From Preference to Performance: Patient-Centered Design of Multimodal Cueing in Parkinson's Disease Gait Training

Parkinson’s disease (PD) commonly leads to gait disorders that necessitate long-term rehabilitation dependent on specialists and clinic-based interventions. To reduce dependence on clinicians and investigate how wearable technology can provide continuous guidance for rehabilitation training. We distilled key design principles from patient–clinician interviews and co-designed a gait training system. The system employs inertial measurement units (IMUs) to capture kinematic data, then delivers multimodal cueing (visual, auditory, and somatosensory) aligned with walking features. Two user studies (N = 16 PD patients) evaluated the effectiveness of multimodal cueing, examining strategies for information delivery and gait correction. Results indicated that visual and auditory cueing were more effective for process-oriented adjustments, whereas somatosensory stimulation better supported periodic cueing. Moreover, a dissociation between performance outcomes and user preferences was observed. These findings highlight the potential of wearable technology to provide continuous, daily training guidance for PD patients.