SISTINE 3.0: plantar pressure assessment in chronic venous disease during figure-of-8 test

Chronic venous disease (CVD) is a multifactorial disorder of the venous circulatory system of the lower limbs. Highly prevalent in the adult population worldwide, it causes venous stagnation, inflammation and complications such as oedema, varicose veins and ulcers that alter motor function and quality of life of sufferers. This study evaluates the ability of the low-cost telemedicine system SISTINE, which integrates smart socks with pressure and inertial sensors, to analyze gait asymmetries in CVD patients during a figure-of- 8 test. The objective was to assess whether the system can distinguish between different CVD severities and identify specific gait parameters related to disease progression. Twenty CVD patients (15 females, 5 males; mean age =57 ± 18 years) and 11 healthy controls (4 females, 7 males; mean age =33 ± 16 years) participated. The CVD group was divided into low severity (C1C2) and high severity (C3-C4) according to the Clinical Etiological Anatomical Pathological (CEAP) classification. Participants completed six Fo8 tests (three clockwise, three counterclockwise) while wearing SISTINE. A medio-lateral pressure gradient index (F V-I) was calculated to assess differences between the inner and outer foot during the test phases. Results showed that CVD patients had longer completion times compared to controls. Low-severity patients displayed significant foot pressure asymmetry during phases 1 and 3, with reversed medial and lateral loading patterns compared to controls. Phase-dependent F V-I values differentiated between controls and patients of varying severities. The findings suggest that SISTINE can effectively monitor foot pressure dynamics and gait asymmetries, providing a promising tool for early CVD detection and progression monitoring through a low-cost, wearable solution.