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Smart sock and app help detect pain in people with intellectual disabilities

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9 January 2025
People with severe intellectual disabilities often struggle to communicate that they are in pain. To identify pain more quickly, cognitive psychologist Helen Korving has designed an app that can recognize pain by measuring sweat using a smart sock.

Detecting pain in people with a severe or profound intellectual disability (SID) is a major challenge for their caregivers. “These individuals often have not only intellectual disabilities but also health conditions affecting their heart, intestines, or bones, which can cause pain,” Helen Korving explains. “Additionally, people with SID are more prone to infections and injuries.” Many people with SID cannot express how they feel, increasing the risk that pain and its underlying causes go unnoticed. This can lead to more serious health problems or even hospitalizations. 

Since observing pain can be difficult for caregivers, there was a demand from the field for a way to measure pain physically. “Caregivers and parents have been involved in every step of this research,” Korving says. The study first examined existing methods for physical pain detection, such as monitoring heart rate, breathing, muscle tension, pupil size, and brain activity. The researchers ultimately chose sweat measurement as it is both accessible and reliable. 

Smart sock

Together with colleagues, the PhD candidate developed an innovative solution for pain detection: the SID Pain App, paired with a smart sock. Korving explains, “The smart sock measures sweating on the sole of the foot, which changes when pain occurs. This data is then wirelessly transmitted to the SID Pain App.” 

The sock was first tested on healthy adults. Participants immersed their hands in ice water and indicated when the pain began. This feedback was combined with sweat measurement data from the smart sock. Based on this information, an algorithm was developed. “The algorithm in the SID Pain App correctly identified pain in 8 out of 10 cases, provided prior data from the same individual was available,” Korving explains. Predicting pain in new individuals proved to be more challenging, meaning the technology still has room for improvement. 

Six seconds

Finally, the SID Pain App was tested with 14 people with SID during physiotherapy sessions. Korving notes, “The smart sock detected pain an average of six seconds earlier than it became visible in their facial expressions or body movements.” This highlights the potential of the SID Pain App to detect pain faster and more objectively. 

This research represents a significant step toward improved care for people with SID. Early pain detection can reduce the risk of complications and contribute to their well-being and safety. While further development is needed to refine the technology, the SID Pain App offers hope for a future where pain in people with SID can be identified and treated more efficiently and effectively. 

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