Falls are not inevitable as people age, despite their frequent
occurrence in the geriatric population. A new device created by researchers at
the Massachusetts Institute of Technology (MIT) reveals the balance issues that
serve as warning signs to predict these falls before they occur.
The iShoe was invented by Erez Lieberman, PhD, while he was working at
NASA several years ago. The NASA researchers were exploring the issue of
balance to better prepare astronauts for changes in gravity. He considered this
problem in his own life, where his grandmother had died following a fall.
Lieberman’s grandmother certainly has not been the only such
casualty. More than one in three people age 65 years or older falls each year,
according to the National Institutes of Health (NIH) National Institute on
Aging. Falls among this population account for the number one cause of
fractures, hospital admissions for trauma, loss of independence and injury
“I [was] interested in the question of whether one could design
some kind of device that would be able to diagnose how well people are
balancing in real-time,” Lieberman, who now works in the bioastronautics
program in the division of health sciences and technology at MIT, said.
His idea was to place that device directly inside a shoe. The iShoe
insole works with any shoe to assess how well the wearer is balancing by
communicating wirelessly with a Bluetooth-enabled device.
Once the balance data is collected, it can be processed in several ways.
The wearer can use it to monitor it him- or herself, just as a person with
diabetes might monitor glucose levels. Alternatively, the balance data could be
relayed automatically to physicians, caregivers or loved ones, who then could
respond appropriately. In the case of a fall, the technology also would have
the capability to notify emergency services immediately.
The iShoe company — headed up by Lieberman and his chief technology
officer. Katharine Forth, PhD — has just begun to scratch the surface of
“The wearable real-time diagnostic systems are in their infancy, as
technologies go,” he told O&P Business News. “I
think there is a lot of work to be done in terms of figuring out how to get
them to where they need to be — how to build them cheaply, how to
interface them well with a person’s lifestyle, with their doctor’s
lifestyle, with their loved ones’ lifestyle, with emergency services and
care giving organizations. I think all of those are factors.”
The array of options for this data includes implications for outcomes
measures. This type of health care monitoring would allow providers the proof
necessary to justify the need for O&P intervention.
“When the paradigm shifts from ‘I go to my doctor
periodically,’ to ‘My health is constantly being monitored by an
array of sensors,’ what is that paradigm shift going to look like?”
he said. “In 20 years from now, this is not going to be cutting edge.
It’s just going to be what everybody does.” — by Stephanie Z.
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Many of my patients who have lower extremity orthotic and prosthetic
needs also have balance issues. This problem is not age specific. A product
like the iShoe would be a powerful tool for the rehabilitation of patients who
wear orthotic and prosthetic systems.
The population that immediately comes to mind is the patient with poor
proprioception. Over the course of my 20 years as an orthotist, I have had to
modify countless orthotic systems to accommodate patients’ poor balance
due to proprioceptive deficits. Many times these adjustments require a widening
of the patients’ base of support. This requires added weight and bulk to
the shoe, and creates a system that has an orthopedic appearance.
A tool like the iShoe will help treat the root of the problem: poor
balance. This will eliminate the need for orthopedic shoe modification. As a
result, increased safety and desired outcomes are achieved for my patients, and
their desire for a more aesthetic look is maintained.
— Michael Dailey, MBA, CO
Orthotic & Prosthetic Design Inc.