Walkasins is a wearable, non-invasive prosthetic device intended to replace part of plantar mechanoreceptor function used for detection and signaling of foot pressure sensation. Walkasins is indicated for use by individuals with lower limb peripheral neuropathy who present with gait and balance impairments and are at high risk of falls.
Centers for Medicare & Medicaid Services (CMS) classified Walkasins as a sensory prosthetic device for replacing the function of damaged plantar cutaneous mechanoreceptors required for accurate balance control.
Walkasins is assigned to the following HCPCS codes:
L8720 “External lower extremity sensory prosthetic device, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg.”
L8721 “Receptor sole for use with L8720 replacement, each.”
RxFunction is the exclusive provider of Walkasins.
Veteran Participant >70 yrs old.
Functional Gait Assessment (FGA)
Item 8: Gait with Eyes Closed
“Walk at your normal pace from here to the next mark [20ft.] with your eyes closed.”
Clinical guidelines recommend a stepwise approach to identifying and addressing fall risk in patients with sensory loss.
PN is a type of degenerative nerve damage that frequently affects sensory nerves in the soles of the feet that are responsible for signaling sense of touch, pressure and vibration – information that is crucial for our sense of balance.1,2,3
In individuals with PN, the ability to accurately sense, measure and communicate plantar pressure information is compromised due to afferent nerve damage, often resulting in poor or staggered gait, which increases the risk of falls with the potential for serious injury.
Identify patients at risk by routinely asking about reduced or absent sensation in the feet, balance difficulties, and a history of falls or fear of falling.
Confirm peripheral neuropathy as a fall risk factor and evaluate gait and balance to determine an appropriate plan of care.
When appropriate, incorporate Walkasins® to address the root cause of instability by replacing lost plantar sensation and providing new somatosensory input for balance control.
Unlike compensatory approaches, Walkasins provides prosthetic functionality – replacing part of lost plantar sensation important for balance control.
Walkasins System consists of a Haptic Module worn around the ankle of each leg and a Receptor Sole inserted under the user’s foot in their shoe.
The Receptor Sole detects and transmits plantar pressure normally performed by mechanoreceptors and distal axons in the soles of the feet. The Haptic Module generates directional specific mechanical tactile stimuli that produce action potentials that signal relevant balance information to the nervous system.
This sensory input is naturally used by the brain to control movement and balance function.
Clinician observations and patient reported symptoms are critical elements in screening for fall risk.
Two objective tests used by clinicians to assess plantar sensory loss and balance in patients with Peripheral Neuropathy (PN) are Monofilament and Single Limb Stance Tests.
Monofilament testing is an objective, in-office assessment that evaluates plantar sensation. Research supports that this well-established test is correlated to gait and helps clinicians determine lost or diminished plantar sensation and the potential need to seek intervention.
Carrer P, Trevisan C, Curreri C, et al. Semmes-Weinstein monofilament examination for predicting physical performance and risk of falls in older people. Arch Phys Med Rehabil. 2018;99:137–143.
Rinkel WD, van Nieuwkasteele S, Castro Cabezas M, et al. Balance, risk of falls, risk factors and fall-related costs in individuals with diabetes. Diabetes Res Clin Pract. 2019;158:107930.
Hicks CW, Wang D, Daya N, et al. Peripheral neuropathy detected by monofilament testing and risk of falls and fractures in older adults. J Am Geriatr Soc. 2023;71(6):1902–1909.
Single-Leg Stance (SLS) test is an objective, widely used assessment for balance control and identification of fall risk. Research supports a strong correlation of SLS to gait performance and daily activities (Vellas 1997). Research also indicates that this test is effective in detecting imbalance in individuals with Peripheral Neuropathy (PN) when plantar sensation impacts stability (Hurvitz et al. 2001).
Vellas, B. J., Wayne, S. J., Romero, L., Baumgartner, R. N., Rubenstein, L. Z., & Garry, P. J. (1997). One-leg balance is an important predictor of injurious falls in older persons. Journal of the American Geriatrics Society, 45(6), 735–738.
Hurvitz, E. A., Richardson, J. K., & Werner, R. A. (2001). Unipedal stance testing in the assessment of peripheral neuropathy. Archives of Physical Medicine and Rehabilitation, 82(2), 198–204.
Walkasins is indicated for patients with lower limb sensory peripheral neuropathy who present with gait and balance impairments. Walkasins is indicated for patients who can feel the tactile stimuli from the Haptic Module on the lower leg.
Please see the Safety Information for a complete list of warnings, precautions, and contraindications.
Caution: Federal law restricts this device to sale by or on the order of a physician.
1Strzalkowski NDJ, Peters RM, Inglis JT, Bent LR Cutaneous afferent innervation of the human foot sole: what can we learn from single-unit recordings? J Neurophysiol. 2018 Sep 1;120(3):1233-1246. doi: 10.1152/jn.00848.2017. Epub 2018 Jun 6.
2Meyer PF, Oddsson LI, De Luca CJ. Reduced plantar sensitivity alters postural responses to lateral perturbations of balance. Exp Brain Res. 2004a Aug;157(4):526-36. Epub 2004 Mar 17.
3Meyer PF, Oddsson LI, De Luca CJ. The role of plantar cutaneous sensation in unperturbed stance. Exp Brain Res. 2004b Jun;156(4):505-12. Epub 2004 Feb 14.
4Foundation for Peripheral Neuropathy, www.foundationforpn.org.
5Koehler-McNicholas SR, Danzl L, Cataldo AY, Oddsson LIE (2019) Neuromodulation to improve gait and balance function using a sensory neuroprosthesis in people who report insensate feet – A randomized control cross-over study. PLOS ONE 14(4): e0216212. https://doi.org/10.1371/journal.pone.0216212.
