Stepping forward: How technology is improving gait for Parkinson’s and aging adults

A new wearable sensor helps individuals regain control of their walking patterns

Lana Liquard
Staff Writer (McGill Tribune)

The ability to walk is something most take for granted. But for individuals with Parkinson’s disease and age-related mobility challenges, it can be a daily struggle. Slow, shuffling steps, difficulty maintaining balance, and unstable walking patterns make simple movements feel like obstacles.

Nancy Mayo, a professor at McGill’s School of Physical and Occupational Therapy, addresses these challenges with her company, PhysioBiometrics. Her team has developed a wearable device called the Heel2Toe sensor, designed to help people improve and regain control over their walking patterns, or gait.

The Heel2Toe sensor is a small device that attaches to the side of a sneaker. It emits a sound when a strong heel strike is detected, reinforcing a standard heel-to-toe walking pattern. By providing real-time auditory feedback, the sensor helps wearers make immediate adjustments, in turn promoting better steps, posture, balance, and coordination.

Mayo conducted a pilot study to test the Heel2Toe sensor in action. Participants were divided into two groups: One using the Heel2Toe sensor, and the other following a workbook-based exercise program. Over three months, those in the sensor group demonstrated significant improvements in their walking ability, with 13 out of 14 participants increasing their walking distance by an average of 66.4 metres in the Six-Minute Walk Test.

To better understand how the Heel2Toe sensor works, The Tribune attended a class run by Natasha Hassija, a PhD student in Rehabilitation Sciences. The class, held biweekly over five weeks, is part of a research project aimed at determining the benefit of combining the Walk-BEST—BEtter, faster, longer, STronger—coaching sessions with at-home practice using the Heel2Toe sensor in participants over 50 years old.

“We are trying to see the benefit of expert coaching plus technology-assisted home practice. We have tested each component separately—now we are combining them,” Hassija explained in an interview with The Tribune.

The session began with participants reflecting on their progress, sharing how they felt about their walking since the previous class. The exercises done during the session were structured around basic elements of proper walking: Heel-to-toe stepping, engaging the hip, arm movement, posture, breathing, and walking while engaging the brain.

Each exercise focused on different aspects of movement, some targeting physical elements like balance, flexibility, and pace, while others targeted cognitive aspects, for example, by continually subtracting seven from 100 while walking. Every exercise concluded with a moment of self-reflection, encouraging participants to be aware of their movement.

After the class concluded, The Tribune met with Mayo to discuss her research further.

She highlighted a key challenge in Parkinson’s gait training.

“Because of the nature of the condition, where dopamine-producing cells die, it’s difficult for people with Parkinson’s to perform automatic movements. Telling them to ‘walk properly’ isn’t enough—their brain doesn’t let them,” Mayo said.

This is where the Heel2Toe sensor makes a difference. Mayo explained that the device provides an external cue, stimulating the dopamine system and reinforcing correct movements.

“One classic example is arm swinging,” Mayo noted. “Most people swing their arms naturally while walking, but those with Parkinson’s don’t, which affects their balance. The sensor helps retrain those movements.”

She also explained that many older adults unknowingly reinforce problematic gait patterns, which can lead to instability and falls.

“If you walk badly for 10,000 hours, your brain will own that bad walking pattern. We have to unprogram that,” Mayo said. “Our program is breaking that cycle and getting them to walk BEST.”

This research is part of an ongoing effort to integrate technology into rehabilitation. While technology alone may not be a complete solution for mobility challenges seen in both Parkinson’s disease and other aging-related conditions, the integration of structured exercise programs with innovative tools like the Heel2Toe sensor represents a promising step forward.

Mayo emphasized the importance of quality, as opposed to quantity, when trying to improve gait.

“Walk better before you walk more. Taking thousands of bad steps won’t help, but practicing good ones will.”

This article was originally published in the March 11, 2025 edition of the McGill Tribune.