# Improving walking in peripheral artery disease using specially designed assistive shoes

> **NIH VA I21** · OMAHA VA  MEDICAL CENTER · 2022 · —

## Abstract

The long-term goal of this project is to improve mobility, functional independence, and quality of life in
patients with peripheral artery disease (PAD) by using specially designed assistive shoes. PAD is a
manifestation of systemic atherosclerosis producing blockages in the leg arteries, resulting in insufficient blood
flow to the lower extremities. Limb ischemia from PAD is the most common disorder treated within the vascular
surgical service of the Omaha Veterans Affairs Medical Center. PAD also accounts for one-third of the operations
performed nationwide in the VA. Walking induced muscle pain known as intermittent claudication is the most
common PAD symptom. Claudicating patients with PAD walk slower, have reduced quality of life and lose
independence in performing activities of daily living. We have identified consistent deficits of the ankle
plantarflexors to effectively push-off during walking. Currently, there is a critical treatment gap for patients whose
disease presentation does not warrant an operative approach, but who desire to restore their functional
independence and walking ability. Specially designed assistive shoes (carbon fiber: CF; spring-loaded: SL) with
specific mechanical properties to absorb and release energy, have been shown to promote push-off efficiency
in walkers and runners. These shoes may lead to improved push-off in populations with reduced ankle push-off
capacity, but this has not been tested yet. This work proposes to evaluate patient preferences in terms of using
assistive shoes and whether these shoes improve walking performance in claudicating patients with PAD. We
hypothesize that assistive shoes (CF and SL) will lead to improved walking performance in patients with PAD as
compared to standard shoes. We also hypothesize that subject reported preference of assistive shoes (CF and
SL) will be positive based on comfort, fatigue, ease of walking, and feasibility. These hypotheses will be tested
by the following three specific aims:
Aim 1: Determine the acute improvement in walking performance (claudication walking distances,
vertical ground reaction force, and muscle oxygenation) in patients with PAD while using their standard
shoes versus the assistive shoes.
Aim 2: Determine the subject-reported preference of assistive shoes.
Aim 3: Determine the progressive improvements in physical activity, quality of life, and walking distance
after a three-month assistive shoe intervention.
Twenty patients with PAD will be recruited for Aims 1 and 2. For Aim 1, each subject will walk on a pressure
instrumented treadmill while performing a progressive treadmill test with a near infrared spectroscopy sensor on
the calf for each shoe condition: i) standard, ii) CF, and iii) SL. Walking performance will be evaluated in terms
of claudication walking distances, vertical ground reaction force, and muscle oxygenation. All outcomes will be
compared across these three types of shoes. Aim 2 will primarily focus on qualitative measu...

## Key facts

- **NIH application ID:** 10368277
- **Project number:** 1I21RX003877-01
- **Recipient organization:** OMAHA VA  MEDICAL CENTER
- **Principal Investigator:** Sara A Myers
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-11-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10368277

## Citation

> US National Institutes of Health, RePORTER application 10368277, Improving walking in peripheral artery disease using specially designed assistive shoes (1I21RX003877-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10368277. Licensed CC0.

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