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Shoes to prevent amputations

Zoltan Pataky, associate professor in the Department of Community Health and Medicine at the UNIGE Faculty of Medicine and staff physician in charge of the at the HUG, has obtained major funding from the SNSF to clinically test 'intelligent' shoes designed to limit plantar lesions in people with diabetes, the main cause of lower-limb amputations.

© Zoltan Pataky. Prototype of an intelligent shoe

The WHO estimates that there are around 250,000 lower-limb amputations per year in Europe among people with diabetes, 85% of which are avoidable. "It usually starts with a small lesion on the foot, which develops into an ulcer, then irreversible damage to tissue and bone, so serious that the only option left is amputation", explains Professor Pataky. "Excessively high blood sugar levels over a long period of time can damage the nerves in the extremities, so that patients no longer feel any pain and allow what were initially minor injuries to degenerate.

A shoe to prevent hyperpressure

Apart from treating diabetes, foot relief is the key to treating and preventing plantar ulcers. There are a number of practical options available, including crutches, orthopaedic insoles and custom-made shoes. - However, the rate of recurrence of ulcers after healing remains very high if the main risk factor, excessive plantar pressure, remains unchanged.

"This is why we have been working for several years with EPFL on an innovative prototype of an 'intelligent' shoe capable of detecting the area of the foot at risk by continuously measuring plantar pressure and automatically adjusting the flexibility of the sole," explains Zoltan Pataky.

Testing the device in real-life conditions

The main objective of the SNSF funding is to evaluate the effects of this shoe in real conditions, i.e. in the day-to-day lives of patients. "We will be able to analyse the impact of the insole's contour adjustments on the biomechanics of walking, develop an artificial intelligence algorithm for managing pressure relief and assess how patients feel," adds Zoltan Pataky. "By reducing the number of amputations, our shoes could significantly improve the quality of life of people with diabetes.