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The portable gait device making big strides in rehab

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HT World talks to Dr Diana Hodgins, CEO of Dynamic Metrics and creator of GaitSmart.

“I hadn’t realised the complexities of working in healthcare,” says Dr Diana Hodgins MBE, of her shift into rehab technology in the early 2000s.

Today Diana holds 30 patents on solid-state sensors and medical applications related to their use.

Back then she had largely focused her science skills on advancing engineering industries; before spotting an opportunity to apply her innovations to healthcare.

“I started to look at medical applications because it’s an area that needs more technological innovation,” she says.

Diana, a renowned sensors expert, identified a gaping unmet need for a new way of taking measurements with minimal intrusion on patients.

“We spent a decade proving why we needed to do this as, despite various trials, there was a huge problem that wasn’t being addressed.”

Dr Diana Hodgins

Having carefully navigated the many “complexities” of establishing a new approach in healthcare, Diana’s company Dynamic Metrics now finds its GaitSmart innovation in high demand.

GaitSmart uses cutting-edge technology to monitor mobility without the need for expensive or time-consuming gait labs.

Cost-effectiveness – an elusive force in neuro-rehab interventions – is key to its success. A typical four-session assessment of a patient via GaitSmart and its affiliated vGym rehab programme, costs around £67.

Seven sensors are mounted in to custom straps on the patient’s thighs, calves and pelvis, plus one on the base of their spine.

The patient then demonstrates their normal gait over 10 metres. Sensors pick up movement and transfer data via an app to the cloud.

Musculoskeletal modelling is used to identify muscle weakness before identifying the optimum exercises for patients.

In-depth reports are then generated, to help shape the changes needed to improve the patient’s mobility.

The data quantifies hip and knee range on both legs and uses traffic light coding and an overall GaitSmart score to indicate the severity of specific gait abnormalities.

The exercises, which are all load bearing, are chosen to address these deficiencies.

GaitSmart plays an important role in keeping people mobile, including fall prevention, providing an alternative in a system which Diana believes is all-too reactive, rather than preventative.

“There are six million people who are frail in this country and 90 per cent of those have difficulty walking. Another four million fall each year, while eight million have osteoarthritis of the hip or knee.

“A third of a million have a joint replacement each year. All of these people are in their sixties to nineties, which is an enormous part of the population.

In addition, there are people suffering from neurological conditions which affects their gait, such as a stroke or Parkinson’s Disease.

For all these patient groups, a detailed gait assessment that describes how the hips and knees move through the gait cycle can form part of their diagnosis and help guide their treatment.

“This is just not being offered. You can go to your doctor to have your blood pressure checked, or to find out if you have cancer, but they don’t check your mobility. Never mind the fact that you hobbled into the surgery.

“If someone starts using a stick or a walker then there is a serious issue, and they may not be mobile for very long. It could be a big flag that someone needs help.”

Diana also believes passionately in making patient results and information as easy to understand as possible, ensuring patients and their loved ones have the full context behind the changes needed to improve or maintain mobility.

“We’ve been into so many clinics and worked with many patients that have no idea what the cause of the problem is, or what they should do. This is about simple guidance and being able to explain the issue and how they should walk, or what they should do to help themselves.

“[After the first assessment] we see them again in a few weeks and they can see their improvements, which keeps them motivated to continue.”

The pandemic clearly brought new challenges to this process, especially in terms of reaching older or more vulnerable patients who may have been trapped at home in self-isolation.

“Now that Covid is on the way out and people are getting back to clinics, we can see that there are millions of people who are struggling even more. They have been sitting at home for two years and, if they are in their 80s, will have serious issues with walking now.

“You are going to be worried about falling over and potentially going into care. Therefore, the market is really big and needs something. Osteoarthritis is often what causes people to change their gait. But shuffling is dangerous because something will catch you and you will fall.”

Against the fallout of Covid and the potentially permanent changes it has brought to healthcare, GaitSmart benefits in that it reduces physical interaction which may be troublesome to patients.

“There is a lot of touching and physical interaction with physio but with our device, the only time you are close to the patient is to apply the straps, which takes 20 seconds. You can keep your distance, which was very important during Covid, but also older people may be less inclined to want physical interaction generally anyway.”

Diana likens her journey to establish GaitSmart as a continuous search for “a portfolio of answers”.

“We have to test everything that we design via a proper cohort. We’ve had to learn to work with clinical people in the UK and worldwide. We have to go out, find these people, put programmes together, collect data and make sure it’s published.

“But you can only really start that once you have a product because you can’t do any trials without it, so you have to do a lot of work. The trials then raise more questions, then more again, which you have to answer. You need to keep answering questions.”

The hard yards are now paying off, however, for patients with mobility issues, as well as Diana’s company.

The National Institute for Health and Care Excellence (NICE) issued a Medtech Innovation Brief (MIB) on GaitSmart, outlining its benefits.

It highlighted that the technology gives patients ownership of their healthcare and empowers them to make beneficial changes.

One area of further development for GaitSmart is to broaden the settings in which it is used beyond its staple of outpatient clinics.

“We are using our information and the support of NICE to get this to as many people as possible,” Diana says.

 

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