Insights into a Gait Analysis Study

Supporting Parkinson’s patients in their disease and giving them back a sense of control and influence: That is one aim of the ParkinsonGo TM App developed by Portabiles HealthCare Technologies. To prove the effects and value the app provides to patients, a clinical study is currently ongoing. For this purpose, Portabiles cooperates with Fraunhofer IIS, using the study management system DPM.research (find out more about another cooperation here). Chantal Herberz of Portabiles provides insights into the study. She has been with Portabiles since it’s foundation and working on gait analysis for 14 years. For her, it is very rewarding to see a research project become a product reimbursed by health insurance and to witness patients’ reactions.

About ParkinsonGo TM

The ParkinsonGo App is the core of a hybrid care solution with digital technology and tele-nurse support. The digital component is the ParkinsonGo App which uses mobile motion sensors attached to the patient’s shoe to collect data on gait quality. Additionally, patients answer questionnaires on topics such as gait safety, medication, and general well-being. Based on this data, the app suggests tailored recommendations for action, such as physiotherapy exercises and tips for dealing with the condition in everyday life. The second component involves human interaction. Portabiles employs Parkinson-Telenurses to serve as the go-to contact for patients. They support patients during onboarding at the beginning of use and act as the first medical contact, linking patients to their treating doctors.

How exactly does the collaboration with Fraunhofer IIS work?

Chantal Herberz: From a technical point of view, the aim was to combine the results (gait data, PROMs) recorded by the ParkinsonGo solution with the DPM.research tool which serves as study management system.
For ParkinsonGo itself, the gait data is stored at our data server and originally displayed via our ParkinsonGo web interface. For studies, together with Fraunhofer IIS we made it possible to access this data via DPM.research. This allows the study staff to have all relevant data in one whole solution and to access the data with no additional login. In addition, they are also able to document the results from patient´s assessment and procedures directly in the system.
Of course, it’s an advantage that the DPM could be customized to this study and be aligned with the needs and aims of the trial. To address the requirements – especially from a clinical point of view – and to know about the details we conducted several workshops during the collaboration with Fraunhofer IIS.

Together, we tailored DPM.research to the needs of the study, defining the questionnaires patients should answer in their study visits and what data needs to be documented by the study staff.

Of course, study doctors were also participating in these discussions. On the part of Fraunhofer IIS, Georg Zweyer was deeply involved in that process. They defined how an appropriate interface for the study goal should look like, which data needs to be collected (e.g. questionnaires) and how this data should be displayed. Based upon that, we defined the interfaces from a technical perspective and of course tested the functionality.

Patients have the wearable attached to their shoes. Which data is recorded exactly?

The gait measurements with the mobile sensors can be started and stopped via the app. Sensors record data throughout the day during activities of daily living. In the evening, patients place the sensors on a charging plate. The sensor data subsequently is downloaded and processed. ParkinsonGo algorithms compute these sensor data and provide gait parameters such as step length, speed, heel strike angle, number of steps, and the variability of the gait parameters.

However, we have the sensor raw data for other parameters, such as foot clearance (how high someone lifts their foot), swing phase, stand phase or asymmetries. In total, there are 15 parameters from the raw data. This means that we have considerably more data accessible in the study.

What were the benefits of the collaboration for you and the study?

We had the pure web interface that displayed our data from the app, but no management interface supporting the documentation needed in a clinical study. For example, patient questionnaires during visits. We also lacked a tool where doctors could document things by themselves, such as noting that a telemedical consultation took place, what the outcome was, and the next steps.

So, it was great for us to have this platform from Fraunhofer IIS, which we can adapt to the study objectives, integrate questionnaires accordingly, and include interfaces.

Implementing all of this was always very easy. This way, we could concentrate purely on our product while using an existing tool for the study.

What’s next for ParkinsonGo?

Our goal is of course to get reimbursed by further health insurance companies and to have more patients and neurologists on board. We want to be the care model par excellence for Parkinson’s. So far, we are the only reimbursed hybrid care model and naturally want to leave a lasting footprint. We are also working on internationalization and are currently expanding partnerships in various countries. Another goal concerning the wearables is to detect so-called freezing episodes, a sudden blockage of movement that occurs in Parkinson’s.

If you interested in working with Fraunhofer IIS in a clinical trial, please do reach out to us.

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