
More than 3 billion people worldwide are living with a neurological condition (source: The Lancet Neurology).
In the UK alone, the burden is set to increase dramatically.
Each year, the number of strokes alone is projected to rise by 60% between 2015 and 2035, and the population of stroke survivors is expected to more than double during the same period.
This growing demand places mounting pressure on the NHS to deliver effective mobility support for neurological patients. Stroke survivors often experience a wide range of impairments, affecting muscle control, balance, coordination, and strength.
Recognising the need for innovative solutions, NHS Tayside physiotherapist Robert Ives set out to explore how technology could enhance support for both patients and clinicians.
Robert explained, “Currently, most clinical assessments for neurological patients rely on visual analysis. While useful, visual assessments often lack the objectivity needed to fully understand a patient’s gait, particularly in complex neurological cases.”
With access to the Gait Lab at Ninewells Hospital generally limited to orthopaedic cases, Robert sought an alternative: using everyday smartphone technology to replicate the capabilities of a clinic-based Gait Lab for neurological patients. His goal was to make gait analysis more accessible in everyday clinical settings, allowing for real-time feedback, informed decision-making, and tailored interventions such as specific exercises, therapies, or orthotics.
Ultimately, the vision is to develop a modern, technology-enabled care plan that delivers community-based rehabilitation, reduces dependency on secondary or tertiary care, and lowers costs related to equipment and training.
To progress his idea to a working prototype, Robert needed dedicated time and resources to conduct a feasibility study, something that was not possible within the constraints of his full-time role as a Physiotherapist in Arbroath. This period of focused research would allow him to explore the practicalities of the concept and connect with a range of stakeholders across Tayside. Key to the study was collaboration, with Robert aiming to engage with a range of professionals who work with patients affected by neurological conditions.
Robert added, “This has been a passion project I’ve had in mind for years. It draws on everything I’ve learned in clinical practice, both back home in Australia and here in Scotland, and on the exciting potential of motion capture technology used in game design. When you can video someone and the system creates an avatar to mimic their movements in a game, it made me think - if the software can do that, why not use it to analyse someone’s gait?”
“The challenge was understanding what technologies were out there and how they could be applied efficiently, affordably and legally within NHS environments.”
To bring the project to life, Robert also required support with project management, helping structure timelines and deliverables, as well as mentorship from experts in innovation, gait analysis, and product development.
To move his idea forward, Robert approached the NHS Tayside Charitable Foundation and was awarded a grant of just under £10,000. This financial support enabled him to dedicate three sessions per week over a six-month period to conduct a detailed feasibility study.
Launched in the summer of 2024 and completed in January 2025, the study marked a significant learning curve for Robert.
“Having never produced a feasibility study before, it was a daunting task, one I probably underestimated in terms of the time and level of detail required,” he admitted. “I had to consider the medical, technical, and increasingly stringent legal implications of the idea. I also needed to engage directly with clinicians, gain experience in the Gait Lab, and understand exactly who has access to that resource.”
The study also involved identifying the target patient population, assessing how accessible the proposed technology could be within NHS settings, and navigating the various logistical and regulatory challenges.
“There were many obstacles,” Robert reflected, “but it had to be thorough, and I was delighted to see it through to completion.”
The Impact
“I’m extremely grateful to the NHS Tayside Charitable Foundation for allowing me to step away from clinical duties to focus on this project.
“Technology in movement analysis and AI is evolving rapidly. My aim is to harness these advancements - combined with clinical experience, evidence, and insight - to improve mobility outcomes for patients with neurological impairments, while reducing long-term costs for the healthcare system.”
Robert envisions a future where gait and movement analysis becomes far more accessible across healthcare settings.
“Ultimately, I want to widen access to gait analysis by reducing reliance on highly specialised therapist training, minimising clinical bias, and delivering consistent, evidence-based care. My ideas have the potential to disrupt how physiotherapy interventions are delivered and monitored in the community.
“By improving patient independence, helping people return to or stay in work, and enhancing long-term health outcomes, this approach could significantly ease the burden on both health and social care services. And as technology continues to advance, it could integrate into socially interactive systems like AI-powered platforms and robotics.”
Beyond clinical benefits, Robert sees a valuable triage role for the technology.
“For many patients, a full Gait Lab assessment isn’t necessary, but they still need an accurate evaluation. The solution I’m developing could help clinicians determine which cases can be managed locally, and which need referral to the specialist Gait Lab. That means saving time, money, and inconvenience while still delivering a high standard of care.”
The Future
With the feasibility study now completed and the grant spent, Robert has taken time to reflect on is findings and is now preparing for the next stage: real-life testing. “I’m now looking to collaborate with the Gait Lab at the University of Dundee, or another lab in Scotland, to begin a case study using the consumer-grade technology we’ve identified as most suitable. We’ll compare it against existing Gait Lab systems to evaluate performance and usability.” Looking ahead, Robert’s vision is clear: to create a scalable, cost-effective, and clinically valuable tool that brings gait and movement analysis closer to patients, wherever they are.
