Handling gait impairments of persons with Parkinson’s disease by means of real-time biofeedback in a daily life environment

A smartphone app with telemedicine capability integrating data from foot-mounted inertial measurement units (CuPiD-system) was developed to realize a portable gait analysis system and, on top of it, to provide people with Parkinson’s disease (PD) remote supervision and real-time feedback on gait performance. Eleven persons with PD were recommended to perform gait training for 30 min, three times per week for six weeks. The app offered praising/corrective verbal feedback, encouraging participants to keep the spatio-temporal gait parameters within a clinically determined ‘therapeutic window’. On average, persons performed 20 training sessions of 1.8 km in 24 min and received 28 corrective and 68 praising messages. The mean walking rhythm was 58 strides/min with a stride length of 1.28 m. System’s usability was determined as positive by the users. In conclusion, CuPiD resulted to be effective in promoting gait training in semi-supervised conditions, stimulating corrective actions and promoting selfefficacy to achieve optimal performance.