May 2020

Use of a Wearable Plantar Sensory Neuroprosthesis Improves Fall Risk

By Laura Fonda Hochnadel

One of the complications of peripheral neuropathy is a lack of sensation in the feet. This, in turn, can cause difficulties with gait and balance, as well as increased fall risk. As a means of addressing these issues, Lars Oddsson, PhD, developed a neuroprosthesis, called Walkasins, to replace the lost sensation. Walkasins consist of a foot pad that analyzes and interprets plantar pressure, sending the information to a leg unit that is worn just above the ankle (Figure). The leg unit delivers sensory signals to nerves in the lower leg, helping the user adjust his gait, thus also restoring balance.

Interim data from the Walk2Wellness trial by Oddsson and several colleagues showed that this neuroprosthesis does indeed appear to decrease falls in this patient population. Fall data during the study, the 6 months prior to the study, and from the ongoing long-term clinical trial were presented in a poster, On Certain Patients, a Wearable Plantar Sensory Neuroprosthesis Appears to Decrease Falls, at the 2020 APTA CombinedSections Meeting held in Denver, CO, February 12–15, 2020.

Fifty-two subjects were enrolled in the study as of the date of the poster publication; 37 participants logged 10 weeks of daily use; and 9,100 days (182 mean use days) in the study were accumulated by participants. The average age of the cohort was 74.6 years. It was also noted that, compared to non-fallers, those who had experienced falls in the 6 months prior to the study had lower Functional Gait Assessment (FGA), walked slower, and scored lower on the Activities-specific Balance Confidence (ABC) scale.

During the study itself, falls were reported by 19 people, a 37% decrease from the 30 people who reported experiencing falls in the 6 months prior to the study.  Of these 19 people, 14 had previously experienced falls. As of the poster publication, during the ongoing clinical trial period, 36 falls were reported compared to 69 in the 6 months prior to the study, for a decrease of 52% (Table). It bears to note that 7 of the falls were on ice/snow or in the shower, and 3 of the 36 falls resulted in a serious injury—however, the device was not being worn at the time of injury

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