Monitoring diabetic patients by novel intelligent footwear system

Daily foot conditions, especially spatial and temporal plantar pressure distributions, are useful measures for monitoring diabetic patients from developing peripheral neuropathy and foot ulcerations. However, many of present foot monitoring systems are clumsy thus cannot be used for uncontrolled dynamic activities such as long-term outdoor use, and can easily interrupt wearer´s natural gait by bulky components and complex connections as well as restriction in research laboratories and clinics. This paper presents the development of an intelligent footwear system, which is able to measure and record, during daily activities, spatial and temporal plantar pressure distributions, in-shoe temperature and humidity, centre of pressure (COP), and 3-axis accelerations. The intelligent footwear system demonstrated satisfactory accuracy, repeatability and wearing comfort, and has been used for dynamic foot monitoring of diabetic patients. The first clinical trial involved an H group of 10 healthy subjects and a DM group of 10 diabetic patients without peripheral neuropathy. This trial explored and identified differences of plantar pressure between the healthy and diabetic subjects in dynamic daily activities. The second trial started with a diabetic patient with healed toe amputation for the evaluation of effects of surgical procedures and treatments on diabetic patients.