YOUR HEALTH: How a new shoe could give the boot to a stroke victim’s limp

But will it work for my problems? 

Foot angles outward due to spasticity?  

Lower leg does not swing freely due to spasticity?

YOUR HEALTH: How a new shoe could give the boot to a stroke victim’s limp

Posted 6:45 pm, March 25, 2019, by Jim Mertens, Updated at 06:49PM, March 25, 2019

 

Video at link.

TAMPA, Florida – In the United States every year close to 800,000 people suffer a stroke.
Many are left with a dragging foot.
But doctors are working on an inexpensive way to fix their footing.
"I used to walk three to five miles a day before my stroke and it would be nice if I could just walk a half a mile."
Well Diane Hintz is on the right track.  She's making strides with this patented portable shoe.
It's called the Moterum I Stride device.  It was invented at USF in Tampa.
These doctors have been working for years to get it just right.  And they're almost to the finish line.
"It took a lot of math," said mechanical engineer Kyle Reed.
"A lot of engineering and quite a few different prototypes to get it to work just right."
Many stroke patients are left with a limp because of damage to their central nervous system.  This shoe helps rewire the brain so they can correct their gait.
Doctors say it's more effective and cheaper than the typical split belt treadmill treatment(Does your stroke hospital have this AND the protocol to go with it?) and patients can even bring this home.
"The I-Stride device causes one foot to move backwards while they're walking and this helps to exaggerate one of the feet so it becomes more asymmetric especially when they take it off they have a corrected gait where it's more symmetric afterwards," explained Reed.
"Don't forget the patient is wearing the shoe on their good side," said University of Southern Florida Physical Therapy and Rehabilitation professor Seok Hun Kim.
The shoe is worn on the good side so it forces the bad side to compensate for the irregular walking pattern.
So far the study shows that within four weeks patients can feel a difference.
"The hope is that if you keep doing this every day you train you get a little more equalized in your step length and you're going to start walking faster," said Reed.

NEW TECHNOLOGY: Engineer Kyle Reed said the iStride device causes one foot to go backwards and this exaggerates your existing asymmetry so that you have to compensate for it.   And so you get a little bit less of asymmetry.   When you go back to walking without the iStride device then that little bit of asymmetry is gone because you've already started compensating for it so now you have a more symmetric walking pattern.

USF doctors say typical stroke rehabilitation uses a split belt treadmill.   It is expensive and has to be done in an office setting with trained staff to monitor sessions.
The I Stride could be available to the public in a year.

Early study shows shoe attachment can help stroke patients improve their gait

But would these bouncy shoes be even better? Since my stroke I have no push-off on walking from my affected leg, no clue how to get there.

Shoes that bounce - KANGOO aerobics

The latest here:

 Early study shows shoe attachment can help stroke patients improve their gait

A new device created at the University of South Florida – and including a cross-disciplinary team of experts from USF engineering, physical therapy and neurology – is showing early promise for helping correct the signature limp experienced by many stroke survivors.

Called the Gait Enhancing Mobile Shoe (GEMS), the shoe attachment is the result of multidisciplinary work and expertise in USF's engineering, physical therapy, and neurology programs.
In addition to offering stroke patients good outcomes for improving their gait and balance, a preliminary study is showing the shoe also provides several advantages over a current stroke rehabilitation tool – the split-belt treadmill – including lower cost, greater convenience, and mobility.
"This is early in the process but we're seeing the benefits we expected so it's very promising," said Kyle Reed, PhD, associate professor in the Department of Mechanical Engineering in the USF College of Engineering and principal investigator for the preliminary study on GEMS.
"We really want to help people who are limited in their walking ability to improve enough so they can return to the activities of their daily lives. The long-term hope is that this shoe attachment could be less expensive and safe enough that, once trained on how to use it, patients could take the GEMS home for therapy."

Credit: University of South Florida

Reed developed the GEMS shoe along with Seok Hun Kim, PT, PhD, associate professor in the School of Physical Therapy and Rehabilitation Sciences in the USF Health Morsani College of Medicine and co-principal investigator for the GEMS study. In 2010, Dr. Reed received funding from the National Institutes of Health to conduct a clinical trial of a small group of stroke survivors trying the GEMS; the study is not for severe stroke survivors, but mild to moderate stroke survivors.
The study also includes USF Health stroke expert David Z. Rose, MD, associate professor in the Department of Neurology in the USF Health Morsani College of Medicine, who said he sees the GEMS as a great potential option for stroke patients to improve their mobility.

"Many stroke patients are devastated that their ability to walk on their own can be so limited, even around their own homes," Dr. Rose said. "Early data for the GEMS is very promising and the next phases of study will really help us see its true potential."
Many stroke patients develop an asymmetric gait because of damage to their central nervous system, resulting in difficulty moving their affected leg – they can't extend their foot backward enough, which prevents natural pushing off into the swing phase experienced in an unaffected walk.

Credit: University of South Florida

Typical stroke rehabilitation to improve gait symmetry involves using a split-belt treadmill that offers two independent belts operating at different speeds to exaggerate the asymmetry of the patient's gait.
But an odd yet natural thing happens when patients leave the treadmill – their brain returns to a fixed-floor state and they regress, with many finding it difficult to recreate the gait correction on solid ground, a regression that is called an after effect.
While generally successful for improving stroke patients' gaits, the split-belt treadmill is expensive, requires a dedicated space to house and a qualified staff to monitor sessions and, because of after effect, can require more time for patients to master the correction, said Seok Hun Kim, PT, PhD, associate professor in the School of Physical Therapy and Rehabilitation Sciences in the USF Health Morsani College of Medicine.
"The GEMS allows movement across any safe surface, thus 'rewiring' the brain to learn the new compensation technique for everyday walking, not just for when they are on the treadmill," Dr. Kim said.

Credit: University of South Florida

"The GEMS is generally worn on the unaffected side, helping the patient use their affected side to compensate for the irregular footing."
While early results of this preliminary study are showing strong support for a successful approach to improving the gait of stroke patients, more detailed study with more patients will be necessary. Dr. Kim said a full study, one that compares to the current approach with the split-belt treadmill, is critical before clinicians adjust their approach.

Explore further: American Stroke Association offers new stroke rehabilitation toolkits

Provided by: University of South Florida