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 Health Design Collective, 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.”
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!”
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.
She said: “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 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.”
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.”
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.”
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 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.”
