This trend started with sensor-based socks for people with diabetes, especially those with nerve damage. This damage makes them more prone to foot ulcers, which can lead to amputation.
Now, the intelligent technology woven into these socks is being tested in other designs to prevent injuries: for wheelchair users, for Parkinson’s patients and even for runners to prevent foot, knee and back injuries.
The technology is known as “smart textiles,” where sensors are inserted into the tissue of the fabric. People with diabetes use them to detect changes in temperature and humidity. The sensors transmit the biometric data to doctors via an app so that the problem can be corrected before the patient is aware of it.
Using smart textiles to protect those who are vulnerable to injury is part of the human expansion of the Internet of Things. As your car, appliances, and other devices become increasingly interconnected, the Internet of Me continues to evolve to keep your body in good shape by collecting and analyzing your personal health information.
Why people with diabetes
This seemingly ordinary piece of clothing plays a role in early detection, preventing the most devastating consequences of nerve damage. Worldwide, 40 to 60 million people with diabetes are affected by nerve damage to the feet and lower limbs. Known as peripheral neuropathy, it can lead to foot ulcers, which is the cause of more than 80% of lower extremity amputations.
The condition leaves patients with a loss of sensation in their feet. As a result, they may not be aware if their feet get hot or sweaty, which increases the risk of blisters. If the loss of sensation is severe, they may not feel the bladder and therefore may not treat it. At the same time, their poor blood circulation caused by diabetes can halt or interfere with the healing process, leading to ulcers. Wound care, which is not always successful, can take many months and increase the risk of the infection escalating. In this case, an amputation can be performed.
Over the past two decades, improvements in preventive medicine have reduced the need for surgery and halved the operation rate. Smart textiles could further reduce the number of amputations.
Any advance in the treatment of this disease is undoubtedly a welcome event. Diabetes rates are remarkable: The International Diabetes Federation estimates 463 million adults, ages 20 to 79, are living with them today, but that number could reach 700 million by 2045.
The sensor functions have brought start-up companies into being around the world. You are at different stages in the commercialization of the technology. Smart socks that are classified as medical devices must meet the legal standards in the countries where they are approved for sale. Patients get them through prescriptions that need to be renewed regularly.
In the US, for example, smart socks must be approved by the Food and Drug Administration. At this point, you will be eligible for Medicare coverage. A brand that is already approved and on the market is manufactured by Siren Care. In a 2018 study, scientists and corporate researchers found that continuous temperature monitoring emerged as a promising tool that could serve as an early warning system for treating foot ulcers. (Siren Care declined to be interviewed for this article.)
The deceit of diabetes involves the absence of symptoms for several years prior to the actual diagnosis. The IDF estimates that one in two diabetics – 232 million worldwide – went undiagnosed in 2019.
A few years ago Trevor Schofield was one of the undiagnosed. As an engineer with a background in textile machinery, he was working in China in 2012 when he developed a foot ulcer that got worse despite treatment with antibiotics. His illness escalated to systemic sepsis. He returned to Belfast where he became CEO of the start-up Bioflex Yarns Ltd. is. He was diagnosed with type 2 diabetes and had to be amputated.
Three years later, when he developed blisters and ulcers in the surviving foot, he founded Bioflex to develop his own version of smart socks.
The Sensoria story
With the established smart textile capability today, “pretty much any clothing and footwear you can imagine, even accessories,” said Davide Vigano, co-founder and CEO of Sensoria. The company is working with the Rancho Los Amigos National Rehabilitation Center to develop “a smart pillow to reduce the risk of ulceration for wheelchair users,” he said in an interview with Medical Daily. The cushions have an insert to accommodate the textile pressure sensors.
Sensoria’s product line includes socks with pressure sensors that monitor impact and foot landing technology. The information generated by the sensors helps runners avoid injuries and therefore knows which shoe types offer them the best protection for their running style. Sensoria is also working with the Cleveland Clinic on a “knee brace that remotely detects and monitors patient rehab”. This idea is particularly timely during a pandemic, Vigano noted, as treating patients with physical rehabilitation outside of a medical facility, especially those with comorbidities, is a primary goal.
The company also plans to use textile-generated data to help Parkinson’s patients avoid falls. The sensors alert you to gait or balance disorders. It is working with the Michael J. Fox Foundation on customizing the socks for this application.
Sensors can also promote diagnostic accuracy. “For the first time we can combine the quantified data and achieve a much more meaningful patient-doctor interaction,” said Vigano. Health professionals can compare sensor-generated and self-reported information for a more complete picture of the patient’s condition.
Innovation doesn’t stop with sensors, said Alison Gault, a lecturer in fashion and knitwear art, design and fashion at the Belfast School of Art at Ulster University who works with Bioflex on research. Nanotechnology, she said in an interview with Medical Daily, could enable fibers to become intelligent.
Ms. Gault and Bioflex have applied for a patent for a composite fabric. The fabric is designed to work with or without sensors and is expected to have a wide variety of medical uses.
The takeaway here: Right now, it’s people with diabetes who are finding they benefit from this injury prevention technology as their medical teams find they have one more resource to help their patients. On the other hand, other consumers and other medical teams might find the same things.
Randy B. Hecht writes on medical and other emerging technologies and materials science.