Kyle B. Reed, PhD, from the University of South Florida, Mechanical Engineering talks about the iStride™ device, how it works, and how it helps stroke survivors.
Interview conducted by Ivanhoe Broadcast News in January 2019.
The shoe – tell us how this came to be and where we’re at right and how it would benefit.
REED: The iStride device came to be as we were looking to help people with a stroke. They frequently have an asymmetry when they walk. The iStride device causes one foot to move backwards while they’re walking and this helps to exaggerate one of the feet so that their walking becomes more asymmetric, such that when they take the shoe off, they have a corrected gait that is more symmetric afterwards. It also works to make one foot unstable and so it encourages them to stand on their impaired side more. And that helps to encourage them to walk on that foot and to regain the ability to walk.
At what point does a patient start seeing results?
REED: Depends exactly on the patient. There are differences between patients. We see that there tends to be a pretty good progression and then they tend to start plateauing over time and we’re still looking to see how long of a treatment we need to have. But very good results are found within four weeks.
Why do you think something like this is beneficial?
REED: There’s different levels of being able to walk and so if you can walk to the grocery store, if you can walk to get your mail, that’s very beneficial. If you’re not able to do those, you’re going to be encouraged not to walk and that’s detrimental. So every little bit extra that you can walk is going to encourage you to walk more. And that naturally helps you to want to walk more and more. And the more you walk, the better you’re going to get. So if we can get them over that threshold of being able to walk around, then they’re naturally going to be able to do more and that helps to give them a better sense of independence.
What did it take to make this shoe?
REED: It took a lot of math, a lot of engineering and quite a few different prototypes to get it to work just right.
What is it made out of?
REED: The fundamental design of the shoe is patented. It’s based on a spiral shaped wheel that causes the foot to redirect the downward force from the user and generate the backward motion. And so it has no motors that actuate it. It’s based on the user. And that helps to allow the person to adapt to it better because they’re still in control. So as they put their weight on it, it causes them to move.
Are there any other things out there that helps patients with their walk? Or are they just advised to use a cane?
REED: There’s a whole realm of different devices that are out there. Many of them are things that you’re supposed to wear all the time. AFOs will help with dropped foot. But you have to wear it all the time. The iStride device is different in that you train on it. And it generates an after effect such that when you take it off you have a corrected gait. The closest thing to it would be a split belt treadmill but that is a much more expensive device. That’s typically used inside the lab.
The person would wear it for a couple hours and then take it off? Or how would it work if some was able to buy this?
REED: Our current trial is based on 30 minutes three times a week for four weeks. In the end, what we’d like to be able to do is actually have them take it home so they can use it 30 minutes – 45 minutes or longer if they want every day. And so if you train more often, you’re going to get better results.
Can you explain again how after you train for 30 minutes when you get off, you can do that motion again?
REED: The iStride device causes one foot to go backwards and this exaggerates your existing asymmetry so that you have to compensate for it. When you step down on it, it causes your foot to go backwards and this encourages your other foot to make up for that so that you have to take a longer step and that equalizes the step length between your two feet. When you go back to walking without the iStride device then that little bit of asymmetry is gone because you’ve already started compensating for it. So now you have a more symmetric walking pattern.
The hope is when you take it off you keep doing that.
REED: Right. So the hope is that as you keep doing this every day you train you get a little bit more equalized in your step length and you’re going to start walking faster. And so as you keep doing it you’re going to get better and better and better. And hopefully get back to symmetry with enough training. And you’ll start walking faster.
Why is it so common with stroke patients?
REED: So what happens in stroke is you essentially get a line drawn down your body where the impairment in your brain affects the opposite side and you lose a lot of ability in this side but you still have a lot of ability in your other side. And this causes the asymmetric motions that many stroke patients have. And it’s not about the strength necessarily but it’s about the connection from the brain to the muscles. And so this device helps to retrain the connection between your brain and body and relearn how to walk again.
Anything else?
REED: I want to talk about the company. The iStride device is being worked on with Moterum Technologies. They funded a lot of the initial study. And they’re working now to commercialize the device. So the hope is that we will be able to have this on the market for individuals to buy hopefully in the near future.
Like three to five year or one to two years?
REED: We are hoping to be able to have this on the market for individuals through Moterum technologies hopefully within a year or two. People will be able to buy it and be able to use it in their own home is the long term plan.
Do you have a ball park price? Or would insurance cover something like that?
REED: There’s too many variables to go into that.
END OF INTERVIEW
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