A personalised, gait training telerehabilitation programme for people with Parkinson’s Disease: A long-term pilot study

Objective: To assess the feasibility and, preliminarily, the effectiveness of long-term, personalized gait training using a digital wearable system (Gait Tutor) that provides real-time audio biofeedback to correct or reinforce gait behaviour. Design: Open-label and non-controlled, with assessments before and after intervention. Setting: Real-world. Participants: Twenty persons with Parkinson's disease. Intervention: Participants performed home-based gait training in their ON medication state for 30 minutes, 3 times per week, for 9 months using a Gait Tutor. Main measures: We evaluated adherence (% of expected sessions), usability, and, preliminarily, efficacy by assessing the motor performance of the participants before and after the intervention. Results: Seventeen participants (85%) completed the study, performing an average of 83 sessions. Adherence was higher for persons with an intermediate disease stage (80.5% of expected training sessions), compared to those with a more advanced disease stage (46.2%). All participants reported extremely positive scores on the questionnaire about ease of use and effectiveness (4.37 ± 0.42). The Movement Disorders Unified Parkinson's Disease Rating Scale motor scores remained stable after the training (mean 9 months). In people with an intermediate disease stage, clinical scores and physical capacity tended to improve. Conclusions: For the first time, this study shows the feasibility of long-term real-world gait training for people with Parkinson's disease, providing preliminary evidence that personalized, technology-driven rehabilitation strategies can be sustained over extended periods and can assist clinicians in objectively assessing gait performance in the real world.