Can An Electrical Stimulation Device Be Part Of A ‘Pacemaker’ In Neuropathic Patients?

David G. Armstrong DPM MD PhD

For patients with diabetic and motor neuropathy, an electrical stimulation device, combined with pressure monitoring and thermometry, may be able to act as a “pacemaker” to stimulate the foot.

At the Southern Arizona Limb Salvage Alliance (SALSA), we have become increasingly interested in the Walkaide system (Hanger Orthopaedics) and its potential future as a delivery system for extracorporeal nerve and muscle stimulation. The device uses electrical stimulation to improve walking in patients with post-stroke footdrop, according to the company.

In the future, we see some significant potential for utilizing the Walkaide in our high-risk patients with diabetic sensory (and motor) neuropathy.

Imagine stimulating the lower extremity and modulating plantar pressure or impulse/pressure in real time. Imagine connecting this device wirelessly to a real-time pressure-sensitive insole or sock. Imagine then porting in an inflammation measurement device like thermometry.

These products now exist independently. If we put them together, we may then have a closed loop system for prevention. This could be a “pacemaker” for the high-risk foot.

Editor’s note: This blog has been adapted with permission. It originally appeared at

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