Vibrating shoes aid stroke and diabetic patients

NewsBot · Jan 25, 2006

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Reuters are reporting:
Vibrating shoes aid stroke and diabetic patients
Tue Jan 24, 2006 05:01 PM ET

NEW YORK (Reuters Health) - Vibrating insoles can improve balance in patients with stroke or diabetic neuropathy, a common nerve problem that affects sensation in the feet and elsewhere, Boston researchers report.

The vibration, adjusted to a sub-sensory level, appears to "tickle" neurons, making them more sensitive to stimuli that are present during standing, Dr. James J. Collins of Boston University, the study's lead author, told Reuters Health.

Collins and his team had previously shown that sub-sensory mechanical noise delivered to the feet via the insoles could help people maintain better balance.

In the current study, published in the Annals of Neurology, the researchers tested the effects of the vibrating insoles on sway parameters in 15 patients with diabetic neuropathy and 15 patients with stroke. Patients stood on the insoles, which contained two vibrating elements on each forefoot and one on each heel.

Data from a previous study of the insoles in 12 healthy elderly patients was included for comparison.

The researchers looked at five traditional sway parameters and three derived from random-walk analysis. All were reduced significantly with the noise application in all of the patients, the researchers found. And the greater a patient's baseline level of postural sway, the more balance control improved with noise input.

Additional research is needed to investigate how the technology may benefit patients with stroke affecting different parts of the brain, for example the right versus the left side of the brain, the researchers add.

"The main thing that we're focusing on now is testing whether the insoles provide benefit in dynamic activity such as walking," Collins said. He and his colleagues have completed prototypes of insoles and shoes incorporating the vibrating elements, and are planning studies to test them as patients walk, climb stairs and negotiate other activities of daily living.

His team also plans to investigate whether the vibrating insoles can help Parkinson's disease patients and patients with multiple sclerosis.

SOURCE: Annals of Neurology, January 2006.
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markjohconley · Jan 25, 2006

vibration ....danger of embolism?????

foot spas are contraindicated for pvd pts due to increased risk of embolism, so shouldn't this be considered.....just because the pt can't perceive the vibration (sub-sensory) doesn't mean it's not potentially risky????????????

NewsBot · May 6, 2006

It also helps in Parkinsons disease

Effect of step-synchronized vibration stimulation of soles upon gait in Parkinson's disease: a pilot study.
J Neuroengineering Rehabil. 2006 May 4;3(1):9

BACKGROUND: Previous studies have suggested that impaired proprioceptive processing in the striatum may contribute to abnormal gait in Parkinson's disease (PD).

METHODS: This pilot study assessed the effects of enhanced proprioceptive feedback using step-synchronized vibration stimulation of the soles (S-VS) on gait in PD. S-VS was used in 8 PD subjects (3 women and 5 men, age range 44-79 years, on medication) and 8 age-matched healthy subjects (5 women and 3 men). PD subjects had mild or moderate gait impairment associated with abnormal balance, but they did not have gait freezing. Three vibratory devices (VDs) were embedded in elastic insoles (one below the heel and two below the forefoot areas) inserted into the shoes. Each VD operates independently and has a pressure switch that activates the underlying vibratory actuator. The VD delivered the 70-Hz suprathreshold vibration pulse upon touch by the heel or forefoot, and the vibration pulse was deactivated upon respective push-offs. Six-minute hallway walking was studied with and without S-VS. Gait characteristics were measured using the force-sensitive foot switches. The primary outcome was the stride variability expressed as a coefficient of variation (CV), a measure of gait steadiness. Secondary outcome measures were walking distance and speed, stride length and duration, cadence, stance, swing and double support duration, and respective CVs (if applicable).

RESULTS: The walking speed (p<0.04) and the CV of the stride interval (p<0.02) differed between the groups and S-VS conditions. In the PD group, S-VS decreased stride variability (p<0.002), increased walking speed (p<0.0001), stride duration (p<0.01), stride length (p<0.0002), and cadence (p<0.03). In the control group, S-VS decreased stride variability (p<0.006) and increased gait speed (p<0.03), but other locomotion parameters were not significantly altered.

CONCLUSIONS: Augmented sensory feedback improves parkinsonian gait steadiness in the short-term setting. Because the suprathreshold stimulation prevented blinding of subjects, the learning effect and increased attention can be a confounding factor underlying results. Long-term studies are needed to establish the clinical value of the S-VS.
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NewsBot · Nov 6, 2007

Development of vibrating insoles.
Hijmans JM, Geertzen JH, Schokker B, Postema K.
Int J Rehabil Res. 2007 Dec;30(4):343-345.

The objective of this study was to describe the development of vibrating insoles. Insoles, providing a subsensory mechanical noise signal to the plantar side of the feet, may improve balance in healthy young and older people and in patients with stroke or diabetic neuropathy. This study describes the requirements for the tactors, (tactile actuators) insole material and noise generator. A search for the components of vibrating insoles providing mechanical noise to the plantar side of the feet was performed. The mechanical noise signal should be provided by tactors built in an insole or shoe and should obtain an input signal from a noise generator and an amplifier. Possible tactors are electromechanical tactors, a piezo actuator or the VBW32 skin transducer. The Minirator MR1 of NTI, a portable MP3 player or a custom-made noise generator can provide these tactors with input. The tactors can be built in foam, silicone or cork insoles. In conclusion, a C2 electromechanical tactor, a piezo actuator or the VBW32 skin transducer, activated by a custom-made noise generator, built in a cork insole covered with a leather layer seems the ideal solution.
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NewsBot · Jul 1, 2017

Design and evaluation of vibratory shoe on balance control for elderly subjects: technical note
Atefeh Aboutorabi, Mokhtar Arazpour, Farzam Farahmand, Mahmood Bahramizadeh, Reza Fadayevatan, Ehsan Abdollahi
Disability and Rehabilitation. Assistive Technology 2017 March 22, : 1-5

BACKGROUND AND AIM: Aging often results in a decline in somatosensory function, and such changes are associated with diminished motor performance. Input noise can enhance sensory and motor function through a mechanism known as stochastic resonance (SR). This paper describes the development and testing of a new vibrating shoe to possibly assist the elderly patients in controlling their balance and decreasing their falling risks.
TECHNIQUE: The new vibrating shoe was evaluated to ascertain its ability to generate appropriate random and nonlinear vibrations. The vibratory shoe performance in two young subjects with decreased foot sensation and two elderly subjects in different static and dynamic balance situations was also evaluated. The postural control, expressed by the stability index (SI), was significantly affected by SR in the older subjects.
DISCUSSION: The vibrating motors could be recommended as a suitable solution for dynamic balance situations. Moreover, the new vibrating shoe could improve the age-related balance impairments in elderly subjects with balance deficiencies and others with impaired foot sensations. Implications for rehabilitations Older adults exhibited decreased postural stability. Noise signal improves sensation and proprioception in older people. New shoe with vibrating motors can operate in different dynamic situations.
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NewsBot · Aug 10, 2019

Improving vibration perception in a patient with type 2 diabetes and sensory peripheral neuropathy.
Ennion L, Hijmans J
SAfr JPhysiother. 2019 Jul 25;75(1):602

INTRODUCTION:
Diabetes mellitus (DM) and its related sensory peripheral neuropathy (SPN) are the biggest risk factors for foot ulcer formation and lower limb amputation. Reduced vibration perception results in less sensitivity to pressure and is a known risk factor for diabetic foot ulcers. Improving vibration perception in the feet of people with SPN could be protective against foot ulcers. The aim of this study was to determine if a therapeutic vibrating insole, used for 35 consecutive days, could improve vibration perception in a patient with type 2 DM.

PATIENT PRESENTATION:
The patient was a 63 year-old male with a medical history of peripheral vascular disease, controlled hypertension, hyperlipidaemia, artherosclerosis and SPN secondary to controlled type 2 diabetes.

MANAGEMENT AND OUTCOME:
The patient used the insoles for 20 min a day for 35 consecutive days. Vibration perception thresholds were measured four times in total: once at baseline, immediately post intervention, 1 month and 10 months later. Vibration perception threshold decreased with an average of 22 V (range 6 V-34 V) dependant on the tested location and time after intervention. The improvement remained after 1 and 10 months.

CONCLUSION:
The use of a vibrating insole as a therapeutic device improved this patient's perception of vibration in his feet. Clinically, vibrating insoles potentially might reduce the risk for ulcer formation and subsequent lower limb amputation in patients with DM and SPN.

CLINICAL IMPLICATIONS:
Using a vibrating insole therapeutically, can potentially improve the perception of vibration and pressure in patients with sensory peripheral neuropathy secondary to type 2 diabetes mellitus. Improved vibration perception might reduce the risk for diabetic ulcer formation and subsequent lower limb amputation.
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NewsBot · Mar 24, 2022

A Therapeutic Vibrating Insole Device for Postural Instability in Older People with Type 2 Diabetes: A Randomized Control Study
Isabelle Bourdel-Marchasson et al
Diabetes Ther. 2022 Mar 23

Introduction: Frail older people with diabetes often present with or develop walking impairments, in part due to lower-limb sensory-motor neuropathy. Several studies suggest a possible improvement of balance control using somatosensory stimulation. We undertook a novel randomized control trial, the aim of which was to observe whether use of this device for 1 month improves walking speed as measured in the 10-m fast walking speed test standardized to body size at month 1 (M1) (FWS). Secondary outcomes were the differences between intervention (VS) and control (C) in the 10-m normal walking speed test, step length, short physical performance battery, timed up and go test, and posturographic measures.

Methods: Subjects were aged ≥ 70 years and had had type 2 diabetes for at least 2 years. The intervention (VS) at home consisted of 22-min daily vibrating sequences with noise intensity set at 90% of the tactile threshold for each foot. The same device was used in group C but noise was set to 0. Compliance was retrieved from the device.

Results: Among 56 subjects, 27 were in the VS group and 29 in the C group; 35 subjects were frail, 15 were prefrail ,and 6 were non-frail. Bilateral neuropathy was present in 17 subjects. More than half of sessions were done in 36 subjects with no discernible difference according to intervention. At M1 there were no discernible differences in FWS between the groups [VS: 0.96 (0.53) cm s-1 cm-1, C: 0.94 (0.47) cm s-1 cm-1]. There were also no discernible differences in other outcomes, irrespective of the presence of bilateral neuropathy.

Conclusion: In a cohort of frail, prefrail, or non-frail older subjects with diabetes, a 1-month intervention using a vibrating insole device did not alter measures of walking speed and related measures. Larger studies with longer term and different stimulation protocols are required to test this hypothesis more fully.
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markjohconley Well-Known Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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