A survey on smart shoe insole systems
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paper_title: Medical diagnostic-based sensor selection

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Wearable sensing systems have facilitated a variety of applications in Wireless Health. Due to the considerable number of sensors and their constant monitoring these systems are often expensive and power hungry. Traditional approaches to sensor selection in large multisensory arrays attempt to alleviate these issues by removing redundant sensors while maintaining overall sensor predictability. However, predicting sensors is unnecessary if ultimately the system needs only to quantify diagnostic measurements specific to the application domain. We propose a new method for optimizing the design of medical sensor systems through diagnostic-based bottom-up sensor selection. We reduce the original sensor array from ninety nine to twelve sensors while maintaining a prediction error rate of less than 5% over all diagnostic metrics in our testing dataset.
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paper_title: Quantifying the dose-response of walking in reducing coronary heart disease risk: meta-analysis

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The evidence for the efficacy of walking in reducing the risk of and preventing coronary heart disease (CHD) is not completely understood. This meta-analysis aimed to quantify the dose-response relationship between walking and CHD risk reduction for both men and women in the general population. Studies on walking and CHD primary prevention between 1954 and 2007 were identified through Medline, SportDiscus and the Cochrane Database of Systematic Reviews. Random-effect meta-regression models were used to pool the relative risks from individual studies. A total of 11 prospective cohort studies and one randomized control trial study met the inclusion criteria, with 295,177 participants free of CHD at baseline and 7,094 cases at follow-up. The meta-analysis indicated that an increment of approximately 30 min of normal walking a day for 5 days a week was associated with 19% CHD risk reduction (95% CI = 14-23%; P-heterogeneity = 0.56; I (2) = 0%). We found no evidence of heterogeneity between subgroups of studies defined by gender (P = 0.67); age of the study population (P = 0.52); or follow-up duration (P = 0.77). The meta-analysis showed that the risk for developing CHD decreases as walking dose increases. Walking should be prescribed as an evidence-based effective exercise modality for CHD prevention in the general population.
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paper_title: Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes.

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BACKGROUND ::: It is a public health recommendation to accumulate at least 150 minutes per week of moderate intensity physical activity. Although pedometers are widely used as a physical activity-monitoring tool, they are unable to measure activity intensity. Translating current physical activity recommendations into a pedometer-based guideline could increase the public health impact of physical activity interventions. ::: ::: ::: METHODS ::: A community sample of 97 adults (60% women, with a mean age of 32.1 [+/-10.6] years and a mean BMI of 28.8 [+/-5.5]) completed four 6-minute incremental walking bouts on a level treadmill at 65, 80, 95, and 110 m x min(-1). A calibrated metabolic cart was used to measure energy expenditure at each speed. Steps were measured using a Yamax SW-200 pedometer. Step-rate cut points associated with minimally moderate-intensity activity (defined as 3 METs) were determined using multiple regression, mixed modeling, and receiver operating characteristic (ROC) curves. All data were collected and analyzed in 2006. ::: ::: ::: RESULTS ::: For men, step counts per minute associated with walking at 3 METs were 92 step x min(-1) (multiple regression); 101 step x min(-1) (mixed modeling); and 102 step x min(-1) (ROC curve). For women, step counts per minute associated with walking at 3 METs were 91 step x min(-1) (multiple regression); 111 step x min(-1) (mixed modeling); and 115 step x min(-1) (ROC curve). However, for each analysis there was substantial error in model fit. ::: ::: ::: CONCLUSIONS ::: Moderate-intensity walking appears approximately equal to at least 100 step x min(-1). However, step counts per minute is a poor proxy for METs, and so 100 step x min(-1) should be used only as a general physical activity promotion heuristic. To meet current guidelines, individuals are encouraged to walk a minimum of 3000 steps in 30 minutes on 5 days each week. Three bouts of 1000 steps in 10 minutes each day can also be used to meet the recommended goal.
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paper_title: Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs

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AIMS ::: To estimate the current and future economic burdens of Type 1 and Type 2 diabetes in the UK. ::: ::: ::: METHODS ::: A top-down approach was used to estimate costs for 2010/2011 from aggregated data sets and literature. Prevalence and population data were used to project costs for 2035/2036. Direct health costs were estimated from data on diagnosis, lifestyle interventions, ongoing treatment and management, and complications. Indirect costs were estimated from data on mortality, sickness, presenteeism (potential loss of productivity among people who remain in work) and informal care. ::: ::: ::: RESULTS ::: Diabetes cost approximately £ 23.7bn in the UK in 2010/2011: £ 9.8bn in direct costs (£1bn for Type 1 diabetes and £ 8.8bn for Type 2 diabetes) and £ 13.9bn in indirect costs (£ 0.9bn and £ 13bn). In real terms, the 2035/2036 cost is estimated at £ 39.8bn: £ 16.9bn in direct costs (£ 1.8bn for Type 1 diabetes and £ 15.1bn for Type 2 diabetes) and £ 22.9bn in indirect costs (£ 2.4bn and £ 20.5bn). Sensitivity analysis applied to the direct costs produced a range of costs: between £ 7.9bn and £ 11.7bn in 2010/2011 and between £ 13.8bn and £20bn in 2035/2036. Diabetes currently accounts for approximately 10% of the total health resource expenditure and is projected to account for around 17% in 2035/2036. ::: ::: ::: CONCLUSIONS ::: Type 1 and Type 2 diabetes are prominent diseases in the UK and are a significant economic burden. Data differentiating between the costs of Type 1 and Type 2 diabetes are sparse. Complications related to the diseases account for a substantial proportion of the direct health costs. As prevalence increases, the cost of treating complications will grow if current care regimes are maintained.
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paper_title: Walking: the first steps in cardiovascular disease prevention

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PURPOSE OF REVIEW ::: Health professionals are presented with the challenge of prescribing physical activity that is likely to be sustained by the sedentary majority. Walking is eminently suited to physical activity prescription for inactive individuals as it is accessible to men and women of all ages and social groups and poses little risk of injury. This paper reviews recent evidence of the health benefits of walking and promotion of walking behavior. ::: ::: ::: RECENT FINDINGS ::: Large observational studies consistently show associations between walking and cardiovascular disease endpoints over long periods of follow-up. Intervention studies further support the health benefits of walking, showing improvements in clinical biomarkers and measures after shorter periods of follow-up. Walking appears to have cardiovascular disease-related health benefits in younger, middle-aged, and older men and women, in both healthy and patient populations. Pedometer-based, mobile phone-based, and computer-based programs are effective in increasing walking levels. Neighborhood and workplace amenities and programs may be important supports for walking behaviors. ::: ::: ::: SUMMARY ::: Walking has the potential to play a key role in the primary and secondary prevention of cardiovascular disease. Clinicians can prescribe walking to assist patients meet physical activity recommendations and help identify supports available to the patient.
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paper_title: Home Monitoring of Foot Skin Temperatures to Prevent Ulceration

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OBJECTIVE ::: To evaluate the effectiveness of at-home infrared temperature monitoring as a preventative tool in individuals at high risk for diabetes-related lower-extremity ulceration and amputation. ::: ::: ::: RESEARCH DESIGN AND METHODS ::: Eighty-five patients who fit diabetic foot risk category 2 or 3 (neuropathy and foot deformity or previous history of ulceration or partial foot amputation) were randomized into a standard therapy group (n = 41) or an enhanced therapy group (n = 44). Standard therapy consisted of therapeutic footwear, diabetic foot education, and regular foot evaluation by a podiatrist. Enhanced therapy included the addition of a handheld infrared skin thermometer to measure temperatures on the sole of the foot in the morning and evening. Elevated temperatures (>4 degrees F compared with the opposite foot) were considered to be "at risk" of ulceration due to inflammation at the site of measurement. When foot temperatures were elevated, subjects were instructed to reduce their activity and contact the study nurse. Study subjects were followed for 6 months. ::: ::: ::: RESULTS ::: The enhanced therapy group had significantly fewer diabetic foot complications (enhanced therapy group 2% vs. standard therapy group 20%, P = 0.01, odds ratio 10.3, 95% CI 1.2-85.3). There were seven ulcers and two Charcot fractures among standard therapy patients and one ulcer in the enhanced therapy group. ::: ::: ::: CONCLUSIONS ::: These results suggest that at-home patient self-monitoring with daily foot temperatures may be an effective adjunctive tool to prevent foot complications in individuals at high risk for lower-extremity ulceration and amputation.
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paper_title: Wearable Multimodal Skin Sensing for the Diabetic Foot

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Ulceration of the diabetic foot is currently difficult to detect reliably in a timely manner causing undue suffering and cost. Current best practice is for daily monitoring by those living with diabetes coupled to scheduled monitoring by the incumbent care provider. Although some metrics have proven useful in the detection or prediction of ulceration, no single metric can currently be relied upon for diagnosis. We have developed a prototype multivariate extensible sensor platform with which we demonstrate the ability to gather acceleration, rotation, galvanic skin response, environmental temperature, humidity, force, skin temperature and bioimpedance signals in real time, for later analysis, utilising low cost Raspberry Pi and Arduino devices. We demonstrate the utility of the Raspberry Pi computer in research which is of particular interest to this issue of electronics—Raspberry Pi edition. We conclude that the hardware presented shows potential as an adaptable research tool capable of gathering synchronous data over multiple sensor modalities. This research tool will be utilised to optimise sensor selection, placement and algorithm development prior to translation into a sock, insole or platform diagnostic device at a later date. The combination of a number of clinically relevant parameters is expected to provide greater understanding of tissue state in the foot but requires further volunteer testing and analysis beyond the scope of this paper which will be reported in due course.
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paper_title: Foot posture, range of motion and plantar pressure characteristics in obese and non-obese individuals

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Abstract Obesity is a world-wide health problem and is strongly associated with musculoskeletal disorders of the lower limb. The aim of this study was to evaluate plantar loading patterns in obese and non-obese individuals, while accounting for the contribution of foot structure, range of motion and walking speed. Sixty-eight participants (mean ± SD age, 52.6 ± 8.0 years), including 47 females (69%), underwent assessments of body mass index, foot pain and foot structure. Plantar pressures were also obtained, using a floor-mounted resistive sensor mat system. Multiple regression analysis was used to determine which variables were most strongly associated with plantar loading patterns. Obese individuals exhibited flatter feet, reduced inversion–eversion range of motion, and higher peak plantar pressures when walking. After accounting for foot structure and walking speed, bodyweight was found to be significantly associated with elevated loading of the foot, particularly the forefoot and midfoot. These findings suggest that obesity increases the stresses applied to the foot directly, via increased bodyweight, and indirectly, via alterations to foot structure, which may partly explain the link between obesity and the development of foot pain. Clinicians dealing with foot problems should consider the effect of increased bodyweight on plantar loading in obese patients.
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paper_title: eCushion: An eTextile Device for Sitting Posture Monitoring

paper_content:

Sitting posture analysis is critical for daily applications in biomedical, education and healthcare fields. However, it remains unclear how to monitor sitting posture economically and comfortably. To this end, we presented an eTextile device, called eCushion, in this paper, which can analyze the sitting posture of human being accurately and non-invasively. First, we discussed the implementation of eCushion and design challenges of sensing data, such as scale, offset, rotation and crosstalk. Then, several effective techniques have been proposed to improve the recognition rate of sitting posture. Our experimental results show that the recognition rate of our eCushion system could achieve 92% for object-oriented cases and 79% for general cases.
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paper_title: Smart Insole: A Wearable Sensor Device for Unobtrusive Gait Monitoring in Daily Life

paper_content:

Gait analysis is an important medical diagnostic process and has many applications in healthcare, rehabilitation, therapy, and exercise training. However, typical gait analysis has to be performed in a gait laboratory, which is inaccessible for a large population and cannot provide natural gait measures. In this paper, we present a novel sensor device, namely, Smart Insole, to tackle the challenge of efficient gait monitoring in real life. An array of electronic textile (eTextile)-based pressure sensors are integrated in the insole to fully measure the plantar pressure. Smart Insole is also equipped with a low-cost inertial measurement unit including a three-axis accelerometer, a three-axis gyroscope, and a three-axis magnetometer to capture the gait characteristics in motion. Smart Insole can offer precise acquisition of gait information. Meanwhile, it is lightweight, thin, and comfortable to wear, providing an unobtrusive way to perform the gait monitoring. Furthermore, a smartphone graphic user interface is developed to display the sensor data in real-time via Bluetooth low energy. We perform a set of experiments in four real-life scenes including hallway walking, ascending/descending stairs, and slope walking, where gait parameters and features are extracted. Finally, the limitation and improvement, wearability and usability, further work, and healthcare-related potential applications are discussed.
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paper_title: Smart insole: a wearable system for gait analysis

paper_content:

Gait analysis is an important medical diagnostic process and has many applications in rehabilitation, therapy and exercise training. However, standard human gait analysis has to be performed in a specific gait lab and operated by a medical professional. This traditional method increases the examination cost and decreases the accuracy of the natural gait model. In this paper, we present a novel portable system, called Smart Insole, to address the current issues. Smart Insole integrates low cost sensors and computes important gait features. In this way, patients or users can wear Smart Insole for gait analysis in daily life instead of participating in gait lab experiments for hours. With our proposed portable sensing system and effective feature extraction algorithm, the Smart Insole system enables precise gait analysis. Furthermore, taking advantage of the affordability and mobility of Smart Insole, pervasive gait analysis can be extended to many potential applications such as fall prevention, life behavior analysis and networked wireless health systems.
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paper_title: eCushion: An eTextile Device for Sitting Posture Monitoring

paper_content:

Sitting posture analysis is critical for daily applications in biomedical, education and healthcare fields. However, it remains unclear how to monitor sitting posture economically and comfortably. To this end, we presented an eTextile device, called eCushion, in this paper, which can analyze the sitting posture of human being accurately and non-invasively. First, we discussed the implementation of eCushion and design challenges of sensing data, such as scale, offset, rotation and crosstalk. Then, several effective techniques have been proposed to improve the recognition rate of sitting posture. Our experimental results show that the recognition rate of our eCushion system could achieve 92% for object-oriented cases and 79% for general cases.
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Title: A Survey on Smart Shoe Insole Systems

Section 1: Introduction
Description 1: Write an introduction to wearable smart shoe insole systems, highlighting their importance in medical diagnosis, patient monitoring, and athletic performance enhancement.

Section 2: System Overview
Description 2: Provide an overview of the Smart Insole system, detailing its components, features, and capabilities in gait analysis and activity monitoring.

Section 3: Hardware Architecture
Description 3: Describe the hardware architecture of the Smart Insole system, including the sensors, micro control unit, wireless transmission module, power sources, and data storage solutions.

Section 4: Systems 
Description 4: Discuss various smart shoe insole systems, comparing their designs, sensor types, battery life, and communication modes. Highlight the factors affecting foot pressure and foot structure during dynamic activities.

Section 5: Discussion
Description 5: Evaluate the validity and utility of smart insole measurements for monitoring patients and controlling diseases. Compare different systems based on error rate, clinical utility, and patient comfort.

Section 6: Conclusion
Description 6: Summarize the benefits of smart insole systems in medical supervision and patient monitoring. Outline future work for enhancing real-time monitoring, system functionality, and user comfort.