Intelligent shoe 

Transforming stroke recovery through self-management in Yorkshire and Humber.

Researchers from the NIHR CLAHRC Yorkshire and Humber have incorporated a hi-tech insole, developed by a Portuguese company,  Kine
matix Sense Ltd, with offices in Sheffield and Boston USA, into a computer-based personalised self-management rehabilitation system. The Personalised Self-Management Rehabilitation System (PSMrS) has the potential to transform stroke recovery by enabling patients to not only self-manage their ongoing rehabilitation in the comfort of their own homes, but potentially buy and use an off the shelf walking application for use with a mobile phone or tablet PC in the years following their stroke.

The PSMrS uses a set of pressure sensors to capture motion while stroke survivors practise vital rehabilitation exercises providing motivational feedback on weight distribution and heel strike. Two of the most common physical constraints leading to falls in stroke survivors.  The technology enables stroke survivors, carers and physiotherapists to compare performance over time providing them with a score on their achievement against pre-set personal goals. In addition, it can assess mood and monitor wellness with an inbuilt prompt for patients to ring an ambulance in an emergency or to speak to a GP if they are feeling unwell and/or have been feeling low for two weeks. The innovative approach to post-stroke rehabilitation has also been reflected at ministerial level: the Rt Hon Earl Howe, Parliamentary Under Secretary of State for Quality, said:

“We know that getting the best possible support and rehabilitation is essential for stroke patients in order to help them regain their independence.” “I am delighted to see that money made available to researchers through the National Institute for Health Research is being used in such innovative ways and for projects which can make a real difference to the lives of NHS patients.”

The PSMrS was also presented to and applauded by Simon Denegri, chair of INVOLVE and NIHR National Director for Public Participation and Engagement in Research, during his visit to the YH CLAHRC in December 2013. 

Using a ‘realistic evaluation’ methodological approach, the PSMrS has been tested with stroke participants at Sheffield’s Assessment and Rehabilitation Centre (ARC).  Initial findings suggest that the system is highly welcomed by users and data indicates improved balance and heel strike over a four week period. Importantly, users report increased confidence and motivation to carry out everyday activities.

In collaboration with the SME an Industrial Knowledge Transfer (IKT) project has been initiated with funding from the University of Sheffield to develop a ‘stand-alone’ application for use on a mobile phone or tablet PC. This novel technology integrates the algorithms developed for motivational feedback on walking and the designed feedback screens, also developed during the initial phase of the research. The research team are working with Medipex the YH innovation hub to establish a collaborative agreement been Kinematic, the NHS and the University of Sheffield as the ‘shoe to app’ innovation may have a global reach from a product to market perspective.

NIHR CLAHRC YH is now funding a pilot RCT of the technology as a physiotherapy prescribed walking rehabilitation tool or a self-prescribed tool. In collaboration with clinicians and other researchers, the current stroke research team are also exploring the use of the intelligent insole with other long-term neurological conditions and in paediatrics.