Doctors who focus on the foot and brain team up on a smart insole

July 12, 2018 by Lex Davis, University of Southern California
The smart insole can measure gait, activity level and balance and detect a rising temperature which could be a sign of infection. The project is the result of a collaboration between a podiatric surgeon and a neurosurgeon. Credit: Bernard Grisoni, Autonomous ID

Professors David Armstrong and Charles Liu at first seemed to be an unlikely pair.

But the podiatric surgeon and neurosurgeon clicked on a personal level and promptly realized they had a lot to offer each other as Keck School of Medicine of USC collaborators.

Both were already studying how much information a person takes in through the nerves of the feet, how to preserve, repair or replace that information system, and how can affect a patient's mobility.

Armstrong is interested in , mobility and neuropathy—the loss of nerve sensitivity that can occur in patients with diabetes, Liu noted.

"As a neurosurgeon, I'm interested in lower-extremity function and metabolic health, too," he said. "In my work, I think about how to restore mobility to patients who can't feel their legs. It's a similar problem to ."

Armstrong added: "We're meeting in the middle, and it's fun. It's so common in medicine for people to silo, but you can't let your ideas sit there alone. Whatever the other guy is doing will make your thing more interesting."

Smart insole, smart physicians

The two started looking for a project on which to collaborate. Oddly enough, they found it with a Canadian security company. The firm was working with the idea of capturing pressure signatures—the way weight is distributed across people's feet as they walk—which are as distinctive as fingerprints. At the time, the company was working with technology that could signal if, for example, an unknown person walked into a secure room.

The doctors soon saw that pressure signatures could be a way to spot changes in a person's gait early on—a potential warning sign of a more serious problem. With their shared interest in wearable technology, Armstrong and Liu steered the company toward a smart insole. The device will flag changes in a patient's gait, activity level and balance, as well as monitor for the localized increase in heat that can reveal a building infection before the human eye can spot it.

"Those early warning signs can be crucial—the best surgery is the one we never have to do," Armstrong said.

Rewarding patients

With such prevention in mind, the "toe doctor and the brain doctor" increase the functionality of the insole to have it reward patients for increasing their activity or losing weight, make nutritional recommendations or discreetly remind a patient to get his or her daily walk in. Their work has the potential to give a sense of greater contact with their care team while reducing the need for physical office visits.

And the collaboration caught fire: The insole tied for first place for the Global People's Choice Award in this year's Diabetes Innovation Challenge run by T1D Exchange.

"Every once in a while, you need to win an award," Liu joked. "Diabetes is a huge problem in the world. In the tech world, people pitch their ideas. If these technologies are identified as being worthy, you can start to get the support."

Explore further: New risk assessment will protect the feet of diabetes patients

Related Stories

New risk assessment will protect the feet of diabetes patients

May 8, 2017
A stringently designed web form with questions about foot ulcers, deformities and neuropathy will soon be brought into use to better protect the feet of people with diabetes. The tool is a result of research conducted at ...

Surgeon urges new focus on diabetic ulcers

June 15, 2017
Foot ulcers are a prevalent complication for millions of people with diabetes. Estimates indicate that as many as one-third of people with the disease will develop at least one foot ulcer over the course of their lifetime. ...

Arch-filled insoles for diabetic patients could be adversely affecting balance

October 19, 2016
Insoles with arch fills designed to prevent diabetic foot ulcers could be having an adverse impact on postural stability, according to new research led by Plymouth University.

Getting smart about diabetic foot ulcers

February 8, 2017
While wearing appropriate footwear can help treat and prevent diabetic foot ulcers, the leading cause of limb amputation among people with diabetes, noncompliance continues to be an issue, especially among those with loss ...

Trial of shoe insoles to improve balance in diabetic patients

September 1, 2017
Shoe insoles are being trialled to improve balance, walking and physical activity in adults with type 2 diabetes and associated foot nerve damage.

Recommended for you

Antibiotics for appendicitis? Surgery often not needed

September 25, 2018
When emergency tests showed the telltale right-sided pain in Heather VanDusen's abdomen was appendicitis, she figured she'd be quickly wheeled into surgery. But doctors offered her the option of antibiotics instead.

3-D-printed tracheal splints used in groundbreaking pediatric surgery

September 19, 2018
Children's Healthcare of Atlanta has performed Georgia's first-ever procedure to place 3-D-printed tracheal splints in a pediatric patient. A cross-functional team of Children's surgeons used three custom-made splints, which ...

Muscle relaxants increase risk of respiratory complications

September 18, 2018
Muscle relaxants are a necessary part of anesthesia during certain major operations. However, studies have hinted at respiratory risks connected with these drugs. POPULAR, a major prospective observational European study ...

Gunshot victims require much more blood and are more likely to die than other trauma patients

September 17, 2018
In a new analysis of data submitted to Maryland's state trauma registry from 2005 to 2017, Johns Hopkins Medicine researchers found that gunshot victims are approximately five times more likely to require blood transfusions, ...

Liver allocation system disadvantages children awaiting transplants

September 17, 2018
Children are at a considerable disadvantage when competing with adults for livers from deceased organ donors in the U.S. allocation system, a University of Pittsburgh Graduate School of Public Health-led analysis reveals ...

Taste preferences connected to success of long-term weight loss after bariatric surgery

September 16, 2018
Following Roux-en-Y gastric bypass (RYGB), a type of bariatric surgery, many patients exhibit a reduction in taste preference for sweet and fatty foods, although this effect may only be temporary, according to new research ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.