Cadense Adaptive Shoes are for anyone who struggles with foot clearance during the swing phase of walking.  If a client has difficulty advancing the foot forward, the shoes allow them to slide if needed before regaining traction when weight is applied.  We’ve seen these shoes work well for people with such difficulties due to stroke, Multiple Sclerosis, Parkinson’s, Peripheral Neuropathy and general weakness in the leg.

These shoes were developed with therapy in mind, as a practical implementation of the Skywalker system, such that people could access more frequent movement practice at home and in the clinic.  We have seen improvements when people use these shoes as a training tool.  However, in all of our tests, we’ve seen an orthotic effect, that is, an effect of using it as an assistive shoe for everyday use. 

The sliding feature need not be used to consciously alter movement, it can simply be something that helps if your client accidentally contacts the floor during swing, allowing the foot to travel under their body instead of getting hung up on the ground as it would with high-traction footwear.

In our Beta test, we had people walk for at least 10 minutes per day, at least 5 times per week for one to six months.  We found that people who took training seriously, could increase the amount of time spent walking with the shoes.  Specifically, one user with stroke started barely able to do 10 minutes and ended doing 40 minutes per day with noticeable calf growth on the affected side. 

The ongoing clinical trial is asking people to walk at least 30 minutes per day, 5 days per week for 12 weeks.  The 30 minutes can be broken up into as many smaller chunks as needed to get to the full 30 minutes.

The progression we have been successful using is as follows:

1. Master sit to stand – apply weight to the shoes before transitioning from a seated position.
2. Test the waters – slide the shoe such that the user can feel the low friction on different surfaces.  Ask the user to apply weight to feel the transition to the traction.  This is best done over any new surface before they begin walking.
3. Force scuff on the first walking attempts.  Ask your client to use the sliding feature of the shoes intentionally on both feet as they walk, even if they only have one affected side.  This starts to get them feeling the difference and can build confidence in the sliding/gripping feature of the shoes.
4. No longer intentionally scuffing on each step, ask the client to start walking with straight steps, as they did when force-scuffing.  Take small steps, focusing on equaling the length of steps between left and right foot.  We want it to look symmetric.
5. Begin taking longer steps, concentrating on keeping the toe pointed in the direction of travel.
6. Focus on rhythmicity.  Studies have shown that rhythmic movements are different than discrete movements.  Walking, being inherently rhythmic take advantage of rhythmic neural circuitry.  Use this by walking to a beat.  As a bonus, the pucks under the Cadense originals will make a sound when in contact with a hard floor.  You can use this biofeedback feature for the client to make a musical “beat with their feet”.
7. Once the gait starts looks pretty and rhythmic, focus on building speed and confidence.

For more helpful videos, please visit our 5-day video getting-started series here: Getting started with your Cadense Adaptive Shoes