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.
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;
Musculoskeletal, neurological, or visual/hearing impairments affecting gait;
Cognitive impairments or severe behavioral symptoms;
History of stroke, severe TBI, or brain tumor;
Cardiovascular contraindications;
Single group
Walking Tall App
BehavioralParticipants 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.
Average Step Count Per Day
Measured via accelerometer
Daily Walking Duration (minutes/week)
Measured using tri-axial accelerometer (Axivity) over 7 days
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.
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).
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.
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.
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