Gamification and Remote Physical Activity for Parkinson’s Disease
Parkinson’s disease is a progressive neurodegenerative disease characterized by bradykinesia (slow movements), rigidity, tremors, postural instability, and reductions in daily physical activity. Thankfully, a growing body of research strongly supports the benefits of regular physical activity for slowing disease progression and improving quality of life. Despite this, people with Parkinson’s disease struggle to achieve adequate daily movement and can greatly benefit from interventions that are low-cost and address barriers to physical activity.
A recent study investigated the use of a fully remote, automated, gamification intervention to help increase daily steps in people with Parkinson’s disease. Their results were highly favorable and strongly support the use of technologies such as remote biofeedback to cue movement, reinforce motor output, and promote sustained engagement in physical activity.
Let’s look at how mTrigger biofeedback can be applied in Parkinson’s disease, highlighted by the evidence and principles in this research.
Disrupted basal ganglia signaling and impaired automatic movements are at the root of the motor impairments seen in Parkinson’s disease. Movements such as walking, initiating walking, or maintaining posture now require increased mental effort. The external cues and augmented feedback provided by mTrigger sEMG biofeedback help to bypass impaired internal cuing mechanisms and offer real time information that allows people with Parkinson’s disease to see, hear, and feel what is happening. Thereby enhancing motor control, improving voluntary muscle activation, and increasing awareness of underactive and poorly timed muscles. mTrigger is designed to link movement goals (steps, exercise, strength training, etc) to the quality and timing of muscle activation that underlies movement. By transforming abstract motor goals into concrete, measurable targets, mTrigger biofeedback can help to improve the adherence and outcomes of physical activity in patients with Parkinson’s disease.
Clinical Application
mTrigger biofeedback can be used to target and address some of the main concerns with Parkinson’s disease.
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Bradykinesia: encourage faster or more forceful muscle activation during functional tasks such as reaching, stepping, walking, etc.
*This video demonstrates reaching in a patient post stroke. While the presentation of Parkinson's is different, the application of mTrigger biofeedback is similar and equally relevant.
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Gait Impairments: improve activation of key muscles involved in the swing phase, push off, and postural control during walking
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Postural Instability: improve endurance and awareness of the trunk and hip stabilizers
- Freezing of Gait: mTrigger biofeedback can help provide external cueing to facilitate movement initiation
This study further highlights the success gamification interventions have when it comes to reaching goals, making mTrigger a perfect tool. Having a gamification aspect to their walking goals helped motivate patients to walk more steps daily. Furthermore, gamifying movement reinforces patients to not just move more, but move better, an essential distinction for Parkinson’s rehabilitation.
mTrigger biofeedback can gamify any exercise. Here is a simple example of ankle dorsiflexion which can be a useful exercise to help improve gait in Parkinson's disease. Overground and treadmill walking can also be used with mTrigger games.
Another huge advantage of mTrigger biofeedback, is its suitability for home-based use. This can help reduce barriers related to transportation, access, or location. Patients were still able to perform their activity/exercise at home, which allowed for those in rural communities, across multiple states, and of all levels of ability/activity to still benefit.
Keep it Simple
When starting out, focus on one or two muscle groups associated with the function goal. Pair mTrigger biofeedback with meaningful tasks for the patient, such as walking, reaching, transfers, or balance, rather than an isolated muscle contraction. The addition of an auditory cue (on top of the visual cue) can enhance motor performance. Finally, make sure to progress gradually, keeping in mind fatigue, medications, and disease severity.
Conclusion
The use of remote, technology-enabled interventions represents a critical advancement in Parkinson’s disease rehabilitation. Evidence supporting automated physical activity programs highlights the value of scalable, feedback-driven approaches. mTrigger sEMG biofeedback builds on these principles by providing neuromuscular-specific, gamified, real-time feedback that supports motor control, external cueing, and sustained engagement. When integrated into home-based care, sEMG biofeedback offers a promising strategy to enhance functional movement and long-term physical activity participation in individuals with Parkinson’s disease.
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References
- Waddell KJ, Greysen SR, Patel MS, et al. Remote, Automated Gamification and Community-Based Physical Activity in Parkinson Disease. JAMA Neurol. Published online 2026. doi:10.1001/JAMANEUROL.2025.4232
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