Parkinson’s disease affects around 145,000 people in the UK, a number expected to double by 2040. As the condition progresses, changes in movement and balance can increase the risk of falls and have a significant impact on quality of life.

Rehabilitation can help people maintain mobility and independence, but access to physiotherapy can be limited by travel, motivation to complete exercises at home and lengthy waiting lists. The NIHR i4i funded Restart-PD study (reference 206530) is testing whether augmented reality (AR) technology used at home, combined with reduced usual care, can improve gait and balance more than usual care alone, at lower cost to the NHS.

The NIHR HealthTech Research Centre: Long-term Conditions, Devices for Dignity (D4D), is working with UK-based innovator Strolll and the Universities of Leeds and York to evaluate its AR glasses by comparing them with standard NHS physiotherapy care, which typically involves a weekly 45-minute outpatient appointment supported by home exercises provided on paper. The technology turns prescribed rehabilitation exercises into interactive games, allowing people to complete guided exercises at home while healthcare professionals remotely monitor and personalise their rehabilitation. In the trial this replaces most weekly face-to-face appointments with an initial set-up consultation, daily rehabilitation at home and a short weekly check-in.

D4D has played a central role in ensuring people with lived experience are involved throughout the study. Core D4D staff and a co-applicant with Lived Experience co-chair the Lived Experience Advisory Group (LEAG), supporting the development of study materials, testing the technology and advising on recruitment and implementation. D4D and the LEAG will also co-develop and deliver a workshop with people from minority communities, to gain insights from them around their experiences of Parkinson’s Disease, care and support. We will include the opportunity to test out the augmented reality glasses to see if there are any adaptations which they feel might be necessary to ensure that the glasses are inclusive and accessible to all.

The randomised controlled trial is ongoing and will run until June 2027.

Why is this work important?

Parkinson’s can progressively affect walking, balance and mobility, making rehabilitation an important part of helping people maintain independence and quality of life. However, traditional clinic-based rehabilitation can create significant barriers. Patients may need to travel regularly to appointments, while NHS physiotherapy services face considerable demand and waiting lists can be between 6 and 12 months.

Home-based rehabilitation could provide a more convenient alternative, but completing exercises independently can be challenging. Motivation, access to appropriate guidance and the ability to tailor exercises to individual needs can all affect how consistently people engage with rehabilitation.

The Restart-PD study is addressing this challenge by investigating whether rehabilitation delivered at home through AR technology, combined with reduced usual care, improves gait and balance and offers better value to the NHS than usual care alone, while still providing the personalisation and clinical oversight patients need.

The potential benefit extends beyond convenience. If people can access effective, personalised rehabilitation at home, this could support the NHS shift towards care closer to home and greater use of digital technology, while potentially reducing pressure on hospital-based services.

How is the NIHR HealthTech Research Centre: Long-term Conditions (Devices for Dignity) helping to tackle this challenge?

The Restart-PD study is evaluating Strolll's technology through a randomised controlled trial, comparing AR-supported rehabilitation with traditional physiotherapy.

The AR glasses turn prescribed exercises into interactive rehabilitation games. Patients can use the technology at home for up to 50 minutes of guided rehabilitation each day, while healthcare professionals can remotely assess progress and personalise exercises.

 

Strolll uses augmented reality to increase engagement, support progression, and help clinicians deliver effective neuro rehab.

 

A key part of D4D's contribution has been ensuring that the technology and research are informed by people living with Parkinson's. Core D4D staff co-chair the project's Lived Experience Advisory Group (LEAG) alongside a person with lived experience.

The LEAG meets together quarterly for an hour online. During these meetings they receive study updates and discuss issues that need solving. During the study the LEAG have contributed to participant-facing materials, including reviewing trial documentation and participant information leaflets. Recently the LEAG have been reviewing strategies to improve recruitment of a diverse range of participants. Members have also tested the AR headset themselves and provided feedback on the device and its capabilities. As the trial progresses, the group will continue to advise on recruitment and retention and how best to support participants.

This approach ensures that the technology is not simply evaluated for patients, but developed and tested with people who understand the realities of living with Parkinson's.

LEAG Co-Chair, Matt Eagles said “as Co Chair of the LEAG, I believe we play a vital role in humanising the tech by providing the energy, enthusiasm and control to hopefully produce better outcomes for people we know only too well will struggle without this kind of innovation and intervention. Lived experience of the condition, knowing ourselves what it can do, and the potential benefits it is able to provide make us the  ideal conduit to enable the team to recruit, retain and enjoy the whole experience”

Alongside the clinical evaluation, D4D has continued to build its relationship with Strolll, including bringing the innovator into wider NIHR engagement opportunities such as the NIHR20 Sheffield Careers Day and NHS ConfedExpo, creating opportunities to showcase the innovation, connect with wider NHS and research audiences and strengthen the relationship between the wider HRC Network and the Strolll team.

 

The Strolll team with the wider HRC Network at NHS ConfedExpo, June 2026.

 

What progress has the project made to date, and what outcomes have been achieved?

The RESTART-PD trial is ongoing, so its findings on how Strolll compares with usual NHS physiotherapy care for people with Parkinson's are not yet available. Strolll is a registered medical device already in clinical use, supported by peer-reviewed research in Parkinson's on gait, balance and freezing of gait.

The study has been designed to determine whether using the technology can increase the intensity and motivation of rehabilitation, with the potential to improve mobility and balance and reduce the risk of falls.

For patients, the technology could make rehabilitation more convenient by allowing exercises to be completed at home rather than requiring regular travel to hospital or community appointments. The ability for healthcare professionals to remotely monitor and personalise rehabilitation could also provide greater support than traditional unsupervised home exercises.

 

Strolll can provide structured programmes patients can follow, while tracking engagement and progress over time. 

 

For the NHS, the potential impact is significant. If the technology is shown to be effective, it could provide an additional way of delivering rehabilitation to people who face barriers to accessing clinic-based services. This could help extend access to physiotherapy, reduce pressure on services and support a shift towards care delivered closer to home.

The project's focus on lived experience is also an important impact in itself. By involving people with Parkinson's throughout the study, D4D is helping ensure that future implementation considers not only whether the technology works, but whether people can and want to use it in their everyday lives.

What has the HealthTech Research Centre learned, and where do we go from here?

Restart-PD demonstrates the value of involving people with lived experience throughout the development and evaluation of health technologies.

The project Lived Experience Advisory Group has provided a direct route for patients and carers to influence the research, co-developing study tools such as patient information sheets, qualitative questionnaires and sharing user experience feedback on the technology first-hand. They help identify practical considerations that may not be apparent through clinical or technical evaluation alone and have also very much helped with publicity, recruitment and ideas for reaching diverse communities.

 

Quote from Lise Sproson, PPIE Lead at the NIHR HRC: Long-term conditions (Devices for Dignity).

 

The next challenge is to translate the findings from the trial into evidence that can inform future NHS use. If the results demonstrate clinical and economic value, the project could provide a pathway towards wider adoption of AR-supported rehabilitation for people with Parkinson's.

Who helped make this work possible?

The NIHR HealthTech Research Centre in Long-term Conditions, Devices for Dignity (D4D) supports the development, evaluation and adoption of technologies that address unmet needs for people living with long-term conditions. Through its work with patients, clinicians, researchers and industry partners, D4D helps innovators generate the evidence and insight needed to develop technologies that are meaningful, usable and suitable for NHS care.

Strolll is a UK-based digital rehabilitation company whose augmented reality platform brings rehabilitation out of the clinic and into people's homes. It now works with 89 customers worldwide, 12 of them NHS organisations.

The Restart-PD study is being delivered in collaboration with Strolll and the project's Lived Experience Advisory Group, with people living with Parkinson's helping shape the research and technology throughout its development.

The study is led by the University of Leeds, with York Trials Unit at the University of York supporting trial coordination and delivery. 

This project is funded by The National Institute for Health and Care Research Invention for Innovation (i4i) Programme (NIHR206530). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.