PDF(Pubmed)
Abstract：
Background: Peripheral neuropathy (PN) can result in either partial or complete loss of distal sensation resulting in an increased fall risk. Walkasins® uses a shoe insert to detect the magnitude and direction of sway and sends signals to a leg unit that provides sensory balance cues. The objective of this case report is to describe the long-term influence of the Walkasins® lower limb sensory neuroprosthesis on balance and gait for an individual with diabetic PN. Case Description: A 51-year-old male with a 3-year history of PN and a 10-year history of type II diabetes mellitus was fitted bilaterally with Walkasins® and utilized them 8-10 hours/day for more than 2 years. Although, vibration and tactile sensation thresholds were severely impaired at his 1st metatarsophalangeal joint and the lateral malleolus bilaterally he could perceive tactile stimuli from the Walkasins® above the ankles. Outcomes: Following Walkasins® use, his Activities-specific Balance Confidence Scale (ABC) scores improved from 33 to 80%. His mean Vestibular Activities of Daily Living (VADL) scores decreased from 3.54 to 1. His Functional Gait Assessment (FGA) scores increased from 13/30 to 28/30 and his miniBESTest scores improved from 15/28 to 26/28. Gait speed increased from 0.23 to 1.5 m/s. The patient described a decrease in pain and cramping throughout his lower extremities and an increase in function. Discussion: Gait and balance improved with the use of the Walkasins® and participation in a wellness program. This improvement suggests that the use of sensory substitution devices, such as the Walkasins®, may replace sensory deficits related to gait and balance dysfunction experienced by patients with PN. Further research is needed to determine if other patients will have a similar response and what the necessary threshold of sensory function is to benefit from use of the Walkasins®.
摘要：
背景：周围神经病变（PN）可导致远端感觉部分或完全丧失，导致跌倒风险增加。Walkasins®使用鞋垫来检测摇摆的幅度和方向，并向提供感觉平衡提示的腿部单元发送信号。本病例报告的目的是描述Walkasins®下肢感觉神经假体对糖尿病性PN患者的平衡和步态的长期影响。病例描述：一名具有3年PN病史和10年II型糖尿病病史的51岁男性双侧安装Walkasins®，并每天使用8-10小时超过2年。虽然,在他的第1meta趾关节和双侧外踝的振动和触觉感觉阈值严重受损，他可以感知脚踝上方Walkasins®的触觉刺激。结果：使用Walkasins®后，他的活动特定平衡信心量表（ABC）得分从33％提高到80％。他的平均日常生活前庭活动（VADL）评分从3.54降至1。他的功能步态评估（FGA）得分从13/30增加到28/30，他的miniBESTest得分从15/28提高到26/28。步态速度从0.23增加到1.5m/s。患者描述了下肢疼痛和痉挛的减轻以及功能的增强。讨论:通过使用Walkasins®和参与健康计划,步态和平衡得到改善。这种改进表明，感觉替代装置的使用，例如Walkasins®，可以替代与PN患者经历的步态和平衡功能障碍相关的感觉缺陷。需要进一步的研究来确定其他患者是否会有类似的反应，以及感觉功能的必要阈值是如何从使用Walkasins®中受益。
