An electronic sock that detects an unhealthy walking style linked with diabetes and poor circulation shows promise for preventing foot ulcers and amputation.
“Patients with diabetes tend to put pressure on the metatarsal area of the foot, rather than the heel,” said researcher Ki Hong Lee, PhD, of Chonnam National University Hospital, Gwangju, Republic of Korea. “This way of walking encourages ulcers, which can become infected and lead to amputation. Identifying walking issues early using an electronic sock would enable patients to learn a healthy walking style and prevent serious foot problems.”
This study examined whether a sock fitted with a ballistocardiogram (BCG) sensor could distinguish between healthy people and patients with diabetes. A BCG detects body motion as the heart ejects blood, and could potentially be used to measure heart rate and pressure exerted on the feet when walking.
The study enrolled 20 patients with diabetes and 20 healthy controls. All participants wore the BCG sock for 40 seconds while standing and 40 seconds while walking to measure heart rate and to assess pressure distribution on the foot. At the same time as wearing the sock, participants had an electrocardiogram (ECG) assessment of heart rate.
The purpose of the heart rate measurement was to assess the accuracy of the BCG sock as a measurement tool relative to ECG, the gold standard method. The researchers found that the heart rate measurements by the BCG sock and ECG were almost the same.
Foot pressure distribution measurements were performed to discover whether the BCG sock could 1) detect differences between patients with diabetes and healthy controls, and 2) detect differences between patients with diabetes according to whether they had damage to the nerves or blood vessels.
Regarding the BCG comparison between patients and healthy controls, this showed that patients with diabetes exerted higher pressure in the metatarsal area of the foot while walking compared to participants without diabetes. The researchers also found that compared to patients without blood vessel damage, those with blood vessel damage exerted significantly greater pressure on the metatarsal area of the foot during walking and less pressure on the heel. There was no significant difference in foot pressure distribution measurements between patients with or without nerve damage.
“Taken together, the results suggest that the electronic sock could be an easy, non-invasive way to find patients with diabetes who could benefit from gait training to prevent foot complications,” said Lee.
