Neurostimulation Enabled Insole for Gait Therapy and Rehabilitation

Gait abnormalities caused by neurological and musculoskeletal disorders significantly affect mobility and quality of life. Conventional rehabilitation approaches, such as physiotherapy and laboratory-based gait analysis, are limited by cost, accessibility, and lack of adaptability for homebased use. This study proposes a closed-loop gait rehabilitation system that integrates piezoelectric insole sensors, an ESP32 microcontroller and a transcutaneous electrical nerve stimulation (TENS) unit to enable real-time detection and correction of gait abnormalities. The system continuously monitors plantar pressure distribution during walking and employs a threshold-based algorithm to identify anomalies such as excessive pronation and supination. Upon detection, corrective stimulation is delivered via a TENS module, while gait data are simultaneously transmitted through Wi-Fi to a remote monitoring interface. Experimental validation included sensor calibration, linearity testing, irregularity detection and real-time testing with healthy participants. Results demonstrated a strong linear correlation between applied load and sensor voltage output (R² = 0.98) and reliable detection of abnormal gait patterns with accuracy exceeding 90%. The system achieved a closed-loop response time of less than 80 ms, ensuring suitability for real-time rehabilitation. Compared with existing wearable rehabilitation devices, the proposed system provides a portable, low-cost, and adaptive solution that integrates corrective feedback with remote supervision. Results show that home-based rehabilitation and tele rehabilitation are feasible, despite being validated only on a small healthy population.