: 25%-50% of the time Walk: 25%-50% of the time

3. Have any of your muscles been injured? Yes, pls. specify the muscle: _________ No

6. What is your priority when buying highheeled shoes for work? Please rank the following, 1 being the highest & 6 the lowest. 2 Aesthetics1 Brand 3 Comfort 6 Made in x 5 Durability4 Price Others: _________________________

4. How often do you wear high-heeled shoes?


How many hours per day? 1/ week 1hr/ day 2/ week 2hrs/ day 1/ mo 3hrs/ day 2/ mo >3hrs/ day

7. In choosing high-heeled shoes for work,


what is your preference when it comes to the characteristics? Please rank your top 3 priority, 1 being the highest. 2 Heel Height Inner lining material 3 Insole material Shoe material 1 Style* Toe box** Type of heels*** Weight Others: __________________________

5. In what body parts have you had trouble


(ache, pain or discomfort)? If yes, please encircle/ highlight the severity, Last 12 months Last 7 days 10 being the Severity Severity most severe. Neck 1 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 9 2 L. Shoulder 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 R. Shoulder 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 L. Elbow 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 R. Elbow 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 L. Wrist/hand 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 2 9 2 R. Wrist/hand 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 2 9 2 Upper back 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 Lower back 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 Hips 1 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 9 2 L. Thigh1 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 9 2 R. *Style strapless 5 6 7 8 1 103 4 5 6 7 8 9 10 Thigh 2 3 4 or not 1 9 2 L. **Toe box2 3 4 5open, 8 1 103 4 5 pointed 9 10 Knee1 close, 6 7 pointed or not 6 7 8 9 2 R. ***Type of heels refer to 1 103 4 5 6 7 8 9type of heels Knee1 2 3 4 5 6 7 8 the 2 9 document entitled 10 L. ****Body 2 3 4 5 6 7 8 1 document entitle body parts Ankle parts refer to the 103 4 5 6 7 8 9 10 1 9 2 R. Ankle 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 L. Foot 1 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 9 2 R. Foot 2 3 4 5 6 7 8 1 103 4 5 6 7 8 9 10 1 9 2 Body Parts

8. What type of heels*** do you prefer for


your work? Please rank your top 3 priority, 1 being the highest.

Chunky Clear Kitten Spool 2 Wedge

Cone Cuban Platform 1 Pump Stiletto

9. What heel height do you prefer for your work if not given any constraints? 1 in 1.5 in 2 in 2.5 in >3 in

TYPE OF HEELS (for reference only)

CHUNKY

CONE

CLEAR

CUBAN

KITTEN

PLATFORM

*Style strapless or not **Toe box close, open, pointed or not pointed ***Type of heels refer to the document entitled type of heels ****Body parts refer to the document entitle body parts

PUMP

SPOOL

STILETTO

WEDGE
BODY PARTS (for reference only)

*Style strapless or not **Toe box close, open, pointed or not pointed ***Type of heels refer to the document entitled type of heels ****Body parts refer to the document entitle body parts

*Style strapless or not **Toe box close, open, pointed or not pointed ***Type of heels refer to the document entitled type of heels ****Body parts refer to the document entitle body parts

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