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Game-changing footwear prevents trips and falls in stroke & MS survivors

By Press Office

Researchers at Queen Margaret University, Edinburgh have developed an innovative new shoe which is helping prevent trips and falls in people with stroke and multiple sclerosis.

The new footwear technology is transforming the lives of people with foot-drop – a condition which makes it difficult for people to lift the front part of their foot and often results in falls.

People living with foot-drop find it very difficult and tiring to walk. They struggle to keep their toes lifted, and can therefore drag or catch their foot on the ground. This can be due to conditions that affect the nervous system, causing a malfunction of the communication between the brain and the muscles that lift the foot at the ankle.

The number of people who experience foot-drop is unknown, however, around 20% of people with stroke and almost 50% of those with MS develop foot-drop. So, just looking at these conditions alone, it is estimated that this new footwear tech could improve walking and prevent falls in 322,400 people across the UK and 3.8m globally.

The cleverly designed footwear has been developed by the , a team of allied health professionals and researchers mainly based at Queen Margaret University, Edinburgh. After several years of design and testing, the research team now has a footwear prototype which has the potential to be a game-changer for people with the condition.

Professor Cathy Bulley, a physiotherapist at Queen Margaret University, is part of the research project, which is funded by the National Institute for Health and Care Research (NIHR) She explained: “Foot-drop can be caused by damage to the nervous system within the brain, spinal cord or the nerves in the lower back or legs.  Walking can be a huge effort for people with foot-drop – both physically and mentally. People must concentrate to ensure their toes clear the ground, often by lifting their hips and knees up further and swinging their leg out.

“The increased risk of trips and falls can have a terrible impact on people’s quality of life. It leads to fear, avoidance of walking, reduced physical activity and less involvement in social and working life. It reduces people’s confidence and independence and can send them into a downwards spiral. There are various products on the market, but there are drawbacks with all of them. They don’t work for everyone, and can be expensive and difficult to tolerate.â€

Cathy confirmed: “People with permanent foot-drop need a comfortable, affordable, and attractive, unobtrusive device that holds the foot up while allowing ankle movement. Our new footwear has been co-designed with people with stroke, MS and cerebral palsy, and feedback from our users is outstanding!â€

Case Study

Jeanette Russell from Edinburgh worked as a nurse in the military before developing MS and subsequently, foot-drop. She was one of the first people to trial the new footwear technology, and has become a key collaborator in the research.

"This footwear is a gamechanger for people who struggle with mobility due to foot-drop. I really put the footwear through its paces. I wore them in and out of the house, at the exercise studio and whilst driving. My mobility, speed of walking, gait and confidence improved immensely, and I knew the team was onto a winner! What really amazed me was watching myself walking with my normal footwear on, and then the shoes. My normal rolling gait was gone, and I was walking upright, with confidence for the first time in eight years. It was life-changing!"
Jeanette Russell

Jeanette loves hillwalking and being outdoors, but foot-drop has really made this challenging in recent years. Thanks to the new footwear, Jeanette has been able to confidently return to hillwalking. She really pushed the footwear to the max as she navigated steep gradients during a walking holiday in Glencoe this February. She said: “The difference in my walking ability is mind-blowing. In my normal boots, I fell down on flat surfaces with no obstacles. Using the footwear, I can walk up and down steep pathways and literally traverse rocks and navigate slippery surfaces without falling. This is what the footwear allows me to do, and why I am so passionate about making sure everyone with footdrop has access to this life-changing footwear.â€

Jeanette concluded: “I also can’t wait to wear them at the Remembrance Day Parade in London, later on this year. As a veteran, it means so much to me to be able to march, with confidence, past the Cenotaph.â€

Low tech but clever footwear

Professor Derek Santos, from Queen Margaret University, is the podiatry specialist on the project. He explained: “We’ve developed a low-tech, all-season, every-day piece of footwear that incorporates an attractive design which is both comfortable and supports the foot during walking. It’s a fairly simple design, but it’s been co-developed with people who have lived experience of foot-drop, alongside experts who really understand the anatomy and mechanics of the feet and limbs when walking.â€

Thanks to a grant from the National Institute for Health and Care Research, the research team is now partnering with a design and manufacturing company to progress the production of the new shoes. The aim is to produce a shoe that will be attractive, low-tech and affordable, which will help to ensure that they are accessible for anyone who can benefit from them.

Professor Mike Lewis, NIHR Scientific Director for Innovation, said: "Innovative devices like this are helping to ensure the NHS can be there for everyone when they need it. This new device is a great example of a simple yet ingenious solution to a common problem for people with stroke and MS that can help them be more independent and live better." 

Professor Bulley concluded: “In the future, we hope that these innovative shoes will become widely available to patients through the NHS, so we can help improve the lives of a wide range of people with foot-drop. We would also like to adapt the design to create other types of footwear, such as hiking boots, exercise boots and an affordable sandal that’s accessible for people with foot-drop in countries with warmer climates.

“No matter where you live, how much money you have, or what condition or trauma has led to foot-drop - everyone deserves to have the best chance to improve their walking. We hope our clever new footwear will provide a simple, affordable solution for millions of people with foot-drop across the UK and internationally.â€

Health Design Collective

is a Community Interest Company that aims to transform product design in health care. They collaborate with end-users to co-design fit-for-purpose, accessible, attractive, affordable health care products to improve the quality of life of people with health conditions. The research team includes:

·       Kavi Jagadamma, Senior Lecturer at Queen Margaret University, Edinburgh - Expert in gait analysis and orthotics 

·       , Neurophysiotherapist and PhD student at Glasgow Caledonian University - Analyses people’s needs, tests existing products and develops new ideas

·       Cathy Bulley, Professor in Physiotherapy at Queen Margaret University, Edinburgh - Expert in qualitative research and user experiences

·       Professor Derek Santos, Professor in Podiatry at Queen Margaret University, Edinburgh - Expert in orthotic design and testing

Numbers of people affected by foot-drop

There are no exact figures for people with foot-drop. Approximately 20% of people with stroke develop foot drop and 48% of those with MS (estimated from Compass clientele ). Focusing on these two conditions, we estimate 322,400 people UK wide, and 3.8 million globally, could benefit from our footwear.

Current products on the market for foot-drop

-       Functional electric stimulation – this is another form of treatment used by people with foot-drop. It involves the use of electrodes which are positioned to stimulate the shin muscle. A box clipped on your waistband sends an electrical stimulation to the shin muscle at the right time during the walking movement to encourage the foot to contract so that the foot lifts up. This is used in the NHS, but it can be a postcode lottery as to whether a patient gets it, and it doesn’t work for everyone with foot-drop – sometimes it doesn’t trigger, it doesn’t always work on stairs, and some people can’t tolerate the sensation. For some people it works very well, but it’s expensive and not everyone can afford it.

-       Ankle Foot Orthosis – The most common device to use for foot-drop is a plastic or carbon fibre, right angled splint (ankle foot orthosis). But most prevent movement at the ankle and they are a real visual sign of disability which means that some people do not like wearing them, or don’t wear them at all. They can also cause discomfort and sometimes skin breakdown, which can lead to infected wounds if not properly attended. They can be difficult to put on by yourself, especially for people with stroke who may have dexterity issues. Âé¶¹·¬ºÅ’s research has shown that lots of people with MS and stroke do not like wearing the orthosis.

About the Funder - National Institute for Health and Care Research (NIHR)

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries

NIHR is funded by the Department of Health and Social Care.

For further media information contact Queen Margaret University’s press office on E: pressoffice@qmu.ac.uk or call 07711 011239.

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