Based in Israel, AgeTech Collaborative™ startup participant GaitBetter promotes healthy aging by improving walking skills and reducing the risk of falling. By adding a virtual reality (VR) experience to treadmills, the company enables a personalized and gamified motor-cognitive intervention that is clinically validated and field-proven.
Co-founder and CEO Hilik Harari sat down with us to explain the innovative strides GaitBetter is making in gait rehabilitation and fall prevention therapies.
This interview has been edited for clarity and length.
What is GaitBetter all about?
GaitBetter adds a cognitive aspect to gait training in order to improve a person’s walking ability and to reduce falls. We do this in several ways. First, we provide a solution for anyone who needs to go through gait rehabilitation because of an acute or chronic condition, such as surviving a stroke, having a knee replacement or being diagnosed with Parkinson’s. Another segment that we’re tackling is on the preventative side. We work with various senior living facilities and assisted living communities to help prevent falls and the injuries that can result from a fall.
We are also doing extensive research into utilizing our technology to predict neurodegenerative diseases, specifically Alzheimer’s and Parkinson’s. We’ve found a way to use our technology platform as a screening test, and we’re conducting clinical studies to show whether the results of that test are indeed predictive measures of neurodegeneration.
Your platform is backed by some impressive research.
GaitBetter is based on research published in The Lancet — a multicenter, multicountry, randomized, controlled trial with more than 300 participants. The research looked at a control group that trained on a treadmill only, and at an experimental group that trained on a treadmill augmented by a virtual reality experience. It showed that adding the VR element clearly led to reduced fall rates compared to treadmill training alone.
How does the technology work?
We place a camera in front of your existing treadmill, and it tracks your foot movements in real time. These foot movements are then incorporated into a simulation that is displayed on a screen so that the person walking on the treadmill can see them.
As they walk, they engage in a personalized intervention that involves both motor and cognitive aspects. They watch their feet on the screen as they negotiate obstacles; by navigating hurdles on the screen, they practice things like high steps and long steps.
At the same time, they attend to different cognitive demand tests by paying attention to things along the way. For example, the system may ask them to click a button when they see a cat on the display — and the cat may be hiding behind a tree. They also practice memorization: The system might show them a map and ask them to memorize the route to the barber shop, and then ask them to navigate their way there.
So patients are using their body and their brain.
It’s this dual tasking and the cognitive elements that make walking more efficient. What the research behind GaitBetter found is that doing this kind of motor-cognitive intervention encourages brain plasticity, which makes the brain more efficient.
That’s why we see a reduction in falls among older adults that range from 50% up to 80%. Not only that, but it “sticks”: We see patients experiencing the benefits of a relatively short intervention six months later, and in some cases, even longer. The secret is in the brain: We train the brain to affect your walking.
Besides being effective, it also sounds like fun.
That wasn't our goal, at first. Instead, we were asking ourselves, “How do we engage the user on a cognitive level? How do we encourage dual tasking and executive function skills?” So our researchers looked for a technology that would allow us to add these cognitive aspects to gait training, and the VR came as the solution to that problem.
But once we started to use VR with patients, we saw that there were even greater benefits. Because the training is gamified and engaging, instead of walking for five minutes and getting bored or distracted, patients were walking for 15 or 20 minutes because they were forgetting about everything else. So by adding the cognitive element, we discovered that we were enhancing the engagement element.
Why did you help start the company in the first place?
I wanted to channel my expertise in technology and business into something that will help make the world better. I worked for almost 25 years in the high-tech space. Six or seven years ago, I was in FinTech, but I didn’t really connect with it on a personal level. Some friends of mine published that paper in The Lancet, and it really resonated with practitioners worldwide; my friends started getting calls from around the world asking them, “Where can we get this technology?”
Being a technologist and businessman, I said, “That’s the idea I've been looking for! Let’s take this technology to market.” So I partnered with a friend of mine, and we founded GaitBetter. Today, the system is being installed in more than 100 locations in the U.S. and Israel, and we see it growing on a daily basis, which makes me happy.
That sounds very gratifying.
Just last week I saw a text message from someone who said, “GaitBetter changed my life.” We literally help people get back on their feet so they can play with their grandchildren. That makes a world of difference.
What next on the horizon for GaitBetter?
Because of the amount of clinical data behind our technology, recently we were successful in applying for a new CPT code, which care providers use to get reimbursement from insurance companies. Our next big effort is to work with payers so that they pay the premium, so that providers will adopt GaitBetter at scale. Our goal is to help every older adult in America and worldwide to have access to modern motor and cognitive therapy, because we know what a huge impact that can make.