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Wireless shoe based sensor device + app

A wireless shoe based sensor device + app to monitor and improve balance and increase weight-bearing.

Photo of Joshua Cohen
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What challenges or opportunities are you trying to address within the problem? (200 characters or less)

A senior "fitness tracker" has unique demands due to the low activity of sedentary individuals who are at high risk of OP-related fractures. This device tracks, reports and incentivizes those measures

Many seniors who are at risk for osteoporotic fractures decrease their physical activity and weight-bearing (for many reasons) which creates a negative feedback cycle and increases their risk of further fractures and falls due to weakness and reduced balance.


This device (wireless sensors embedded in insoles or shoes) would aid in monitoring, tracking, and improving objective balance measures. It is able to track the center of mass (COM) over the base of support (BOS) using sensors and feed that data to a mobile app. Similar in concept to the Wii Fit balance board, this device is much more flexible and allows complete ease of movement without restriction, which allows for monitoring throughout the day as well as focused game play apps to improve balance.


As opposed to other tracking sensors (ie. accelerometers like FitBit) this sensor can objectively track time in weightbearring, track COM over BOS movement, and can even provide feedback for guided exercises.


Although this technology exists in other industries (ie running) it does not exist at all in the realm of balance control and would offer many opportunities for furthering research into fall prevention. My hope is that this device would have an open API to allow other innovators to develop novel approaches to fall prevention. It also offers new opportunities for other markets such as pediatric rehab, concussion monitoring, sports training, and the gaming market.



To truly improve balance, the patient must improve the control of their center of mass over their base of support. That is difficult for patients, caregivers, and even physical therapists to convey. Current smart sensors such as accelerometers do not collect this type of data. This device measures those parameters in a valid, low cost way and provides an entertaining game that can motivate even patients with dementia.

I am a geriatric physical therapist with degrees in biomechanics and product design. I have already tested a prototype with seniors and received positive feedback from PT and biomechanics researchers. I know that this could be a very helpful resource for many patients with OP to reduce the incidence of fractures.


This sensor technology has already been developed for other consumer fields. For example, https://www.arion.run/wearable/ uses shoe based force sensitive resistors to report and track pressure patterns while running, which suggests that such a device would be able to withstand the rigors of a senior lifestyle :)


IMPACTING SOCIAL ISOLATION

  • Loneliness and isolation can be significant issues that affect seniors' motivation for increasing activity.  This device could be used to reduce these factors by implementing some of the following ideas...
  • Multiplayer balance games with the possibility to connect with other players. I love the concept of the video game Journey (https://youtu.be/bKqeD7ojynw?t=57) that allows player interactions in a non-forced way.
  • Offering incentives and listings for local, evidence based balance classes.
  • Partnering up app users (or family/caregivers) to work towards goals.


RESEARCH

Computerized dynamic posturography, aka CDP (ie. the use of computers to quantify postural control in upright stance in either static or dynamic conditions) has a substantial evidence base showing it's validity for improving balance and reducing falls. Here are just a few of many published articles.

https://www.ncbi.nlm.nih.gov/pubmed/11568601 - CDP is sensitive for identifying people who have previously fallen. The Limits of Stability test was the most significant indicator.

https://www.ncbi.nlm.nih.gov/pubmed/21801090 - a CDP training program showed promise as a systematic, objective method to reduce fall risk with improved overground performance of balance tasks in an individual with chronic stroke.

https://www.ncbi.nlm.nih.gov/pubmed/25515202 - Balance training with a gaming system showed promise as a feasible, objective and enjoyable method to improve physical performance and reduce fall risk in an individual.




Who is your target end user and why will they be interested? (650 characters or less)

This idea excels because it is both a preventative, tracking, and rehabilitative aid. It could appeal to multiple levels of senior demographics as well as rehabilitation therapists. I could also imagine assisted living facilities using such devices to track activity levels and balance among their residents to prevent losing residents (and therefore revenue) to higher levels of care after a fall. Shoe companies may also be interested in integrating this technology to offer to their consumers. Emergency fall alert system companies may also be interested in partnering to offer an option that not only alerts to a fall, but may help in alerting before the fall even occurs by tracking trends in activity and center of mass control over time.

How is your idea scaleable? (650 characters or less)

Scaling this product should not be an issue, since it consists only of an app and hardware sensors.

What do/will you measure to know if your solution worked? (500 characters or less)

As a practicing physical therapist, I would be encouraged to suggest this device if it were able to increase patient's standing activity time by even 5% per day. Since any improvement can often open the doorway to other gains and progress. Other objective measures may include: 1. Lateral center of mass (COM) excursion measurements to track the patient's ability to control center of mass in single leg stance. 2. Number of falls based on self report. 3. Anterior/posterior COM control

What is the current stage of development of your idea?

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

If you were to become a Top Idea, would you want to actively participate in piloting your idea?

  • I am flexible. I would be glad to assist in piloting, but do not need to be exclusive.

Tell us about yourself or your team (500 characters or less)

I am the owner of Mobile Rehab LLC. MobileRehabNC.com I have studied gaming/Unity/3D modeling for rehabilitation & learning. I received my baccalaureate degree in Physical Therapy from Northern Illinois University and a Master’s degree in Human Movement Science / Biomechanics from the University of North Carolina at Chapel Hill. I also completed supporting classes in the Industrial Design program at North Carolina State U. I have designed other commercially available products.

Location (50 characters)

Chapel Hill, NC

What is your legal / organizational structure?

  • We are individuals

How did you hear about the Challenge?

  • OpenIDEO announcement email

Why are you participating in this Challenge?

This is the target community that I work with and strive to improve their quality of life and improve their ability to remain independent and age in place. It's a very important question to tackle and one that is vitally important to the seniors it affects.

How does your idea help more people who have had a first fracture either 1) discover they have osteoporosis or 2) access/navigate care?

This device could help to access/navigate care by providing a method to track, improve, and maintain the patient's mobility and balance. By doing so, the patient's family, physical therapist or physician could stay updated on the patient's progress as well as intervene when necessary and prevent patients from becoming forgotten in the care journey.

How is your idea new in the world or how does it build on existing interventions?

My device combines existing technology (sensor insoles with computerized dynamic posturography (CDP)) in a novel and low cost method. My prototype demonstrates the efficacy of a low fidelity foot pressure map using only two force sensors per foot for this purpose. Insoles with sensor technology exist and can be easily replicated and manufactured for this purpose. (just one of many examples... https://www.arion.run/wearable/) CDP also already exists. (ie. the use of computers to quantify postural control in upright stance in either static or dynamic conditions.) It has strong research evidence supporting balance improvements and reduction in fall risk. These devices are currently clinic based and VERY expensive. (ex. http://balanceandmobility.academy/product-overview/smart-balance-master/) My design is inexpensive, easy to use, engaging, and clinically relevant and trackable. It has the added benefit of allow complete freedom of movement, which reduces risk of user falls.

Please upload your journey map. Be sure your journey map shows when your user is introduced to the idea and when/how they access it, and illustrates which moments in the Challenge Journey Map your journey map touches.

Who did you test your idea with, what did you learn, and how did you evolve your concept?

This device was tested on a small sample of seniors from my community with balance issues. The device and app succeeded greatly in encouraging the patient to perform balance exs properly, independently, and with greater enthusiasm. The feedback it provided also aided the patient in improving their balance by providing valuable insights into their limitations of balance. The largest barrier with the prototype was the design of the hardware and how to affix it to multiple shoe sizes with various sole designs and still get proper pressure feedback. I feel that the best design may either be an insole made to fit multiple shoe sizes, or integrate it into a stand alone shoe, sandal, or slipper design.

(Optional) Share documentation of your solution prototyping and testing, such as photos.

This video demonstrates the prototype I developed and the various clinical and game apps that I created.

Please upload your Business Model Canvas

Please upload your team video.

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Photo of Wesley Wells
Team

There's a professor called Lisa Muratori at Stony Brook University who might already have a prototype for this. She helps patients figure out when their gait is drifting away from a stable pattern by putting sensors in their shoes. https://www.wired.com/story/sonification-era-of-aural-data/

Photo of Joshua Cohen
Team

Wesley,
Thanks for that link and input. Yes, auditory feedback is one type of use case for this design, and other foot sensor arrays exist on the market.
The difference is that my design costs exponentially less than what is currently on the market, and I was able to gamify balance activities using mobile phone technology, which greatly reduces the cost and complexity of bringing the product to the consumer.
***I would like to bring this low cost, easily accessible technology to market and create an open API so that researchers could investigate, build, and monetize terrific programs that they create (such as auditory gait feedback for patients with Parkinson's that Lisa Muratori studied) to a wide variety of patient conditions.***
I have noticed that many academic researchers tend to develop unique solutions based on expensive, complex technology, that rarely makes it to the market. I believe that, in the space of balance disorders, that may be due to the lack of low cost, effective, open API tools like what I am describing. I want to change that.
PS. I just emailed her to find out more about what, specifically, she was focused on and which sensors she used. Thanks again.

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