Parkinson’s Tech - a "Which?" for Gait Gadgets

Last week I had a fascinating visit to a team of Exeter University scientists all trying to understand how people with Parkinson’s walk and what might be done to help them tackle mobility issues. They’re based at a lab called VSimulators, a multimillion pound facility featuring a platform that can simulate the built environment - anything from a skyscraper swaying in the wind to a moving train or ferry.

The university thought its commercial customers would mainly be architects but in fact the lab has turned out to be useful to health researchers, notably those looking into Parkinson’s. I was there to take part in a clinical trial which I will write about later this week. But I also had a fascinating chat with one of the researchers who has come up with a great idea - a Which guide to Parkinson’s walking gadgets.

Prof Helen Dawes

Helen Dawes started out as a sports physiotherapist - she laughs as she tells me the highlight of her career was in 1996 when she worked with the least successful UK Olympics team of recent times which came home from Atlanta with just one gold. But nowadays she is Exeter’s Professor of Clinical Rehabilitation after an academic career which has taken in biomechanics and neuroscience.

I though rehabilitation meant helping people recover from accidents but Helen defines it as enabling people to live the life they want to live, and much of her work focuses on Parkinson’s. That has led her to cast a critical eye on the many devices which now promise to help people with the condition to walk better.

Recently I wrote about three gadgets using a technique called “cueing” to improve mobility but found that none of them had much in the way of clinical trials supporting their efficacy. The same thought had struck Helen Dawes and she and her team decided to conduct a review of what is out there.

They published their findings in a paper with the catchy title “Evidence for the Efficacy of Commercially Available Wearable Biofeedback Gait Devices: Consumer-Centered Review”.

They found 17 devices, 11 of which were on sale to the public, and examined the claims they made. (The Cue-1, Gait-q and Stryd AR devices I have written about were at too early a stage to be included in the study.) The devices included wearable sensors, insoles with haptic feedback and a vest which detects when your posture is bad and uses electrical stimulation to try to correct it.

But just four out of the eleven commercial devices making all sorts of promises of what they could do to improve matters for people with Parkinson’s had any scientific studies backing up their claims, a finding Helen described as “shocking’.

One of the gadgets that did have some proper research behind it is called heel2toe, available only in Canada for now, and Helen let me try it out. You clip the device, which is linked to an app, to the side of your shoe. When you walk the app on your smartphone rewards you with a beep every time you land heel and then toe correctly.

It reminded me of my wife, on holiday a few years ago just before I was diagnosed with Parkinson’s, telling me to “pick your feet up” — and I rather liked it.

But Helen Dawes isn’t expecting her academic paper to act as a consumer guide to Parkinson’s gadgets. Rather, she is hoping that it will inspire someone to create something which would focus on answering three questions: “My feeling is that if you're going to get a product or health technology to help, you want to know, one - is it safe? Two - does it work? And three - how much does it cost?”

It is both heartening to see how many companies are developing wearable technology which could improve the lives of people with Parkinson’s and worrying how little evidence there is that many of these gadgets work. So “Which Parky Gadget” sounds a great idea - let’s hope that someone sees a business opportunity and makes it happen.

But elsewhere in the lab a team is working on a way to help people with a more severe symptom where they freeze and can’t move forward - and this time it involves psychology, not technology.