Motorised shoe that could prevent ulcers

AHIGH-TECH shoe insole with a mini-motor inside could prevent dangerous leg and foot ulcers. The insole, called Footbeat, fits most shoes and keeps blood pumping through the feet and lower legs — even when the patient is sitting or lying down.

It does this by pushing up a tiny ramp, covered in a cushioned pad, in the middle of the insole every 30 seconds. The pad presses on the arch of the foot for two seconds at a time, mimicking what happens when we walk.

This makes muscles in the foot and lower leg contract, forcing blood to keep moving through blood vessels, which happens automatically when we walk or run because of pressure on the bottom of the foot, but stops once we sit down.

The motor is controlled by a smartphone app, so the patient can activate it once they stop moving about. It will then raise and lower the insole arch until switched off.

The insole could help prevent a common complication of diabetes, where circulation in the lower limbs is damaged, raising the risk of amputation.

At least one diabetes patient in ten develops poor circulation in the legs and feet because high sugar levels in the blood thicken the walls of capillaries — tiny blood vessels — in the lower leg.

Even a slight cut can then develop into an open wound because, as circulation slows, the damaged skin is starved of the oxygen-rich blood and immune cells it needs to repair itself.

Such wounds often get bigger, as bacteria in them feed off the raised sugar levels, flourish and break down surrounding tissue.

The risks are heightened because diabetes patients often have nerve damage in their feet, so they feel little pain and are often unaware they have tiny injuries until these become infected and harder to heal.

Up to 40% of diabetic ulcers take at least three months to mend, and in 14% of cases wounds are still present after a year. A technique similar to the insole foot compression has been used for years in hospitals to reduce the risk of clotting in patients after major surgery, but the equipment needed is bulky.

The Footbeat insole could provide the same benefits to patients while they go about their daily tasks, and may eventually allow patients to go home sooner after operations.

A 2013 study on an early prototype of the device, carried out at Wellington University in New Zealand, compared the motorised insole to compression stockings — widely used to improve blood flow in the lower legs — in 20 healthy adults.

The results, published in the International Journal of Vascular Medicine, showed blood flow was higher with the insole.

The device, which was approved for use in the US late last year, costs around €365 and the motor lasts for about two years.

Footbeat is expected to become available in Europe in the next two to three years.

Professor Andrea Nelson, a wound care expert, said: ‘Improving blood flow may help in some conditions, such as leg ulcers, and this device has been shown to improve blood flow.

‘But I’m not aware of any studies demonstrating that it increased healing of ulcerated skin.’

MEANWHILE, taking probiotics — or ‘friendly’ bacteria — may help speed healing of diabetic ulcers, according to a study in the journal Diabetes/Metabolism Research and Reviews. A group of 60 diabetes patients with quite deep foot ulcers were given a probiotic capsule containing four different ‘good’ bacteria, or a placebo, each day.

After three months, those who took the probiotic had reductions in ulcer length, width and depth — as well as reductions in their blood sugar and insulin levels compared with those who took the placebo.

Researchers suggested probiotics reduce inflammation that can worsen the condition.