Cue4ALL: Walking Support for People with MS and After Stroke

The Cue4ALL project further develops the successful Cue2Walk technology. The proven CE-marked Cue2Walk wearable, currently used by people with Parkinson's disease, is being adapted for people with multiple sclerosis (MS) and those recovering from stroke. The system detects and predicts walking difficulties in everyday life and provides personalised auditory or tactile feedback linked to an individual eHealth home rehabilitation programme. Together with patients, informal caregivers, healthcare professionals, researchers and technology partners, researchers from the Centre of Expertise Health Innovation are developing and evaluating a solution that supports safe mobility, self-management and social participation.

Together with patients, healthcare professionals, researchers and technology partners, we are adapting a proven technology for two new target groups. This ensures that the solution is not only innovative, but above all clinically relevant and capable of making a real difference in the daily lives of people with MS or those recovering from stroke.

- Researcher Astrid Horstman

Background

People with MS or those recovering from stroke often experience gait impairments, such as sudden slowing, hesitation or balance problems while walking. These context-dependent walking difficulties - for example when experiencing fatigue, distraction or navigating busy or confined environments - increase the risk of falls. They also reduce physical activity, limit independence and restrict participation in society. Existing interventions are largely reactive and provide insufficient support within people's own living environments.

Cue2Walk is a proven wearable solution for people with Parkinson's disease. Cue4ALL builds on this CE-marked technology by adapting it to the specific needs of people with MS and stroke, while also supporting informal caregivers and home-based rehabilitation.

Objective

The aim of this project is to further develop the existing CE-marked wearable so that it can detect, predict and support walking difficulties in people with MS and stroke in real time through personalised feedback and home rehabilitation.

Method

The project begins by identifying the needs and compensation strategies related to walking difficulties through a co-creation process involving people with MS or stroke, informal caregivers and healthcare professionals. Detection and prediction algorithms are then developed and integrated into the existing CE-marked wearable, which is linked to a personalised eHealth home rehabilitation programme.

Based on this work, two real-world pilot studies will be conducted to evaluate the feasibility, usability and preliminary effects on mobility, self-management and social participation. This person-centered, practice-oriented approach focuses on everyday situations.

Results

The project will run for three years and is expected to deliver an impactful continuation of Cue2Walk. Cue4ALL will result in a validated wearable combined with an eHealth home rehabilitation programme for people with MS and stroke.

The system will detect and predict walking difficulties during daily life and provide personalised auditory or tactile support. In addition, the project will deliver new detection and prediction algorithms, a unique dataset of walking difficulties in home environments, practical implementation guidelines for healthcare professionals and scientific publications. Together, these outcomes will support the broader adoption of the technology in clinical practice and future healthcare innovations.

Impact

Cue4ALL contributes to safe and independent mobility for people with MS and stroke by detecting and predicting walking difficulties at home and providing personalised support when it is needed. This is expected to reduce falls, increase confidence while walking, improve adherence to rehabilitation programmes, enhance independence and strengthen social participation.

By involving patients, informal caregivers and healthcare professionals from the outset, the intervention is designed to meet real-world needs and facilitate sustainable implementation. The project will also generate new knowledge, datasets and opportunities for education and research, supporting the continued development of person-centered digital rehabilitation and home monitoring.

Duration

The project starts in September 2026 and will run until September 2029.

Collaboration

• Amsterdam University of Applied Sciences
• Cue2Walk International B.V.
• HAN University of Applied Sciences
• Neuronet Foundation
• Basalt Rehabilitation

More Information

Read more about the original wearable technology on the Cue2Walk website.

Team

Researchers from the Centre of Expertise Health Innovation involved in this project:

• Jorit Meesters – Professor of Research Group Rehabilitation & Technology
• Astrid Horstman – Researcher
• Yvonne van Zaalen – Professor of Research Group Relational Care

Contact

Astrid Horstman ([email protected])