Digital Health: 'Socksess' - Smart Sensing Socks For Monitoring Diabetic Feet And Preventing Ulceration

背景：糖尿病损害足部神经，被称为“神经病变”，每2个糖尿病患者中就有1个受到影响。这会导致人们失去双脚的所有感觉和感觉，这意味着患有糖尿病和神经病变的人会在不知情的情况下对他们的脚施加高压。由于神经受损，人们没有任何自然的方法来知道他们对脚施加了多大的压力，实际上可能会在脚底留下一个洞，称为糖尿病足溃疡。虽然开始时可能是脚上的一个小洞，但糖尿病足溃疡可能会被感染，有人可能需要切除一部分脚或腿来阻止感染并挽救他们的生命。在英国，每周有超过120例因糖尿病足部溃疡而截肢。我们的目标：Socksess项目旨在创造新的技术，帮助糖尿病患者意识到他们对脚施加了多大的压力，并防止溃疡。我们将开发和测试一种新的“智能感应袜子”，它将“让人们的脚重新连接起来”，并有助于防止溃疡和截肢。我们的方法是：我们将通过“联合设计”来实现这一点--与有糖尿病生活经验的人、他们的家人和医疗保健专业人员密切合作，开发技术，做出设计选择，并宣传这项工作。我们还将得到国际糖尿病足部护理专家小组和行业合作伙伴的支持，他们将帮助指导长期开发、临床评估和商业化。计划工作：该项目涉及四个主要工作领域：1.了解糖尿病患者、他们的护理人员和临床医生的需求和偏好，共同设计一种智能传感袜子，适合糖尿病患者的生活，并帮助他们保护自己的脚。开发和测试内置在可伸缩袜子织物中的小型传感器，用于以两种方式测量脚部负荷：i)直接对准脚部(压力)和ii)侧到侧(剪切力)。在一组糖尿病患者中测试智能传感袜子的原型，这些人是患溃疡的高危人群，并使用这项新技术来更好地了解足部负荷如何影响足部特定部位的溃疡风险。开发一个易于使用的反馈系统：一种让人们知道他们脚上的负荷可能太高并开始导致足部溃疡的方法。这将是共同设计的(如上面的1)，以使它尽可能地便于每个人使用。为实现这一目标，我们将开发一系列进步：-用于测量压力和剪切力(侧到侧足部负载)的新传感技术-将传感集成到跨整个脚部的“智能袜子”中-来自我们的临床研究的新数据提供了更好地了解糖尿病患者的足部负载-易于使用的反馈系统，旨在“重新连接人们的脚”，并帮助他们更好地监控他们的脚部健康影响：该项目将通过开发急需的数字健康监测解决方案来帮助解决影响数百万糖尿病患者生活的糖尿病足部溃疡和截肢这一全球性问题。通过其易用性，这项技术将有助于支持一系列糖尿病患者更好地管理他们的脚部健康并重新连接他们的脚，提高生活质量，预防糖尿病足部溃疡和截肢。这项工作还将带来除用于糖尿病足健康之外的好处。它还可以通过监测和提供行走和平衡方面的反馈，来评估和帮助管理影响行动能力的情况(如关节炎)。当人们长时间躺在医院的病床上时，这项技术还可以帮助防止脚部和腿部后部的床疮。这些智能感应袜子还可以帮助更好地穿上新鞋。

Background: Diabetes damages nerves in the feet, known as 'neuropathy', affecting 1 in every 2 people with diabetes. This can cause people to lose all sensation and feeling in their feet and means that people with diabetes and neuropathy put high pressure on their feet without knowing. With nerves that are damaged, people do not have any natural way of knowing how much high pressure they put on their feet and can literally wear a hole in the bottom of their foot, known as a diabetic foot ulcer. Although it can start off as a small hole in the foot, a diabetic foot ulcer can become infected and someone may need to have part of their foot or leg removed (amputated) to stop the infection and save their life. In the UK, there are over 120 amputations every week because of a diabetic foot ulcer. Our Aim: The 'Socksess' project aims to create new technology to help make people with diabetes aware of how much pressure they put on their feet and prevent ulcers. We will develop and test a new 'smart-sensing sock' that will 'reconnect people with their feet' and help prevent ulcers and amputations. Our approach: We will do this through 'co-design' - working closely with people who have experience of living with diabetes, their families and healthcare professionals, to develop the technology, make design choices and publicise the work. We will also be supported by a panel of international experts in diabetic foot care and industry partners who will help guide long-term development, clinical evaluation and commercialisation.Planned Work: the project involves four main areas of work:1. Understanding the needs and preferences of people with diabetes, their carers and clinicians, to co-design a smart-sensing sock that will suit the lives of people with diabetes and help them to protect their feet.2. Developing and testing small sensors built into stretchable sock fabric for measuring foot loading in two ways: i) directly against the foot (pressure) and ii) side-to-side (shear stress).3. Testing prototypes of the smart-sensing socks in a group of people with diabetes who are at high-risk for getting an ulcer, and using this new technology to better understand how foot loading affects ulcer risk at specific points on the foot.4. Developing an easy to use feedback system: a way of letting people know when the loading on their feet might be too high and begin to cause a foot ulcer. This will be co-designed (as in 1 above) to make it as easy as possible for everyone to use.Working towards this goal, we will develop a number of advances:- new sensing technology for measuring pressure and shear stress (side-to-side foot loading)- integration of sensing into a 'smart-sock' measuring across the whole foot- new data from our clinical studies providing better understanding of foot loading in diabetes- Easy to use feedback system designed to 'reconnect people with their feet' and help them better monitor their foot healthImpact: This project will help address the global issue of diabetic foot ulcers and amputations that affect the lives of millions of people living with diabetes by developing a much-needed digital health monitoring solution. Through its ease of use, this technology will help to support a range of people with diabetes to better manage their foot health and 'reconnect with their feet', improving quality of life and preventing diabetic foot ulcers and amputations. The work will also bring benefits beyond use in diabetic foot health. It could also be used to assess and help manage conditions affecting mobility (e.g. arthritis) by monitoring and providing feedback on walking and balance. The technology could also help prevent bed sores on the feet and backs of the legs when people are lying in hospital beds for long periods of time. These smart-sensing socks could also help with better fitting of new footwear.