Vibrating insoles to improve balance

NewsBot · Oct 25, 2014

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A Shoe Insole Delivering Subsensory Vibratory Noise Improves Balance and Gait in Healthy Elderly People
Lewis Lipsitz, MD, Matthew Lough, James Niemi, Thomas Travison, PhD, Harold Howlett, Brad Manor, PhD
Archives of Physical Medicine and Rehabilitation; Articles in Press

Objective
The objective of this study was to test whether subsensory vibratory noise applied to the sole of the foot using a novel piezo-electric vibratory insole, can significantly improve sensation, enhance balance, and reduce gait variability in elderly people. We also aimed to determine the optimal level of vibratory noise , and whether the therapeutic effect would endure and the user’s sensory threshold would remain constant during the course of a day.

Design
A randomized single-blind crossover study of three subsensory noise stimulation levels on 3 separate days.

Setting
Balance and gait laboratory

Participants
12 healthy community-dwelling elderly volunteers aged 65 – 90 years who could feel the maximum insole vibration.

Intervention
A urethane foam insole with the piezo-electric actuators delivering subsensory vibratory noise stimulation to the soles of the feet.

Main Outcome Measures
Balance, gait, and timed up-and-go tests.

Results
The vibratory insoles significantly improved performance on the timed up-and-go test, reduced the area of postural sway, and reduced the temporal variability of walking at both 70% and 85% of the sensory threshold and throughout the course of a day. Vibratory sensation thresholds remained relatively stable within and across study days.

Conclusions
This study provides proof of concept that the application of the principle of stochastic resonance to the foot sole sensory system using a new low voltage piezoelectric technology can improve measures of balance and gait that are associated with falls. Effective vibratory noise amplitudes range from 70% to 85% of the sensory thresholds and can be set once daily.
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Admin2 · Oct 25, 2014

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NewsBot · Oct 24, 2015

A patent was just granted for this:
VIBRATING ORTHOTIC SHOE INSERT AND METHOD OF MANUFACTURING THE SAME

Vibrating orthotic shoe inserts and a method of manufacturing the same. In an embodiment, a vibrating orthotic shoe insert includes a forefoot portion configured to support a forefoot portion of a human foot; an arch portion configured to support an arch of the human foot, the arch portion including an area configured to be under a porta pedis of the human foot; and a heel portion configured to support a heel of the human foot. The arch portion includes a vibration element positioned within the area configured to be under the porta pedis of the human foot. The vibration element is configured to deliver vibration to the porta pedis of the human foot.
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Patent attached:

NewsBot · Sep 8, 2016

Use of an Enactive Insole for Reducing the Risk of Falling on Different Types of Soil Using Vibrotactile Cueing for the Elderly.
Otis MJ et al
PLoS One. 2016 Sep 7;11(9):e0162107. doi: 10.1371/journal.pone.0162107.

BACKGROUND:
Our daily activities imply displacements on various types of soil. For persons with gait disorder or losing functional autonomy, walking on some types of soil could be challenging because of the risk of falling it represents.
METHODS:
In this paper, we present, in a first part, the use of an enactive shoe for an automatic differentiation of several types of soil. In a second part, using a second improved prototype (an enactive insole), twelve participants with Parkinson's disease (PD) and nine age-matched controls have performed the Timed Up and Go (TUG) test on six types of soil with and without cueing. The frequency of the cueing was set at 10% above the cadence computed at the lower risk of falling (walking over the concrete). Depending on the cadence computed at the lower risk, the enactive insole activates a vibrotactile cueing aiming to improve gait and balance control. Finally, a risk index is computed using gait parameters in relation to given type of soil.
RESULTS:
The frequency analysis of the heel strike vibration allows the differentiation of various types of soil. The risk computed is associated to an appropriate rhythmic cueing in order to improve balance and gait impairment. The results show that a vibrotactile cueing could help to reduce the risk of falling.
CONCLUSIONS:
Firstly, this paper demonstrates the feasibility of reducing the risk of falling while walking on different types of soil using vibrotactile cueing. We found a significant difference and a significant decrease in the computed risks of falling for most of types of soil especially for deformable soils which can lead to fall. Secondly, heel strike provides an approximation of the impulse response of the soil that can be analyzed with time and frequency-domain modeling. From these analyses, an index is computed enabling differentiation the types of soil.
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NewsBot · Jan 25, 2021

Vibratory Insoles Improve Walking in Individuals with Chronic Post-stroke Hemiparesis
Jing NongLiang et al
Gait & Posture 23 January 2021

Highlights
•Augmented suprathreshold somatosensory input can alter post-stroke gait.
•Tactor embedded vibratory insoles improve paretic gait kinematics.
•Low-cost solution to address inadequate toe clearance in post-stroke gait.
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Background
Stroke survivors suffer from hemiparesis and somatosensory impairments, which adversely impact walking function, placing them at higher risks for trips and falls. Augmented somatosensory inputs have been demonstrated to improve static standing balance and postural control in non-neurologically impaired, and in people post-stroke. Effects of enhanced somatosensory input on post-stroke walking have not been investigated.

Research question: We sought to investigate whether enhancing somatosensory input using vibratory insoles, can improve post-stroke gait.

Methods
Fifteen individuals with chronic post-stroke hemiparesis and 15 age-similar non-neurologically impaired controls participated in this cross-sectional study. Enhanced somatosensory stimulation was delivered using a pair of tactor-embedded insoles, providing suprathreshold vibratory stimulation to the bottom of the feet. Participants walk over an instrumented treadmill with self-selected speeds, under 5 stimulation conditions: No insole in shoe (NT), insoles in shoe with no vibration (BOFF), vibration under both feet (BON), vibration under one foot only (ION, CON), in a randomized order. Kinetics and kinematics during walking were recorded and analyzed offline.

Results
Our hypothesis that vibratory stimulations applied to the bottom of the feet would improve gait kinetics and kinematics in the paretic legs of individuals with chronic post-stroke hemiparesis was partially supported. We observed increased ankle dorsiflexion in the paretic legs with vibratory insoles.

Significance
Vibratory stimulations applied at suprathreshold intensity to the bottom of the feet to augment somatosensory feedback can be used as a low-cost solution to address the inadequate toe clearance during walking in people post-stroke, which is an important goal in post-stroke rehabilitation.
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Attached Files:

US20150265496A1.pdf

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