INNOVATION FOR INDEPENDENCE
ISSUE 130 DECEMBER/JANUARY 2019/20 £6.95
Insole helps reduce diabetic-related foot ulcers re-emerging AN early warning system powered by a smart shoe insole can help prevent the reemergence of diabetes-related foot ulcers which can lead to complications such as amputation, a study suggests.
One of the challenges for the clinical profession is how to help patients with diabetes avoid developing reocurring foot ulcers on the sole of their feet: one in every fourth person with diabetes will get one in their lifetime and the danger is they fail to heal and become infected over time. Tragically, up to 30 per cent of patients with a diabetic foot ulcer may go on to require some form of lower limb amputation. Diabetic patients with peripheral neuropathy – nerve damage in the extremities – experience less sensitivity in their hands and feet and as such run a higher risk that in some common situations, such as walking, sitting or standing, their feet may experience higher than normal foot pressures, causing skin damage to the bottom of the foot and leading to an ulcer. Researchers at Manchester Metropolitan University, The University of Manchester and Manchester Diabetes Centre tested the effectiveness of an intelligent shoe insole system that tracks pressures and provides instant feedback, prompting users to adjust their behaviour or stance to alleviate or offload the kind of pressure that can cause ulcers.
The results of the study show the system reduced the reoccurrence of foot ulcers in patients by 71 per cent over the course of the 18 months of the project. Lead author on the paper, Dr Caroline Abbott, Research Fellow within the Research Centre for Musculoskeletal Science and Sports Medicine at Manchester Metropolitan University, said: “This is the first clinical trial to test if ‘smart’ or ‘intelligent’ insoles, worn during daily life over a long period of time, can prevent debilitating foot ulcers from recurring in ‘high-risk’ diabetic patients.
“We realised that any active technology that alerts patients to their daily periods of harmful high foot pressures would be a very powerful foot ulcer prevention strategy. “The benefits of the technology are that the patients are empowered to monitor their own risk themselves and better understand their own foot pressures and then actively offload pressures during harmful periods. “The patients with the best compliance and self-management were best protected against ulcers recurring. “This finding illustrates the concept of the effectiveness of patient empowerment through targeted technology.” The smart insole study involved 90 diabetic patients with diabetic neuropathy in the UK and was funded by Diabetes UK and Orpyx Medical Technologies.
A Welsh company that designs and manufactures prosthetic leg covers is expanding rapidly. LIMB-art, which was established by former Paralympian Mark Williams, has just become an accredited supplier to the NHS. It is the first time that prosthetic leg covers have been available to people on the NHS. Full story on page 2.