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.

Study Overview

• Status: Recruiting
• Conditions: Parkinson's Disease
• Intervention / Treatment: Behavioral: Walking Tall App

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Marina Brozgol, MS; Phone Number: +972-3-6947514; Email: marinab@tlvmc.gov.il
• Study Contact Backup: Name: Tatyana Gurevich, Prof; Email: tanyag@tlvmc.gov.il

Study Locations

• Israel
  • Tel Aviv, Israel, 6423906
    • Recruiting
    • Tel Aviv Sourasky Medical Center (Ichilov Hospital)
    • Contact: Sourasky Medical Cente; Phone Number: +972-3-6974000; Email: ichilov-intru@tlvmc.gov.il

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Walking Tall App Intervention; Participants will use the Walking Tall smartphone app to complete 4-5 home-based walking sessions per week for 6 weeks. The app provides rhythmic auditory cues and verbal prompts to improve gait quality.	Behavioral: Walking Tall App; Participants will use the Walking Tall smartphone app to complete 4-5 home-based walking sessions per week for 6 weeks. The app provides rhythmic auditory cues and verbal prompts to improve gait quality.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average Step Count Per Day	Measured via accelerometer	Time Frame: Baseline and 6 weeks
Daily Walking Duration (minutes/week)	Measured using tri-axial accelerometer (Axivity) over 7 days	Time Frame: Baseline and 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gait Speed (m/s) - single- and dual-task	Assessed using a 1-minute walking test under two conditions: (1) single-task (normal walking) and (2) dual-task (walking while performing a cognitive task such as serial subtraction). Gait speed is calculated in meters per second based on distance walked over time in each condition.	Time Frame: Baseline and 6 weeks
Short Physical Performance Battery (SPPB)	The SPPB is a standardized test that evaluates lower extremity function using three components: balance (side-by-side, semi-tandem, tandem stance), gait speed over a 4-meter walk, and chair stands. Each component is scored from 0 to 4, with a total score ranging from 0 (worst performance) to 12 (best performance).	Time Frame: Baseline and 6 weeks
Timed Up and Go (TUG) - single- and dual-task	The TUG test measures functional mobility by timing how long it takes a participant to stand up from a chair, walk 3 meters, turn, return, and sit down. It is performed under two conditions: (1) single-task (normal walking) and (2) dual-task (walking while performing a cognitive task, such as serial subtraction). The test evaluates gait, balance, and cognitive-motor integration.	Time Frame: Baseline and 6 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-reported questionnaires: Activities-specific Balance Confidence (ABC)	Activities-specific Balance Confidence (ABC) Scale A 16-item self-report questionnaire assessing participants' confidence in performing various daily activities without losing balance or becoming unsteady. Scores range from 0% (no confidence) to 100% (complete confidence), with higher scores indicating greater balance confidence.	Time Frame: Baseline and 6 weeks

Collaborators and Investigators

• Sponsor: Tel-Aviv Sourasky Medical Center
• Investigators: Principal Investigator: Tatyana Gurevich, Prof, Head of the Movement Disorders Unit at Ichilov Hospital

Publications and helpful links

General Publications

• Brodie, M. A., & University of New South Wales. (2023, August 7). New app is a step towards helping people with Parkinson's disease walk more confidently. UNSW Newsroom. Retrieved from https://www.unsw.edu.au/newsroom/news/2023/08/new-app-is-a-step-towards-helping-people-with-parkinsons-disease

Study record dates

Study Major Dates

• Study Start (Actual): December 29, 2025
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: January 25, 2026
• First Submitted That Met QC Criteria: January 25, 2026
• First Posted (Actual): February 2, 2026

Study Record Updates

• Last Update Posted (Actual): February 13, 2026
• Last Update Submitted That Met QC Criteria: February 12, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Gait; Parkinson's Disease; Walking App; Rhythmic auditory cueing
• Additional Relevant MeSH Terms: Synucleinopathies; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Movement Disorders; Parkinsonian Disorders; Basal Ganglia Diseases; Parkinson Disease
• Other Study ID Numbers: 0481_25_TLV_TG

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No