Parkinson’s Needs Its Own Home Monitoring Revolution
A person living with diabetes can check their glucose at home. A person with hypertension can measure their blood pressure, observe a pattern, adjust their behavior, and know when to contact a clinician.
These tools did more than move measurements out of the hospital. They gave people a way to participate in managing their condition between appointments. Importantly, their value does not come from measurement alone. It comes from connecting a measurement to an appropriate response.
Parkinson’s disease, and neurology more broadly, does not yet have a widely used equivalent.
Most Parkinson’s care still depends on occasional clinical assessments, supported by what a person or care partner can remember from the preceding weeks or months. Yet Parkinson’s changes from hour to hour and day to day. A short walk through a clinic corridor cannot fully represent what happens at home, while turning in a crowded kitchen, getting up at night, walking during an “off” period, or trying to move while holding a conversation.
The next important advance in Parkinson’s care may therefore be a decentralized system that can observe these everyday changes, help people respond to them, and involve the traditional healthcare system when its expertise is needed.
The missing measurement
Consider turning.
A person may still walk at roughly the same speed in a straight line, but begin to take more steps to turn, turn more slowly, or show increasing instability in the trunk. These changes may develop gradually and may not be obvious to the person or family. They may also be absent during a scheduled appointment.
Today, this information is rarely available routinely. A clinician may learn about the problem only after a near-fall or fall.
Yet measures such as walking speed, stride length, gait variability, trunk motion, and turning performance can contain useful information about mobility and fall risk. Current research suggests that gait variability and changes in dynamic stability may be particularly informative, although the field still needs standardized protocols and stronger prospective validation before individual measures can be treated as definitive clinical predictors.
Imagine instead that a system detects that, over three weeks, a person is taking progressively more steps to turn, hesitating more often in confined spaces, and becoming less stable during dual-task walking. The system does not declare that a fall is inevitable. It notices a meaningful change from that individual’s own baseline.
It could then ask relevant questions: Have there been changes in medication timing? Has the person been sleeping poorly? Is dizziness occurring on standing? Has activity reduced because of fear or fatigue?
Depending on the pattern, it could suggest a personalized mobility assessment, reinforce a previously prescribed exercise, recommend a review by a physiotherapist, or escalate the change to the person’s neurologist. Technology would function not simply as a tracker, but as a guardian.
From a device to a care philosophy
This vision has shaped our work at Lifespark Technologies.
We initially developed WALK as a wearable neuromodulation system for people with Parkinson’s experiencing freezing of gait. WALK delivers phase-specific vibration during movement with the aim of strengthening relevant sensory feedback and supporting gait.
While WALK works well to improve mobility, our work with WALK also indicated that knowing the risk profile early can improve outcomes quite a bit.
In the research presented at WPC, we examined data from a few participants with Parkinson’s and freezing of gait, those who responded to treatment with WALK and those who didn’t. Some showed a clear immediate response. Some showed little benefit. Others appeared to improve only after longer use. Responders and non-responders also differed in aspects of their motor and non-motor presentation, including rigidity, tremor, disease duration, pain, sleep disturbance, and autonomic symptoms. These findings are preliminary and require further validation, but they challenge a simple binary idea of whether a technology “works.” The more useful question is: for whom does it work, under what circumstances, and how does that response change over time?
These questions cannot be answered through a single assessment. It requires longitudinal observation. Sometimes a completely different symptom may help identify the effectiveness of a solution for a particular symptom.
Building a system that looks out for you
Our next innovation, PATHFINDER, is being developed in this spirit.
Its objective is to create a conversational chronic-care system that uses natural movement data from WALK combined with objective mobility assessments. The longer-term aim is for the system to learn a person’s usual patterns, identify subtle but sustained deviations, and recommend interventions appropriate to that individual.
For fall-risk management, this could mean bringing together changes in turning, balance, gait variability, freezing, near-falls, confidence, medication response, and daily activity. PATHFINDER could then distinguish between an isolated bad day and a pattern that deserves attention.
The intervention should also be proportionate. A small change might prompt a home exercise or a check-in. A persistent deterioration might lead to therapist review. A sudden or concerning change should be escalated to the person’s clinical team.
This is not a replacement for neurologists, physiotherapists, or hospitals. It is a way to use their expertise more effectively. Routine support can happen closer to home, while clinicians receive clearer information and are involved when the situation genuinely requires them.
A different model of neurological care
The home blood-pressure monitor did not replace the physician. The glucometer did not replace the diabetes clinic. They made continuous self-management possible and gave clinicians better information on which to act. Evidence from hypertension care shows that home monitoring becomes especially useful when measurements are connected to structured self-care support and clinical pathways, rather than being collected in isolation.
Parkinson’s needs its own version of that transformation. Why can’t the armchair tell us whether a person cannot control descent while sitting? Why doesn’t a smartphone tell them that they may need to see a speech therapist?
The answer may not be one universal measurement. Parkinson’s is too variable for that. Instead, it may be a personalized system that listens, observes, understands an individual’s baseline, supports day-to-day decisions, and knows when to call for help.
That is the idea connecting WALK and PATHFINDER: technology that does not wait for the next appointment or the first serious fall but quietly looks out for the person every day.
Amey Desai is the CEO of Lifespark Technologies, Mumbai, India. He presented her poster at the 7th World Parkinson Congress in Phoenix.
Ideas and opinions expressed in this post reflect that of the author(s) solely. They do not necessarily reflect the opinions or positions of the World Parkinson Coalition®