Stroke shoe retrains the brain, correcting gait

By  | 

In the United States every year, close to 800,000 people suffer a stroke – a sudden interruption in the blood supply of the brain.

Many are left with a dragging foot. But doctors are working on an inexpensive way to fix their footing.

“I used to walk 3 to 5 miles a day before my stroke, and it would be nice if I could just walk a half a mile,” stroke survivor Diane Hintz said.

Diane is on the right track. She’s 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," USF mechanical engineering Dr. Kyle Reed said. "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. The 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, and patients can even bring 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 they have a corrected gait where it’s more symmetric afterwards,” Reed said.

“Don't forget, the patient is wearing the shoe on their good side,” USF physical therapy and rehabilitation sciences associate professor Dr. Seok Hun Kim said.

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,” Reed said.

And that’s just what Diane needs so she can get that pep back in her step.

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 iStride could be available to the public in a year.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: STROKE SHOE RETRAINS THE BRAIN
REPORT: MB #4547

BACKGROUND: More than 795,000 Americans suffer a stroke each year. About two-thirds survive. Many need rehabilitation to help them recover successfully. Disabilities that can result from a stroke include paralysis or problems controlling movement, sensory disturbances, including pain, problems using or understanding language, problems with thinking and memory, and emotional disturbances. Paralysis is one of the most common stroke disabilities. It usually occurs on the side of the body opposite the damaged side of the brain. So a stroke on the left side of the brain affects the right side of the body. It may affect the face, an arm, a leg, or the entire side of the body. Stroke patients may have problems with swallowing, posture, balance and walking, or grasping objects.
(Source: https://medlineplus.gov/magazine/issues/spring13/articles/spring13pg6-7.html)

REHABILITATION: Even after rehabilitation, many individuals with strokes have residual gait deviations and limitations in functional walking. Applying the principles of motor adaptation through a split-belt treadmill walking paradigm can lead to short-term improvements in step length asymmetry after stroke. Kyle Reed, PhD, from the University of South Florida, Mechanical Engineering said “There's a whole realm of different devices that are out there. Many of them are things that you're supposed to wear all the time. So AFOs will help with dropped foot. But you have to wear it all the time. The iStride device is different in that you train on it. And it generates an after-effect such that when you take it off you have a corrected gait. The closest thing to it would be a split belt treadmill but that is a much more expensive device. That's typically used inside the lab.”
(Source: Kyle Reed, PhD & https://www.ncbi.nlm.nih.gov/pubmed/21084921)

NEW TECHNOLOGY: Reed explained how the iStride device works: “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.” He hopes people will be able to bring it home soon, “We are hoping to be able to have this on the market for individuals through Moterum technologies hopefully within a year or two that people will be able to buy it and be able to use it in their own home; that’s the long term plan.”
(Source: Kyle Reed, PhD)