HappierFeet-Disrupting the vicious cycle of healthcare decline in Diabetic Foot Ulceration through active prevention: The future of self-managed care
Lead Research Organisation:
University of Manchester
Department Name: Mechanical Aerospace and Civil Eng
Abstract
Diabetic foot ulcers (DFUs) are common, chronic and cost the NHS £1Billion annually. Up to 25% of patients with diabetes develop a DFU within their lifetime. Healing is slow and 40% of patients re-ulcerate within 12 months. DFUs frequently recur and lead to amputation and/or death, with a 40% mortality rate at 5 years. DFUs are more common in people who are socially and economically disadvantaged. The physical and emotional burden of ulceration is considerable: 32% are depressed and this is related to a 3-fold greater risk of mortality. Gait is often maladaptive in this group, overloading parts of the foot, making movement painful/unsafe, and they are scared of movement. They often feel hopeless about the future, as it's not currently possible to prevent DFUs. A consequence is a downward vicious cycle of reduced movement, self-efficacy and mood, which is thought to negatively impact patient ability to engage in preventative behaviours for DFUs and increase chances of re-ulceration, but also has significant potential to increase other disorders which are influenced by lack of physical activity/low mood, e.g. pain, cardio-metabolic disorders, and cancer.
This project proposes to build and expand on current smart insole technologies for the detection of Diabetic Foot Ulcers, utilising a multiple sensor-based approach for their identification. A smart insole with integrated pressure, temperature, acoustic and sensors which measure how someone walks will identify early indicators of ulceration and when movement is appropriate/ inappropriate. The smart insole will respond to these inputs and adjust the foot, and hence the way someone walks, through embedded actuators, to support better, safe and comfortable movement. The smart insole will alert the user to potential problems, through a smartphone, enabling self-management; promoting users to check their foot and seek medical attention as required. Although data sharing with the cloud to facilitate community self-management and to inform clinical decision-making is beyond the scope of this project, this research will lay the foundations for future proofing the security and privacy of highly sensitive information against advancements in quantum computing. This project will seek to understand and overcome the barriers of technology adaptability, acceptability and adoption for users and their social networks (friends, family etc). This smart insole can break the vicious cycle by increasing self-efficacy to self-manage Diabetic Foot Ulcers and to be more active, thus impacting across multiple illnesses which respond to physical activity.
This project proposes to build and expand on current smart insole technologies for the detection of Diabetic Foot Ulcers, utilising a multiple sensor-based approach for their identification. A smart insole with integrated pressure, temperature, acoustic and sensors which measure how someone walks will identify early indicators of ulceration and when movement is appropriate/ inappropriate. The smart insole will respond to these inputs and adjust the foot, and hence the way someone walks, through embedded actuators, to support better, safe and comfortable movement. The smart insole will alert the user to potential problems, through a smartphone, enabling self-management; promoting users to check their foot and seek medical attention as required. Although data sharing with the cloud to facilitate community self-management and to inform clinical decision-making is beyond the scope of this project, this research will lay the foundations for future proofing the security and privacy of highly sensitive information against advancements in quantum computing. This project will seek to understand and overcome the barriers of technology adaptability, acceptability and adoption for users and their social networks (friends, family etc). This smart insole can break the vicious cycle by increasing self-efficacy to self-manage Diabetic Foot Ulcers and to be more active, thus impacting across multiple illnesses which respond to physical activity.
Publications
Eccles A
(2022)
The challenges of multi-disciplinary research in the design and adoption of self-managing technologies
in Gerontechnology
Pathmaperuma M
(2022)
CNN for User Activity Detection Using Encrypted In-App Mobile Data
in Future Internet
Pathmaperuma MH
(2022)
Deep Learning for Encrypted Traffic Classification and Unknown Data Detection.
in Sensors (Basel, Switzerland)
Wylie TAF
(2022)
Ageing well with diabetes: A workshop to co-design research recommendations for improving the diabetes care of older people.
in Diabetic medicine : a journal of the British Diabetic Association
Description | We have developed an in-shoe sensing insole which can measure parameters at the bottom of the foot and the way someone walks to better understand the relationships between them. This is an important achievement as it enables the investigation of how the sensed parameters vary in healthy people and those living with condition such as Diabetes. |
Exploitation Route | We are discussing the potential to commercialise this technology with a view to developing a system to enable people living with Diabetes to better self-manage their foot health. In the remainder of this project we will capture data from healthy people and those living with Diabetes. We will publish details of the study results to inform the research community opening up a new route to understand and manage diabetic foot ulceration. |
Sectors | Healthcare |
Description | Happier Feet project and Diabetes UK |
Organisation | Diabetes UK |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | Our research team have contributed through participating in a National Diabetes UK workshop on ageing well with Diabetes. Discussions with Diabetes UK representatives have enabled knowledge exchange from the team in the areas of technologies for monitoring foot health, social science, digital privacy and security, behavioural science and condition management. |
Collaborator Contribution | Diabetes UK have provided essential input into the project to shape its strategic direction. Input has ensured that the wider views of people living with Diabetes are represented and that the technology being developed is more likely to meet the needs of people with the condition. |
Impact | A journal paper titled: Ageing well with diabetes: A workshop to co-design research recommendations for improving the diabetes care of older people, published in Diabetic Medicine. |
Start Year | 2021 |
Description | Manchester Diabetes Centre Visit |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Visit to Manchester Diabetes centre to discuss research with clinical staff and patients and capture input to shape the project and technology development. The visit gave excellent context to the project and emphasised the importance of sensing plantar tissue parameters to identify early indicators of Diabetic Foot Ulcers. |
Year(s) Of Engagement Activity | 2022 |
Description | Presentation to the NIHR Exeter Biomedical Research Centre |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | We presented details of this research to colleagues from NIHR. The significance and potential of the technology were discussed and feedback gathered. |
Year(s) Of Engagement Activity | 2023 |
Description | Strategic workshop (Exeter) |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | A strategic focus group involving the research team, external expert researchers in the field, professional practitioners, charitable organisations, study participants and postgraduate students. An overview of the project was provided and progress across work packages presented. Feedback was sought on progress and to inform the activities within the project. Wider implications of the research and how it might influence future directions and priorities were discussed. |
Year(s) Of Engagement Activity | 2023 |
Description | Strategic workshop (Manchester) |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | A strategic focus group involving the research team, external expert researchers in the field, professional practitioners, charitable organisations, study participants and postgraduate students. An overview of the project was provided and progress across work packages presented. Feedback was sought on progress and to inform the activities within the project. Wider implications of the research and how it might influence future directions and priorties were discussed. |
Year(s) Of Engagement Activity | 2022 |
Description | Strategic workshop (Online) |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | A strategic focus group involving the research team, external expert researchers in the field, professional practitioners, charitable organisations, study participants and postgraduate students. An overview of the project was provided and progress across work packages presented. Feedback was sought on progress and to inform the activities within the project. Wider implications of the research and how it might influence future directions and priorities were discussed. |
Year(s) Of Engagement Activity | 2021 |