Next generation gait analysis in the cloud for patients with Parkinson’s Disease – A feasibility study

Magnes Nushu is a smart shoe with embedded sensors and vibrotactile actuators, capable of real-time gait analysis and gait-driven haptic cueing. Magnes Nushu enables patients to collect data on their gait and share this data with healthcare professionals (HCPs). Data will be automatically uploaded via a mobile phone app linked to the smart shoes. Data will be available to the Research team in Princess Alexandra Hospital and Queensland University of Technology and the Magnes company who owns the shoe. This non- identifiable data is accessible only if participant gives permission to access the data. Magnes Nushu has the potential to help patients with gait deficits by providing them notifications via vibrations on how they walk to assist normal walking. The vibration function will not be used in this study. The study is designed in three phases to align with our research objectives directly. The total study duration is 14 weeks, and it is separated into three phases. Duration of each study visits is 1-2 hours. Study participants will be provided with a diary by the study coordinator and asked to maintain the diary to record falls, NUSHU usage and physical activity at each study phase. Participants will be asked to provide this diary back to the study team at their next study visit. A study member will check in with participants weekly throughout the study to ensure participants are not having issues with using the investigational product and to enquire about any falls or other adverse events that may have occurred. Phase 1 (week 1-4): Observational phase: Patients will wear the NUSHUs at home while performing their everyday activities (min 1 hr/day). Phase 2 (week 5-10): Intervention phase: Patients will wear the NUSHU while conducting a Physiotherapy-prescribed daily home-exercise program targeting gait, balance and freezing of gait and while at home performing everyday activities (min 1 hr/day). Participants will undergo assessment by a Physiotherapist and will receive a tailored home-based exercise program for the subsequent six weeks (i.e., phase 2). The program, utilising evidence-based physical therapy practice will be developed by a Physiotherapist with experience in managing Parkinson's Disease across the disease progression. Exercise prescription will be tailored targeting falls prevention, freezing of gait and endurance. Participants will be supported and monitored through their home-based exercise program while wearing the NUSHUs Participants will be expected to complete NUSHU inbuilt assessments such as Timed Up and Go tests,10m walk test and tests of standing balance. We expect the exercises will take about 20 minutes per day. Completing of the exercises is being monitored through the NUSHUs and the NUHSU app. Participants will also be followed weekly via phone call during this period. Phase 3 (week 11-14): ‘Washout’ and monitoring phase: Patients will continue to wear the NUSHUs at home while performing their everyday activities (min 1 hr/day). If these participants have a caregiver, they will be invited to participate in the study. participant’s and caregiver’s acceptability of using this new technology of smart shoes as measured by their ratings at the exit survey.