IDF21-0164 Effect of stimulating footwear on gait and posture in people with Diabetes and foot complications

Abstract

Background: The maintenance of human posture and gait requires the central integration of afferent information and is highly dependent on the somatosensory information from the plantar cutaneous mechanoreceptors. Normal foot structure sends undistorted signals to the brain due to the proper stimulation of mechanoreceptors in the foot soles and therefore brain responds properly by adjusting the skeletal framework into good posture. In the case of abnormal foot structure, the brain receives distorted signals due to poor stimulation of mechanoreceptors. As a result, the brain generates alternate signals to deal with these abnormalities, resulting in poor gait and posture. Aim: The main intention of this study was to develop a new footwear with ultrasonic sensors that emit ultrasonic waves at a lower frequency of 35 kHz to properly stimulate plantar mechanoreceptors. The objective of this study was to evaluate the effect of the above footwear on gait and posture of people with diabetic neuropathy, with foot deformity (bow knee, bilateral genu valgum, leg length discrepancy, abnormal foot arch) and also with foot and/or joint discomfort after 15days of wearing it for 10minutes each day. Method: A total of 5 (3 men and 2 women) subjects volunteered for this study. Informed consent was obtained from each participant. Subjects were prepared using a specialized wireless inertial sensor as per the protocol and were asked to walk freely on the sensorized platform for measuring their plantar pressure and also their spatial temporal parameters. Data was captured using Plantar pressure measuring device and wearable inertial system (BTSBioengineering, Italy). For data analysis, three trials were recorded. A single best trial was selected for processing and reporting. After completion of the initial assessment, subjects were asked to wear the test footwear as a therapy for 10 minutes every day for 15 days. When the switch is on the sensors will emit ultrasound at a frequency of 35 kHz. Following the completion of the 15-days, the subjects were re-evaluated using plantar pressure measuring device and wearable inertial system. Then a comparison was made between the data collected before and after therapy. Results: See Table 1 and Table 2.Table 1Results of Spatial temporal data before and after the therapy. Open table in a new tab Table 2Results of Plantar pressure data before and after the therapy. Open table in a new tab Discussion: The spatiotemporal data, in Table 1, shows a considerable improvement after using the developed footwear. There was a considerable decrease in double limb support time and increase in single limb support, indicating that the subject was able to minimize the contact time of the foot during walking which significantly minimizes foot plantar pressure loading which is the precursor of diabetic foot ulcer. Also, there was a significant increase in cadence and gait velocity after completion of therapy. The plantar pressure data, in Table 2, indicates an increase in the foot contact area which significantly improve the foot pressure distribution, leads to reduction in peak plantar pressure. Also, there was a shift in the maximum pressure from lateral foot to medial foot which shows the distribution of body weight shifted from lateral to medial which is the sign for good posture.