Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 33,991 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
Don't accept this tyranny of low expectations from anyone. You also need to be able to tie those shoes, because you can't walk in sandals or flats forever.
This post was written by Nicole Potter, BSN, RN, stroke coordinator, Parkview Hospital Randallia and community hospitals, Parkview Neurosciences.
After a stroke, many patients believe recovery ends when they leave the hospital. Stroke recovery doesn’t end at discharge; it is only the beginning.
Post-stroke fatigue is real. The brain and body must work harder to relearn skills that once came naturally, which often leaves patients feeling too tired for therapy. But even when energy is low, therapy is gold, and continuing movement is critical for recovery.
Therapy doesn’t only happen in a rehab gym. It happens in everyday life:
Putting on your own shoes
Getting dressed
Walking through the house
Going to the store
Getting out of the house
The days and weeks after a stroke are a crucial window for healing. Movement helps the brain rewire and supports long-term recovery. That’s why participating in therapy during hospitalization and continuing it after discharge is so important.
I encourage patients and families to learn as much as possible during the hospital stay. Watching therapy sessions, asking questions and understanding safe movement helps carry recovery forward at home.
Formal therapy may end, but recovery does not. Daily movement becomes therapy, small efforts matter and progress continues long after discharge. Movement is medicine.
By understanding the importance of post-stroke therapy and supporting even small daily activities, we can empower survivors to keep moving forward. Whether it’s formal therapy or simply putting on your shoes, every movement matters and recovery continues one step at a time.
In a rural village near Guadalajara, Mexico, Maria Magdalena
Valencia Juares, known as Elena, has to climb 120 stairs to get to her
home on the top of a hill. It's a source of exercise for the 70-year-old
and the connection to her longtime community below. But a stroke in
2021 left her isolated in her 1,000-square-foot home. Her feet, too
unsteady for stairs; her state of mind, declining with the compounded
loneliness caused by the COVID-19 pandemic.
Valencia Juares wasn't formally educated, so her world depends on social interaction. However, the muscle weakness
caused by her stroke and the risk of falling made that difficult to
obtain. Her family lives thousands of miles away, her daughter Noemi
Armenta in Los Angeles, and her unofficially adopted daughter, KC
Hostetler, in Alaska. They saw from afar the toll Valencia Juares's
stroke was having on her mental health and started searching for
solutions in the United States.
"I had not been able to get back to Mexico because of COVID, so it
had been a while since I was able to see her," Hostetler said. "By the
time I reached her, she was in a really tough spot mentally and she was
in a depression. We talked about how we can fix this, and she said she
needed something that could stabilize her leg."
"Before the iStride treatment, I was isolated. Every day was a
struggle, and I became desperate and very sad," Valencia Juares said. "I
taught myself to get around the best I could so that I could try to do
chores. I felt like such a burden. It was very hard."
Hostetler found information online about the iStride device, invented
and patented by Kyle Reed, associate professor of mechanical
engineering at USF, and licensed by Moterum Technologies Inc. The
iStride is a portable, lightweight device designed for stroke patients
that helps improve their walking ability. It straps over the patient's
shoe on the good side of their body and the specially designed wheels
generate a corrective motion during each step. Repeated use results in
the stroke-impacted leg getting stronger and an improved gait once the shoe is removed.
After
months of coordination, Hostetler and Armenta brought their mother to
North Carolina to get therapy on the iStride device. They practiced what
many take for granted—shifting from a sitting to standing position and
walking. They walked up and down the halls over and over again on the
iStride device, soon able to walk without a cane.
"The iStride gait device challenges the wearer by destabilizing the
unimpaired leg, promoting increased use of the affected side," Reed
said. "This changes the gait pattern so walking becomes easier after
each session with an increased gait speed and reduction in gait
asymmetry."
Credit: Molly Menchen, University Communications and Marketing
After about a month of therapy on the iStride, Valencia
Juares returned home to Mexico, climbed all 120 stairs, and danced
ecstatically when she got to the top.
"She was dancing. She hasn't danced in years, and being able to
express that sense of joy since her incident has been really amazing,"
Hostetler said. "It's been amazing to see that transformation, she's
much more like the person we knew before the stroke."
Valencia Juares's success story is far from anecdotal. Reed just published a study in the academic journal Frontiers in Neurology
that examined the long-term impact of the iStride on gait speed in
stroke survivors. The research team worked with 18 individuals who
suffered a stroke, averaging within the last five years. Each patient
received three, 30-minute therapy sessions a week for four weeks and had
their gait checked several times over the course of the following year.
The
results were rapid, with gait speed up an average of 50% within one
month of starting therapy. What's even more remarkable, the improvements
remained mostly unchanged one year after the iStride therapy sessions
concluded. The average patient is now walking 0.21 meters per second
faster than they were before the start of the study, averaging 0.74
meters per second. According to the National Institutes of Health, the
walking speed of an average healthy adult ranges between 0.9 and 1.3
meters per second.
Reed says this is one of the greatest improvements ever recorded in
an academic journal that's focused on enhancing gait speed in stroke
survivors. He's published several related studies since he patented the
iStride a few years ago—one dedicated to using the iStride at home—but
this was by far the toughest paper to place.
"The paper was initially rejected because one of the early reviewers
stated that the gait speed improvement was way beyond what had
previously been reported in the literature," Reed said. "Showing the
reviewers videos of the subjects walking before and after therapy helped
them understand the dramatic difference."
"Moterum is shifting the paradigm of stroke.
Hope is a powerful tool," said Lauren S. Rashford, president of Moterum
Technologies. "Providing personalized journeys and meeting each patient
where they are at allows us to create a relationship that has been
proven to instill and expand hope in each life."
More information:
Brianne Darcy et al,
One-year retention of gait speed improvement in stroke survivors after
treatment with a wearable home-use gait device, Frontiers in Neurology (2024). DOI: 10.3389/fneur.2023.1089083
But are these other shoes better? WHOM do we go to to get that simple question answered? With NO leadership and NO strategy, NOTHING EVER GETS SOLVED IN STROKE!
The purpose of the study was to observe the immediate
changes on gait speed and qualitative gait parameters with and without
the use of additional shoe raise on unaffected lower limb in poststroke
hemiparetic patients.
MATERIALS AND METHODS:
Thirty-one participants with chronic
stroke from SBB College of Physiotherapy, of either gender (40–70
years), able to walk 20 m with or without external aids were included in
the study by purposive sampling. Patients with severe spasticity, fixed
contractures, and audio, visual, or perceptual impairments were
excluded from the study.(So cherry picking your better patients. There is this goal of 'leave no survivor behind'. You failed that goal!)An observational study was conducted where
patients were tested under two conditions – pre- and postinserting a 1.5
cm shoe raise on the unaffected limb. Patients explained the nature of
the study, and a 10-m walk test was performed along with video recording
from anterior, posterior, and lateral views, which were later analyzed
using Wisconsin Gait Scale (WGS).
RESULTS:
The mean age was 52.903 ± 8.423 and poststroke duration
was 28.806 ± 1.836. Out of 31 patients, 20 were male and 11 female; 17
patients had right-sided hemiparesis, in 14 left-sided hemiparesis, out
of which 26 were chronic and 5 were acute poststroke patients. Values
for pre- and postscores of WGS were Z = −4.88, P = 0.000, and scores for speed were Z = −4.89, P = 0.000.
CONCLUSION: From this study, it has been concluded that shoe
raising, given on unaffected lower limb to hemiparetic patients, has
shown a significant difference in pre- and postgait qualitative
parameters and speed in both males and females of age group 40–70 years.
Neeti Jariwala, Shraddha Diwan, Nehal Shah Department of Neurorehabilitation, SBB College of Physiotherapy, Ahmedabad, Gujarat, India
This was easy before, even if I had to hop around a bit to stay upright. I'm not sure that I could even slip into Zeba shoes standing up.
I pretty much failed the Berg Balance Scale all the time because I could never stand long enough one-legged on my affected side. It says it is objective but nothing about it is objective. I thought this test was totally fucking worthless, because it was tested all the time and I NEVER received ANY PROTOCOLS to address the balance issues.
What other shoes is your hospital using in your walking rehab?
Ask
your stroke hospital which shoes they have already tested and
which one of these they like. No testing, you have an incompetent stroke
hospital doing nothing for stroke survivors. That should get me lots of
angry replies.
A therapeutic shoe engineered to improve
stroke recovery is proving successful and expected to hit the market by
the end of the year. Clinical trials have been completed on the U.S.
patented iStride device, which is licensed by Moterum LLC, a startup
company located in the University of South Florida (USF) Research Park.
Its results were just published in the Journal of NeuroEngineering and Rehabilitation.
Stroke sufferers experience muscle weakness or partial paralysis on
one side of the body, which greatly impacts how they walk, known as
gait. Gait asymmetry is associated with poor balance, a major cause of
degenerative issues that make individuals more susceptible to falls and
injuries.
The iStride device is strapped over the shoe of the good leg and
generates a backwards motion, exaggerating the existing step, making it
harder to walk while wearing the shoe. The awkward movement strengthens
the stroke-impacted leg, allowing gait to become more symmetrical once
the shoe is removed. The impaired foot wears a matching shoe that
remains stationary.
"The backward motion of the shoe is generated passively by
redirecting the wearer's downward force during stance phase. Since the
motion is generated by the wearer's force, the person is in control,
which allows easier adaptation to the motion," said developer Kyle Reed,
PhD, associate professor of mechanical engineering at USF. "Unlike many
of the existing gait rehabilitation devices, this device is passive,
portable, wearable and does not require any external energy."
"The importance of over-ground gait training has been emphasized in
previous studies," said Seok Hun Kim, PT, PhD, research collaborator and
associate professor in the School of Physical Therapy and
Rehabilitation Sciences in the USF Health Morsani College of Medicine.
"However, the training options available after stroke are very limited.
This novel device allows gait rehabilitation in the environment of daily
activities."
The trial included six people between ages 57 and 74 who suffered a
cerebral stroke at least one-year prior to the study. They all had
asymmetry large enough to impact their walking ability. Each received
twelve, 30-minute gait training sessions for four weeks. With guidance
from a physical therapist, the patients' gait symmetry and functional
walking were measured using the ProtoKinetics Zeno Walkway system in the
Human Functional Performance Laboratory at USF.
All participants improved their gait's symmetry and speed. That
includes how long it takes to stand up from a sitting position and walk,
as well as how long it takes to walk to a specific location and
distance traveled within six minutes. Four improved the percentage of
time spent in a gait cycle with both feet simultaneously planted on the
ground, known as double limb support. As far as the other two that
didn't improve, one started the study with severe impairment, while the
other was highly functional. It's also important to note that three
participants joined the study limited to walking in their homes.
Following the trial, two of them could successfully navigate public
venues.
Reed and Kim compared their method to a previous study conducted on
split-belt treadmill training (SBT), which is used to help stroke
patients improve their gait. The equipment allows the legs to move at
different speeds, forcing the patient to compensate in order to remain
on the treadmill. While the SBT improves certain aspects of gait, unlike
the iStride, it doesn't strengthen double limb support. That research
concluded only about 60 percent of patients trained on the SBT corrected
their gait when walking in a normal environment.
Walking is context dependent where visual cues impact how quickly one
tries to move, and in what direction. The iStride allows patients to
adjust accordingly. Movement on a treadmill is predictable and provides
individuals a static scene.
Since patients are often disappointed in their progress after being
discharged from rehabilitation, the iStride's portability allows
patients to relearn to walk in a typical setting more often and for a
longer duration. Reed and his collaborators are now working on a
home-based clinical trial with 21 participants and expects to publish
results within the next year. He recently received a Fulbright
scholarship to conduct research at Hong Kong Polytechnic University.
He's working in the rehabilitation sciences and biomedical engineering
departments throughout the 2019-2020 academic year.
Seok Hun Kim, David E. Huizenga, Ismet Handzic, Rebecca Edgeworth
Ditwiler, Matthew Lazinski, Tyagi Ramakrishnan, Andrea Bozeman, David Z.
Rose, Kyle B. Reed. Relearning functional and symmetric walking after stroke using a wearable device: a feasibility study. Journal of NeuroEngineering and Rehabilitation, 2019; 16 (1) DOI: 10.1186/s12984-019-0569-x
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.
Interesting that this is put on the good foot, similar to this? This probably would do nothing for me, the spasticity turning my foot out and lack of a free swinging lower leg wouldn't be corrected by this.
"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," she said.
Hintz is making strides with a patented portable shoe. It's called the Moterum iStride device. It was invented at the University of South Florida in Tampa. 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, a lot of engineering and quite a few different prototypes to get it to work just right," said Kyle Reed, an associate professor of mechanical engineering at USF.
Many
stroke patients are left with a limp because of damage to their central
nervous system. The shoe helps rewire the brain so they can correct
their gait. Doctors said it's more effective and cheaper than the
typical split belt treadmill treatment, and patients can even take it
home.
"The iStride 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," Reed
continued. "They have a corrected gait where it's more symmetric
afterwards."
"Don't forget the patient is wearing the shoe on their good side," said Seok Hun Kim, an associate professor of physical therapy and rehabilitation sciences at USF.
I normally would have said I don't drag my affected toe as I walk. Obviously wrong, I do notice going down hill it doesn't clear very well. This is an Italian shoe I bought in Madrid 1.5 years ago. It just means I can replace this shoe as I travel to Portugal in October.
Freezing of gait, an absence of forward progression of
the feet despite the intention to walk, is a debilitating symptom of
Parkinson's disease. Laser shoes that project a line on the floor to the
rhythm of the footsteps help trigger the person to walk. The shoes
benefit the wearer significantly, according to research by the
University of Twente and Radboud university medical center, which will
be published on December 20 in Neurology, the scientific journal of the
American Academy of Neurology.
Walking problems are common and very disabling in Parkinson’s
disease. In particular, freezing of gait is a severe symptom which
generally develops in more advanced stages. It can last seconds to
minutes and is generally triggered by the stress of an unfamiliar
environment or when medication wears off. Because the foot remains glued
to the floor but the upper body continues moving forward, it can cause
the person to lose her balance and fall. Lines on the floor
Parkinson patient experience a unique phenomenon. By consciously
looking at objects on the floor, such as the lines from a zebra crossing
(‘visual cues’), and stepping over them, they are able to overcome
their blockages during walking. This activates other circuits in the
brain, hereby releasing the blockages and allowing the person to
continue walking. This is why patients often make use of floor tiles at
home. With the laser shoes, these useful cues can be continuously
applied in everyday life, to walk better and safer. The principle behind
the laser shoes is simple: upon foot contact, the left shoe projects a
line on the floor in front of the right foot. The patient steps over or
towards the line, which activates the laser on the right shoe, and so on
(see videos below the text). Beneficial effect
The present research study shows a beneficial effect in a large group
of patients. The number of 'freezing' episodes was reduced by 46% with
the use of the shoes. The duration of these episodes was also divided by
two. Both effects were strongest in patients while they had not taken
their medication yet. This is typically when patients experience the
most problems with walking. But an improvement was also seen after the
patients had been taking their medication. Daily environment
"Our tests were administered in a controlled lab setting with and
without medication," says researcher Murielle Ferraye. " Further
research in their everyday environment is necessary. We plan on testing
this using laser shoes that in the meantime came on the market." Activating the laser
Of the nineteen patients who tested the shoes, the majority would be
happy to use them. The patients did not seem to mind that the laser was
activated for each single step. "Ideally, the laser should only be
activated once the blockage is detected, but we're not quite there yet,"
says Ferraye. "Freezing is a very complex phenomenon."
Murielle Ferraye, who developed the laser shoes, conducted her study
at the Donders Institute at Radboud university medical center and the
MIRA Institute for Biomedical Technology and Technological Medicine at
the University of Twente. Videos Video 1: Patient walking with laser shoes turned off (https://www.youtube.com/watch?v=22bzNDq4AJA) Video 2: PAtient walking, but now with laser shoes turned on (https://www.youtube.com/watch?v=GT5QHX07HrY) https://www.radboudumc.nl/en/news-items/2017/laserschoen-voorkomt-blokkade-bij-parkinson
Attached files
Figure1: laser shoes
Full bibliographic informationThe laser shoes
Claudia
Barthel, Jorik Nonnekes, Milou van Helvert, Renée Haan, Arno Janssen,
Arnaud Delval, Vivian Weerdesteyn, Bettina Debû, Richard van Wezel,
Bastiaan R. Bloem, Murielle U. Ferraye
Neurology Dec 2017, 10.1212/WNL.0000000000004795; DOI: 10.1212/WNL.0000000000004795
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.
Since I'm with three women shoe stores were regularly visited, I bought two pair, The Geox ones have elastic laces, no tying needed. They were fairly tight and the plastic shoe horn from the first hotel was not strong enough, but fingers worked well enough. I wore them the last 10 days of the trip. Threw out the two pairs of shoes I brought since my luggage did not have enough room, had to have one of the women carry back my bottle of wine I was bringing back.
One of the most exciting
developments in footwear this year is the appearance of auto-lacing. The
technology of a self-lacing shoe was first imagined up by Tinker
Hatfield, the legendary sneaker designer who brought us most of the
first dozen Air Jordans. He fabricated the idea for Back to the Future: Part II,
predicting future footwear that laced itself. The shoe became the Nike
Mag, a sneaker so far ahead of its time that none but the dreamers ever
thought that it would be possible. It's true that technology develops at
exponential rates, but it was still a shock when Nike filed patents for auto-lacing in 2010. Something that seemed impossible just two decades years earlier was suddenly looking like a realistic possibility.
Then nothing happened.
There
were a few rumors here and there, but nothing materialized. Filing
patents for impractical technology happens all the time; it's standard
corporate development defense. But the hope of the masses was that this
was more than a shrewd corporate move. The following year Nike released a
version of the Mag via auction as a way to raise money for the Michael
J. Fox Foundation. It quickly became a hot commodity, but it didn't have
auto-lacing. Fans were sure they would get a piece of history. They
didn't.
On May 3 of this year, it happened again. A patent was published by Nike for a "motorized footwear lacing system," everything that auto-lacing would require.
Fans
were excited but did their best not to get their hopes up; they'd seen
this before. Then the announcement came: Auto-lacing was real.
The technology was to be introduced on a different, previously unknown pair of shoes: the HyperAdapt 1.0,
which releases on December 1. The shoes feature auto-lacing that
employs a sensor under the midfoot that automatically tightens the
system when you put your foot in the shoes (it also lights up). Buttons
on the side of the sneakers allow you to tighten and loosen for a
dialed-in fit.
The auto-lacing unit on the HyperAdapt 1.0.
Nike
Although the HyperAdapt isn't the Mag, in a way it is
the Mag. The Mag was a vision of our future—something designed for a
movie, but not reality. That's fine. Plenty of artists imagine
impossible futures not only because of the limits of technology but
because of how cultural forces change over time. The HyperAdapt was
designed not as a fantasy but as a sneaker that would be wearable for
the average consumer. The Nike Mag is impractical. The HyperAdapt,
however, was made to be worn.
“Innovation at Nike is not about dreaming of
tomorrow. It’s about accelerating toward it,” says Tinker
Hatfield. “We’re able to anticipate the needs of athletes because we
know them better than anybody. Sometimes, we deliver a reality before
others have even begun to imagine it.”
Welcome the Nike HyperAdapt 1.0, the first
performance vehicle for Nike’s latest platform breakthrough, adaptive
lacing. The shoe translates deep research in digital, electrical and
mechanical engineering into a product designed for movement. It
challenges traditional understanding of fit, proposing an ultimate
solution to individual idiosyncrasies in lacing and tension preference.
Functional simplicity reduces a typical athlete
concern, distraction. “When you step in, your heel will hit a sensor and
the system will automatically tighten,” explains Tiffany Beers, Senior
Innovator, NIKE, Inc., and the project’s technical lead. “Then there are
two buttons on the side to tighten and loosen. You can adjust it until
it’s perfect.”
And just when the hell will stroke survivors get a walking protocol? These earlier posts have obviously not done one bit of good getting to useful stroke walking analysis and rehab. With NO stroke leadership following up a stroke strategy it takes decades longer to get something useful for survivors. With this objective analysis of walking problems maybe we can finally get stroke protocols that address those problems. Rather than the craptastic support I got from one of my PTs, 'Walk this way'.
For optimal guidance of walking
rehabilitation therapy of stroke patients in an in-home setting, a small
and easy to use wearable system is needed. In this paper we present a
new shoe-integrated system that quantifies walking balance during
activities of daily living and is not restricted to a lab environment.
Quantitative parameters were related to clinically assessed level of
balance in order to assess the additional information they provide.
Methods
Data of 13 participants who suffered a
stroke were recorded while walking 10 meter trials and wearing special
instrumented shoes. The data from 3D force and torque sensors, 3D
inertial sensors and ultrasound transducers were fused to estimate 3D
(relative) position, velocity, orientation and ground reaction force of
each foot. From these estimates, center of mass and base of support were
derived together with a dynamic stability margin, which is the
(velocity) extrapolated center of mass with respect to the front-line of
the base of support in walking direction. Additionally, for each
participant step lengths and stance times for both sides as well as
asymmetries of these parameters were derived.
Results
Using the proposed shoe-integrated
system, a complete reconstruction of the kinematics and kinetics of both
feet during walking can be made. Dynamic stability margin and step
length symmetry were not significantly correlated with Berg Balance
Scale (BBS) score, but participants with a BBS score below 45 showed a
small-positive dynamic stability margin and more asymmetrical step
lengths. More affected participants, having a lower BBS score, have a
lower walking speed, make smaller steps, longer stance times and have
more asymmetrical stance times.
Conclusions
The proposed shoe-integrated system and
data analysis methods can be used to quantify daily-life walking
performance and walking balance, in an ambulatory setting without the
use of a lab restricted system. The presented system provides additional
insight about the balance mechanism, via parameters describing walking
patterns of an individual subject. This information can be used for
patient specific and objective evaluation of walking balance and a
better guidance of therapies during the rehabilitation.
Trial registration
The study protocol is a subset of a larger protocol and registered in the Netherlands Trial Registry, number NTR3636.
Yonathan Manor’s father was the inspiration for his latest invention, the B-Shoe, a shoe that promotes stability and stops wearers from falling.
A biomechanical engineer, Manor was concerned when his aging father,
like millions of elderly persons worldwide, started struggling with
mobility and began to fall a lot. So he decided to do something about
it.
Working with physiotherapists and doctors, Manor theorized that when
people age, they lose the ability to keep themselves stable and as a
result are unable to make the minor adjustments needed to prevent falls.
Digging out the heel from an old sneaker for his first prototype, Manor joined with electronic engineer partners Abraham Stamper and Aharon Shapiro to develop a system that corrects an elderly person’s gait.
“We built prototypes of shoes that can save lives,” Stamper said of the design that has been six years in development.
He also explained how the B-Shoe works. “The main electronic
mechanism is in the heel, and the rechargeable battery will be embedded
in the sole along with the pressure sensors,” Stamper explained. “The
sensors can detect that the center of pressure is going beyond the back
line of support. If there is no reaction from the wearer for more than a
few milliseconds, the shoes begin moving backwards five to seven
centimeters until stability is regained.”
Manor and the B-Shoe team has already secured patent for its products
in both Israel and the United States and has launched a crowd-funding
campaign to get the financing needed to bring the high-tech shoe to
market.
If all goes well, the B-Shoe may be available in the US and Israeli
markets in as little as two years, helping to keep seniors, and others
with stability issues, safer.
Background:
In the United Kingdom, stroke is the most significant cause of adult
disability. Stroke survivors are frequently left with physical and
psychological changes that can profoundly affect their functional
ability, independence, and social participation. Research suggests that
long-term, intense, task- and context-specific rehabilitation that is
goal-oriented and environmentally enriched improves function,
independence, and quality of life after a stroke. It is recommended that
rehabilitation should continue until maximum recovery has been
achieved. However, the increasing demand on services and financial
constraints means that needs cannot be met through traditional
face-to-face delivery of rehabilitation. Using a participatory design
methodology, we developed an information communication
technology–enhanced Personalized Self-Managed rehabilitation System
(PSMrS) for stroke survivors with integrated insole sensor technology
within an “intelligent shoe.”. The intervention model was based around a
rehabilitation paradigm underpinned by theories of motor relearning and
neuroplastic adaptation, motivational feedback, self-efficacy, and
knowledge transfer. Objective: To understand the conditions under which
this technology-based rehabilitation solution would most likely have an
impact on the motor behavior of the user, what would work for whom, in
what context, and how. We were interested in what aspects of the system
would work best to facilitate the motor behavior change associated with
self-managed rehabilitation and which user characteristics and
circumstances of use could promote improved functional outcomes.
Methods: We used a Realist Evaluation (RE) framework to evaluate the
final prototype PSMrS with the assumption that the intervention consists
of a series of configurations that include the Context of use, the
underlying Mechanisms of change and the potential Outcomes or impacts
(CMOs). We developed the CMOs from literature reviews and engagement
with clinicians, users, and caregivers during a series of focus groups
and home visits. These CMOs were then tested in five in-depth case
studies with stroke survivors and their caregivers. Results: While two
new propositions emerged, the second importantly related to the
self-management aspects of the system. The study revealed that the
system should also encourage independent use and the setting of
personalized goals or activities. Conclusions: Information communication
technology that purports to support the self-management of stroke
rehabilitation should give significant consideration to the need for
motivational feedback that provides quantitative, reliable, accurate,
context-specific, and culturally sensitive information about the
achievement of personalized goal-based activities.
After the problems on the cruise and Barcelona I need a lot tighter shoes. For work I'm wearing one of the Italian shoes I bought last year. It has the curly laces and since my left foot is still swollen my foot doesn't slide and jostle my detached big toenail. Part of the problem is that my current athletic shoes were bought a size larger - 13 - to accommodate an AFO
You'll have to ask your doctor if the Parkinson's shoe would be helpful for your walking needs. Does your doctor even know about this or anything new at all? Has your doctor changed or created any stroke protocols in the last 10 years? If not, they should be fired.
If we don't start firing doctors for not keeping up with new research they will never change. Call the hospital president when you find such incompetent doctors. Yes I know this is not a way to ingratiate myself with the stroke medical world, but I don't want to interact with doctors that don't keep up-to-date.
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