iStride™ Device

Background

Effective gait rehabilitation requires precise coordination between the legs, a capability often impaired in individuals with central nervous system lesions, such as those caused by stroke. Traditional rehabilitation methods, like the split-belt treadmill, have been shown to correct walking asymmetries by moving the legs at different speeds. However, these methods have significant limitations. The primary issue is the limited transfer of learned walking patterns to over-ground walking, a crucial aspect of daily mobility. Additionally, split-belt treadmills require a controlled, stationary environment, which restricts the ability for individuals to practice walking in their natural, everyday settings. Walking on a treadmill provides a static visual flow, which differs significantly from the dynamic visual experience of over-ground walking. This discrepancy creates a sensory conflict that can hinder the effective transfer of training from the treadmill to real-world walking scenarios. Addressing this challenge requires a solution that not only corrects gait asymmetry but also allows for practice in real-world environments, ensuring better retention and transfer of improved walking patterns.

iStride™ Device

The iStride™ Device is an innovative solution designed to overcome the limitations of traditional gait rehabilitation methods. This device replicates the benefits of split-belt treadmill therapy while allowing users to walk over ground, thereby providing a consistent sensory experience that enhances the transfer of learned gait improvements to everyday walking.

The iStride™ Device is engineered to enhance interlimb coordination and increase walking velocity without the need for external power. Its mechanical design converts the wearer's downward and horizontal forces into a backward motion of the foot, promoting natural and efficient walking patterns. This device is lightweight and completely mobile, making it ideal for continuous use outside the rehabilitation clinic. Users can practice walking in their home or community environments, facilitating more frequent and effective rehabilitation sessions.

Results of walking on the iStride™ Device

This is one of the subjects from our study. Before treatment starts when the subject was several years post-stroke and had gone through traditional rehabilitation. He then went through 12 sessions of walking on the iStride Device for 30 minutes per session. We followed up with the subject at several timepoints over the year after his iStride therapy ended. You can see the dramatic change in his gait and how it persisted.

Key Features and Benefits

• Natural Over-Ground Walking: The iStride™ Device mimics the effects of split-belt treadmill therapy while walking over ground, ensuring that users experience consistent sensory information. This natural walking experience aids in the effective transfer and retention of improved walking patterns to real-world environments.
• Mechanical, Power-Free Design: The iStride™ Device requires no external power source. It mechanically harnesses the wearer's own forces to generate the necessary motion, making it a lightweight and user-friendly option for gait rehabilitation.
• Long-Term Rehabilitation: By enabling continuous use outside the clinic, the iStride™ Device promotes frequent practice, which is crucial for effective motor relearning and retention. Users can incorporate rehabilitation into their daily routines, leading to faster and more sustainable improvements in gait.
• Cost-Effective Solution: The iStride™ Device is significantly less expensive than traditional split-belt treadmills, making it accessible for both clinical and home-based rehabilitation. Its affordability allows more individuals to benefit from advanced gait training without the financial burden associated with other high-cost rehabilitation technologies.
• Safe and Controlled Motion:The device incorporates rotary dampers to ensure smooth and controlled backward foot motion. This design enhances stability and user confidence, reducing the risk of falls and promoting safer rehabilitation sessions.
• Proven Efficacy: Clinical trials and user testing have demonstrated the effectiveness of the iStride™ Device in improving gait symmetry, walking speed, and overall functional mobility in stroke survivors. Participants have reported significant gains in gait performance and quality of life, highlighting the device's potential to make a meaningful impact on stroke rehabilitation.

Summary

The iStride™ Device represents a transformative advancement in gait rehabilitation technology for stroke survivors. By providing a mobile, cost-effective, and efficient solution for correcting gait asymmetry, the iStride™ Device enables users to practice in real-world environments, leading to better long-term outcomes. This innovative device has the potential to revolutionize the way gait rehabilitation is delivered, making effective and continuous rehabilitation accessible to a broader population.

While the invention of the iStride™ Device started at the REED Lab at the University of South Florida, commercialization is moving forward in collaboration with Moterum Technologies.

Related Publications

• B. Darcy, L. Rashford, N.T. Tsai, D. Huizenga, K.B. Reed, and S.J.M. Bamberg, "One-year retention of gait speed improvement in stroke survivors after treatment with a wearable home-use gait device," Frontiers in Neurology, vol. 14, 2024. doi: 10.3389/fneur.2023.1089083
  [ frontiers ]
• B. Darcy, L. Rashford, S. T. Shultz, N. T. Tsai, D. Huizenga, K. B. Reed, and S. J. Bamberg, "Gait device treatment using telehealth for individuals with stroke during the covid-19 pandemic: Nonrandomized pilot feasibility study," JMIR Formative Research, vol. 7, no. 1, p. e43008, 2023.
  [ JMIR ]
• D. Huizenga, L. Rashford, B. Darcy, E. Lundin, R. Medas, S. T. Shultz, E. DuBose, and K. B. Reed, "Wearable gait device for stroke gait rehabilitation at home," Topics in Stroke Rehabilitation, 2021.
  [ Taylor & Francis Online ]
• D. Huizenga, B. Darcy, L. Rashford, E. Lundin, R. Medas, S.T. Shultz, E. DuBose, K.B. Reed. "Home Use Gait Device for Stroke Hemiparesis: Long-Term Follow-Up Results", in Archives of Physical Medicine and Rehabilitation, v. 101, issue 11, p. e68, 2020.
  [ Archives PMR ]
• B. Darcy, L. Rashford, E. Lundin, R. Medas, T. Shultz, E. DuBose, D. Huizenga, K. B. Reed. "Active Limb Orthosis for Home Use-Stroke Gait Rehabilitation", Combined Sections Meeting (CSM), APTA, February 2020.
  [ APTA ]
• B. Darcy, L. Rashford, E. Lundin, R. Medas, T. Shultz, E. DuBose, D. Huizenga, K. B. Reed. "The Relationship Between Gait Speed and Self-Reported Quality of Life in Stroke Survivors After Treatment With a Therapeutic Gait Device", Stroke, February 2020.
  [ Stroke ]
• L. Rashford, B. Darcy, E. Lundin, R. Medas, T. Shultz, E. DuBose, D. Huizenga, K. B. Reed. "Active Limb Orthosis for Home Use - Stroke Gait Rehabilitation", American Congress of Rehabilitation Medicine (ACRM), November 2019.
  [ ACRM ]
• S. Kim, D. Huizenga, I. Handzic, R. Ditwiler, M. Lazinski, T. Ramakrishnan, A. Bozeman, D. Rose, K. B. Reed. "Relearning functional and symmetric walking after stroke using a wearable device: a feasibility study," Journal of NeuroEngineering and Rehabilitation, Volume 16, 2019.
  [ Springer Nature ]
• S. H. Kim, D. Huizenga, I. Handzic, R. Edgeworth, M. Lazinski, T. Ramakrishnan, D. Rose, K. B. Reed. "Device for Improving Double Limb Support, Step Length Symmetry, and Gait Speed in Hemiparetic Patients", in Archives of Physical Medicine and Rehabilitation, v. 98, issue 10, p. e52
  [ Archives PMR ]
• S. H. Kim, I. Handzic, D. Huizenga, R. Edgeworth, M. Lazinski, T. Ramakrishnan, and K. B. Reed. "Initial Results of the Gait Enhancing Mobile Shoe on Individuals with Stroke," in Intl. Conf. of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, USA, 2016.
  [ EMBC ]
• "Gait-Altering Shoe," K. B. Reed and I. Handzic, U.S. Patent 9,295,302, issued March 29, 2016, priority date February 17, 2012.
  [ USPTO ]
• I. Handzic and K. B. Reed. "Kinetic Shapes: Analysis, Verification, and Applications," ASME Journal of Mechanical Design, Vol. 136, No. 6, pp. 061005(1-8), 2014.
  [ ASME | ASME | abstract ]
• I. Handzic and K. B. Reed, "Comparison of the Passive Dynamics of Walking on Ground, Tied-belt and Split-belt Treadmills, and via the Gait Enhancing Mobile Shoe," Proc. of the 13th Intl. Conf. on Rehabilitation Robotics (ICORR), Seattle, USA, June, 2013.
  [ ICORR ]
• I. Handzic, E. Vasudevan, and K. B. Reed, "Developing a Gait Enhancing Mobile Shoe to Alter Over-Ground Walking Coordination," Proc. of IEEE Intl. Conf. on Robotics and Automation (ICRA), St. Paul, USA, May, 2012.
  [ ICRA | .mp4]
• I. Handzic, E. Barno, E. V. Vasudevan, and K. B. Reed. "Design and Pilot Study of a Gait Enhancing Mobile Shoe," Journal of Behavioral Robotics, Special Issue on Assistive Robotics, Vol. 2, Num. 4, pp. 193-201, 2011.
  [ SpringerLink | preprint | PubMed | abstract ]
• I. Handzic, E. Vasudevan, and K. B. Reed, "Motion Controlled Gait Enhancing Mobile Shoe for Rehabilitation," Proc. of the 12th Intl. Conf. on Rehabilitation Robotics (ICORR), Zurich, Switzerland, June, 2011.
  [ ICORR | .mp4 | PubMed ]
• A. de Groot, R. Decker, and K. B. Reed. "Gait Enhancing Mobile Shoe for Rehabilitation," Third Joint Eurohaptics Conference and Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems (World Haptics), Salt Lake City, USA, 2009.
  [ World Haptics | .mp4 ]

• "Stroke therapy shoe invented at USF empowers patients' recovery"
       https://www.usf.edu/news/2024/stroke-therapy-shoe-invented-at-empowers-patients-recovery.aspx
• "Stroke shoe retrains the brain, correcting gait"
       https://www.wndu.com/content/news/Stroke-shoe-retrains-the-brain-correcting-gait-506721291.html
• "Early study shows shoe attachment can help stroke patients improve their gait"
       https://medicalxpress.com/news/2017-12-early-patients-gait.html
• "Shoe offers stroke recovery revolution"
       http://www.fox13news.com/health/shoe-offers-stroke-recovery-revolution
• "Early study shows new shoe attachment can help stroke patients improve their gait"
       https://hscweb3.hsc.usf.edu/blog/2017/12/13/early-study-shows-new-shoe-attachment-can-help-stroke-patients-improve-gait/
• "Spirals inspire walking aids for people with disabilities"
       https://www.sciencenews.org/article/spirals-inspire-walking-aids-people-disabilities

This work has been funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NIH NICHD award #R21HD066200), Moterum Technologies, and the Florida High Tech Corridor.