Feasibility and Preliminary Effects of the Walking Tall App for Home-Based Gait Training in Parkinson's Disease: A Pilot Study

Feasibility and Preliminary Effects of the Walking Tall App for Home-Based Gait Training in Parkinson's Disease: A Pilot Study

This is a pilot study designed to assess the feasibility, adherence, and preliminary effects of a 6-week home-based gait training intervention using the Walking Tall mobile app in individuals with Parkinson's disease. The app delivers rhythmic auditory cues and motivational verbal prompts to promote gait improvements. Primary outcomes include daily walking duration and step count measured via wearable sensors; secondary outcomes include gait speed, balance, self-reported confidence, and usability.

This open-label, single-arm feasibility study will recruit 30 participants with idiopathic Parkinson's disease, currently enrolled in a rehabilitation program at the Ezra LeMarpe Organization in Israel. Participants will perform 4-5 walking sessions per week for 6 weeks using the Walking Tall smartphone application. The app delivers rhythmic cueing and motivational prompts to enhance walking speed, stride length, and confidence. The study includes baseline and post-intervention assessments. Walking behavior will be monitored using a tri-axial accelerometer worn for 7 days at each timepoint. The primary aim is to evaluate feasibility, adherence, and changes in daily walking activity, with secondary outcomes addressing gait parameters and user satisfaction. Findings will guide the design of future randomized controlled trials.

Inclusion Criteria:

• Clinical diagnosis of idiopathic Parkinson's disease (MDS criteria);
• Hoehn & Yahr stage II-III (ON-medication state);
• Able to walk independently for ≥5 minutes;
• Stable medication for ≥1 month;
• Currently enrolled in a rehab program at Ezra LeMarpe;
• Able to provide written informed consent;

Exclusion Criteria:

• Musculoskeletal, neurological, or visual/hearing impairments affecting gait;
• Cognitive impairments or severe behavioral symptoms;
• History of stroke, severe TBI, or brain tumor;
• Cardiovascular contraindications;
• Inability to use a smartphone;
• Participation in other concurrent intervention studies.