In sub-project 2 " Sensor-based monitoring of gait impairments in HSP patients and real-life application", gait patterns were recorded both cross-sectionally and longitudinally in the hospital and compared with established clinical scales. The world's largest data set to date on digital gait patterns in a cohort of patients with HSP was collected and analysed using mobile sensor technology. Disease-specific gait characteristics were identified using instrumented methods in a multicentre setting (three centres: Erlangen, Essen, Tübingen) in n=112 patients and compared with those of 112 age- and gender-matched control subjects. This largest cross-sectional study to date on gait characteristics in HSP was published in NEUROLOGY (Regensburger et al., 2022).

In addition, longitudinal clinical, sensor-based and patient-reported data (so-called patient-reported outcome measures, PROMs) were collected in a multicentre study in order to obtain information on disease progression and map it multi-parametrically. A total of 55 data sets were collected and analysed during clinical follow-up examinations of HSP patients and published in Annals of Clinical and Translational Neurology (Loris et al., 2023). We observed that gait parameters recorded quantitatively using sensor technology reflect the course of the disease and correlate with clinically established scales and PROMs.

Furthermore, a graphical user interface for the annotation of gait signals was developed as part of the project, which enables developers and clinicians to apply algorithms and generate clinically relevant results with a time saving of 75%. The usability of this application has been tested and shows superiority compared to currently available solutions. The results of this work were published in the journal Sensors (Ollenschläger et al., 2022).

With regard to the evaluation of treatment effects of the standardised application of botulinum toxin A, data from n=56 patients with HSP were recorded in a pre-post comparison using sensor-based gait analysis, clinical scales and PROMs in a multicentre study. The analysis shows an improvement in clinical symptoms and gait parameters at medical presentation one month after botulinum toxin injection. The digital gait parameters correlate with clinical scales, which confirms the use of digital technologies in therapy monitoring (Ibrahim et al., 2024).