Many stroke victims have trouble walking due to an uneven gait and physical therapy often requires expensive and cumbersome equipment. Now, a mechanical engineer with a passion for helping people and a dedicated physical therapist have teamed up to develop a device that’s much easier to use.
A shoe is helping stroke victims relearn how to walk
Many stroke victims have trouble walking due to an uneven gait, and physical therapy often requires expensive and cumbersome equipment.
Now a mechanical engineer with a passion for helping people and a dedicated physical therapist have teamed up to develop a device that's much easier to use.
Here's the story.
This is the computer-assisted rehabilitation environment, or CARN.
It's housed at the University of South Florida, with a price tag of over a million dollars.
Only a handful of universities utilize them for research.
It's basically a split-belt treadmill, so the two treads can move at different speeds, mounted on a six-degree-of-freedom base, so we can rotate it, twist it, move it up and down, and all around.
It's got a 180-degree screen so you can put virtual-reality environments in front of you.
It has 10 cameras that track markers that we can place in various places on the body.
We use it to understand how people can walk and how we can change their gait patterns.
Dr. Kyle Reid is a mechanical engineer with a passion to help people who need physical therapy.
He decided to create a new device that would be less expensive and more accessible to patients who have difficulty walking.
I had seen a split-belt treadmill, and that was the inspiration for the shoe.
The point of the shoe is that it lets people train in the real world, where they're actually gonna be active and doing the motions that they are going to be walking.
The shoe he's referring to is the Gait Enhancing Mobile Shoe, or GEMS.
Dr. Kyle teamed up with physical-therapist researcher Seok Hun Kim at USF School of Physical Therapy and Rehabilitation Sciences.
The goal -- to develop this new device for stroke survivors.
Individuals with stroke, they tend to put more weight on their good side.
Then, if they don't use their affected side, then you're going to lose it.
This GEM shoe is seven years in development.
After going through several iterations, they came up with a device ready for study.
They're now in the middle of testing the device on stroke survivors.
Diane is the fourth patient to be tested.
Although her stroke occurred seven years ago and caused extensive damage, she was determined to join the study.
In the beginning, I was kind of scared, but I got used to the shoe, so then I think I did pretty good.
As I've been using it, I notice there's some changes at home.
I'm able to walk faster, and my knee moves, and my toes, I've noticed they're starting to move.
And those are a couple of things that didn't happen before.
Dr. Kim has Diane take steps along a gait-measuring walkway that has sensors to measure her walking pattern.
We are comparing their spatial temporal variable.
Spatial means stride length and how each toe's deviated from the linear line, and temporal variable means how long they take step.
We put this shoe on the healthy side, which seems a little counterintuitive, but it's actually working on the impaired side.
In some sense, it makes the healthy leg less stable, and so it is causing them to have to spend more time and try harder to walk with their impaired leg.
Dr. Reid's design is based on the spiral.
Standing on the shoe, there's basically these asymmetric wheels, that as you put down weight, there's an asymmetry of where the axle force is and where the ground-reaction force is, so as you push down on it, it causes the wheel to rotate.
That rotation causes the shoe to go backwards, and so it's mimicking a split-belt treadmill in the sense that, when you step down, it's causing your foot to go backwards.
He's usually present during each evaluation and training.
Sometimes, during the training sessions, there's a piece that breaks or something's not quite working right, so I have to go and grab it, fix it up, and kind of work on it.
Putting it on them and seeing it and getting their feedback is immensely valuable to find out what parts are not working as well so we can redesign those, and to keep the ones that are working very well.
These clinical trials are being run with very strict protocols.
We are looking at the walking pattern -- provide very minimal guidance.
And, also, we have to check blood pressure and respiratory rate, as well as heart rate.
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Sometimes, research engineers like Dr. Reid experiment with their designs.
There's a device we came up with called the 'kinetic board.'
In some sense, it's a very large version of the GEMS.
You actually kind of lean back and forth, and that rocking back and forth motion engages the back wheels and then the front wheels, and that allows you to propel yourself forward.
We've actually found it demonstrates the principal of the GEMS.
Because it's much bigger, you can see it moving.
You can understand how the pieces are working.
Another spin-off we had from it was taking that same wheel shape but putting it on the end of a crutch.
So it's not the entire wheel shape, but it's more of a curve that is asymmetric from front to back.
The same principal as the GEMS -- when you push down, because it's asymmetric, it causes a forward motion that is going to assist you while you're walking on the crutch.
With the kinetic crutch tip, it allows you to plant down, and then once you get into the motion, it will propel you forward.
Whatever the challenge, Dr. Reid is focused on helping people.
I started learning more and more about physical-therapy realm and really just got a passion for it that I wanted to make these devices more effective so they can help people restore their motions that they have.
For test subject Diane, she's well on her way to restoring some functionality to her gait.
For normal overall walking, she improved about 20% of improvement in the walking speed and step length about 10% to 20% so far, and also we can see more symmetrical gait pattern.
We expect it to a certain extent, but the outcome we are looking at is beyond what we expected.
This is very promising.
Well I know I'm never gonna be a 100%, but, you know, I want to get as close to that 100% as possible, and I think that this shoe is really helping out.
The goal is to be able to mass produce the GEM shoe and make it available to all patients in the near future.
I would love to see the GEMS be available at a either rental model or low cost for purchase where people could go into a clinic, learn how it works, and then come back and take it with them to home, and they could train every single day for a month, two months -- however long they need it -- to be able to get to the walking ability that they want.