Description
This research area addresses the theoretical and experimental understanding of motor and balance dysfunction and the effect of disorders on patients in their daily activities.
We develop a wide range of multi-modal assistive tools to support people with neurological movement disorders and psychological disorders. We address the preclinical and clinical phases of various neurological disorders, including Cerebellar Ataxia, Hereditary Spastic Paraplegia, Parkinson’s disease, and Apraxia. Furthermore, multi-modal systems are used to improve therapeutic interventions for mentally ill subjects, e.g., obsessive-compulsive disorders.
Researchers
Angehrn, Sarah; Bohn, Kristina; Gehre, Lukas; Ilg, Winfried; Lang, Jana; Laßmann, Christian; Malsch, Milena; Salatiello, Alessandro; Seemann, Jens; Thierfelder, Annika; Umer, Syed Muhammad; Willms, Hannah
Current Projects
Real-life gait assessment in degenerative cerebellar ataxia: Towards ecologically valid biomarkers
In order to establish ecologically valid biomarkers evaluating treatment-responses really in the patients’ everyday life, we develop multi-variate measures of ataxic gait using wearable sensors, which demonstrate high sensitivity to small differences in disease severity in real-life walking.
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SSTeP KiZ: smart sensor technology in tele-psychotherapy for children and adolescents with obsessive-compulsive disorder
With sensors that can be worn in everyday life and an intelligent analysis of multi-modal sensor data, SSTeP KiZ aims to significantly improve the treatment options for patients with obsessive-compulsive disorder. We support telemedical treatment of affected children and adolescents in their home environment by integrating data collected with wearables.
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Gait in hereditary spastic paraplegia – from axonal degeneration to movement disorder
In Hereditary Spastic Paraplegia (HSP) type 4 (SPG4 / SPAST) a length-dependent axonal degeneration in the cortico-spinal tract leads to progressing symptoms of hyperreflexia, muscle weakness, and spasticity of lower extremities. The therapeutical potential for future intervention is likely most promising in the early stages of HSP. Therefore, it is crucial to identify and quantify first changes already in the prodromal phase of HSP patients.
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Detecting and Quantifying Ataxia-Related Motor Impairments in Rodents Using Markerless Motion Tracking With Deep Neural Networks
Animal models of adult-onset neurodegenerative diseases have significantly enhanced the understanding of the molecular (patho-)mechanisms and have offered enormous potential for therapeutic target evaluation in many neurodegenerative diseases.
Read moreFinished Projects
Cerebellar involvement in the facilitation of action perception by concurrent motor activity
The execution of motor behavior influences concurrent visual action observation, and especially the perception of biological motion. Exploiting Virtual Reality technology, we have studied how the cerebellum contributes to action-perception coupling, comparing cerebellar patients with controls.
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Smart sensor technology in telepsychotherapy for children and adolescents SStep-KiZ
Through the use of sensors that can be worn in everyday life and an intelligent analysis of multi-modal sensor data, SSTeP-KiZ aims to significantly improve the treatment options for mentally ill children and adolescents with obsessive-compulsive disorders.
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Development of exergames for the motor training in cerebellar ataxia
Computer games provide a possibility to enhance physiotherapeutic training and to increase the motivation of patients in such training. We develop own games that are optimally adapted to the needs of different patient groups, and specifically cerebellar ataxia patients.
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The influence of focal cerebellar lesions on the coordination in walking
In this study we examined patients with focal cerebellar lesions in order to investigate the influence of different regions of the cerebellum on the performance in a working memory task (n-back task), as well as on gait variability and gait stability during dual task walking.
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Cost-efficient system for movement quantification in neurology
The Microsoft Kinect sensor for computer games allows robust body motion tracking for relatively low cost. We use this technology for the analysis of patient movements and develop cheap systems for the quantification of movement deficits that can be deployed at home or simultaneously at multiple places for multi-center studies.
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Design and development of a mobile robot supporting the rehabilitation of free walking
Current walking rehabilitation is mainly restricted to treadmill walking in order to train basic rhythmic walking patterns. Together with the Fraunhofer IPA (Stuttgart) we designed a new robot platform to train walking in complex situations (turning, standing up, etc.).
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Influence of action execution on biological motion perception
The perception and execution of motor actions are tightly interlinked, and numerous experiments suggest the existence of common sensory-motor representations.Using a virtual-reality setup we aim to investigate the influence of self-generated body motion on the perception of online generated biological motion in combined motor behaviour and psychophysical studies.
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Motor learning and the functional role of the cerebellum
The cerebellum plays an essential role in motor learning. Combining psychophysics and neuropsychological studies in patients we investigate different types of motor learning mechanisms and the role of the cerebellum.
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Quantification of subtle motor changes in preclinical stages of neurodegenerative diseases
Movement disorders such as cerebellar ataxia or Parkinon’s disease result in subtle degradations of motor behavior already long time before the become clinically manifest. Using motion capture technology and machine learning, we try to identify such subtle preclinical motor symptoms.
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Rehabilitation training exploiting physiotherapy, computer games and biofeedback
The symptoms o movement disorders, such as cerebellar ataxia or Parkinon’s disease, can be partially improved y motor training. We have shown that (opposed to the classical view) physiotherapy results in substantial and enduring benefits for patients with cerebellar ataxia, if such training is continuously administered. We exploit biofeedback and computer games to improve such training.
Read morePublications
Ilg, W., Wochner, I., Charaja, J. P., Hofmann, V., Strenge, O., Adam, M. et al (2025). iAssistADL: Intelligent assistive device for patients with neuro- degenerative movement disorder: Concepts and first implementations. In Proc. International Consortium for Rehabilitation Robotics (ICORR), pages 1-6.
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iAssistADL: Intelligent assistive device for patients with neuro- degenerative movement disorder: Concepts and first implementations
Abstract:
Upper-limb activities of daily living like eating and drinking are crucial for self-determination and autonomy and, thus, quality of life. Patients with neurodegenerative diseases such as Parkinson’s disease, multiple sclerosis or cerebellar ataxia are often severely impaired in performing these activities of daily living. While these patients are still able to plan motor actions, and their muscle strength is rarely impaired, tremor or overshooting movements disturb the intended movements. This occurs progressively in the course of disease in a way that inde- pendent eating and drinking becomes increasingly difficult. The goal of this research project is to develop a non-invasive assistive device suppressing pathological movement components while allowing intended movement. The newly designed hardware will be controlled by a combination of computational methods to detect user intention, detect pathological movement components within intended movements, and predict the required correction forces for several upper-limb activities of daily living. In this manuscript, we will describe concepts of control hard- and software as well as first implementation and experiments with the individual components we plan to integrate in the future.
Authors:
Ilg, Winfried; Wochner, Isabell Charaja, Jhon Paul Feliciano Hofmann, Veronika Strenge, Ole Adam, Melanie Lendway, Regine Kerner, Jan Vashisht, Bhavya Deep Ackermann, Marko Bunjes, Friedemann Schneider, Urs Giese, Martin A.; Bulling, Andreas Schmitt, Syn Maufroy, Christophe Haeufle, Daniel Florian Benedict
Type of Publication:
In Proceedings
Book title:
Proc. International Consortium for Rehabilitation Robotics (ICORR)
Pages:
1-6
Willemse, I., Mellone, S., Tacconi, C., Ilg, W., Schüle, R., Synofzik, M. et al. (2025). Smartphone Application for Spastic Ataxias: Cross-Sectional Validation of a Newly Developed Smartphone App for Remote Monitoring in Spastic Ataxias. The Cerebellum, 24.
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Smartphone Application for Spastic Ataxias: Cross-Sectional Validation of a Newly Developed Smartphone App for Remote Monitoring in Spastic Ataxias
Abstract:
Effective trial-planning in Spastic ataxias (SPAX) is impeded by the absence of validated outcome measures for detecting longitudinal changes. Digital outcome measures show promise, demonstrating sensitivity to disease severity changes in ataxia and strong correlations with clinical scales. The objective of this study was to develop a smartphone application for SPAX (SPAX-app) to obtain valid digital outcome measures for use in clinical trials. The app contains four tasks assessing gait, standing balance (stance), and finger and hand movements. We carried out a validation study in 22 SPAX patients and 10 controls. Subjects performed the tasks three times during one visit. In parallel, we performed Ambulatory Parkinson's Disease Monitoring (APDM) sensor recordings, Q-motor upper limb assessment, and the Scale for the Assessment and Rating of Ataxia (SARA). Significant correlations were found between the SPAX-app and APDM or Q-motor for step time (r = 0.91), all measures of stance (r = 0.51-0.87) and duration of hand alternation (r = 0.64). No significant correlations were found for variability measures (e.g. standard deviation of step time). All tasks of the SPAX-app, except for stance, can discriminate SPAX from controls and show moderate to high test-retest reliability (ICC 0.67-0.97). Significant correlations were found between SARA and step time (r = 0.70), inter-onset interval in finger tapping (r = 0.57), and duration of hand alternation (r = 0.65). The stance task did not show significant correlations with SARA. With the SPAX-app, we present a set of digital outcome measures for potential use in clinical trials. Longitudinal studies are needed to evaluate whether these measures can track disease progression.
Authors:
Willemse, Ilse Mellone, Sabato Tacconi, Carlo Ilg, Winfried; Schüle, Rebecca Synofzik, Matthis Nonnekes, Jorik Warrenburg, Bart
Type of Publication:
Article
Journal:
The Cerebellum
Volume:
24
Year:
2025
Month:
03
Seemann, J., Beyme, T., John, N., Harmuth, F., Giese, M. A., Schöls, L. et al. (2025). Capturing longitudinal change in cerebellar ataxia: Context-sensitive analysis of real-life walking increases patient relevance and effect size. Accepted for Movement Disorders in 2025.
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Capturing longitudinal change in cerebellar ataxia: Context-sensitive analysis of real-life walking increases patient relevance and effect size
Abstract:
OBJECTIVES: With disease-modifying drugs for degenerative ataxias on the horizon, ecologically valid measures of motor performance that can detect patient-relevant changes in short, trial-like time frames are highly warranted. In this 2-year longitudinal study, we aimed to unravel and evaluate measures of ataxic gait which are sensitive to longitudinal changes in patients{\textquoteright} real life by using wearable sensors. METHODS: We assessed longitudinal gait changes of 26 participants with degenerative cerebellar disease (SARA:9.4{\textpm}4.1) at baseline, 1-year and 2-year follow-up assessment using 3 body-worn inertial sensors in two conditions: (1) laboratory-based walking (LBW); (2) real-life walking (RLW) during everyday living. In the RLW condition, a context-sensitive analysis was performed by selecting comparable walking bouts according to macroscopic gait characteristics, namely bout length and number of turns within a two-minute time interval. Movement analysis focussed on measures of spatio-temporal variability, in particular stride length variability, lateral step deviation, and a compound measure of spatial variability (SPCmp). RESULTS: Gait variability measures showed high test-retest reliability in both walking conditions (ICC \> 0.82). Cross-sectional analyses revealed high correlations of gait measures with ataxia severity (SARA, effect size ρ >= 0.75); and in particular with patients{\textquoteright} subjective balance confidence (ABC score, ρ>=0.71), here achieving higher effect sizes for real-life than lab-based gait measures (e.g. SPCmp: RLW ρ=0.81 vs LBW ρ=0.71). While the clinician-reported outcome SARA showed longitudinal changes only after two years, the gait measure SPCmp revealed changes already after one year with high effect size (rprb=0.80). In the subgroup with spinocerebellar ataxia type 1, 2 or 3 (SCA1/2/3), the effect size was even higher (rprb=0.86). Based on these effect sizes, sample size estimation for the gait measure SPCmp showed a required cohort size of n=42 participants (n=38 for SCA1/2/3 subgroup) for detecting a 50\% reduction of natural progression after one year by a hypothetical intervention, compared to n=254 for the SARA. CONCLUSIONS: Gait variability measures revealed high reliability and sensitivity to longitudinal change in both laboratory-based constrained walking as well as in real-life walking. Due to their ecological validity and larger effect sizes, characteristics of real-life gait recordings are promising motor performance measures as outcomes for future treatment trials.Competing Interest StatementDr Ilg received consultancy honoraria by Ionis Pharmaceuticals, unrelated to the present work. Mr Seemann reports no disclosures. Mrs Beyme reports no disclosures. Mrs John reports no disclosures. Mr Harmuth reports no disclosures. Prof Giese reports no disclosures. Prof Schoels served as advisor for Alexion, Novartis and Vico. He participates as a principal investigator in clinical studies sponsored by Vigil Neuroscience (VGL101-01.001; VGL101-01.002), Vico Therapeutics (VO659-CT01), PTC Therapeutics (PTC743-NEU-003-FA) and Stealth BioTherapeutics (SPIMD-301), all unrelated to the present work. Prof Timmann reports no disclosures. Prof Synofzik has received consultancy honoraria from Ionis, UCB, Prevail, Orphazyme, Biogen, Servier, Reata, GenOrph, AviadoBio, Biohaven, Zevra, Lilly, and Solaxa, all unrelated to the present manuscript. Funding StatementThis work was supported by the International Max Planck Research School for Intelligent Systems (IMPRS-IS) (to J.S.) and the Else Kroener-Fresenius-Stiftung Medical Scientist programme ClinbrAIn (to W.I. and M.G.). as well as the Else Kroener-Fresenius Stiftung Clinician Scientist program PRECISE.net (to M.S.). In addition, this work was supported by the European Union, project European Rare Disease Research Alliance (ERDERA, $\#$ 101156595) (to M.S.).Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethics committee/IRB of University Tuebingen, Germany gave ethical approval for this workI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesData will be made available upon reasonable request. The authors confirm that the data supporting the findings of this study are available within the article and its Supplementary material. Raw data regarding human participants (e.g. clinical data) are not shared freely to protect the privacy of the human participants involved in this study; no consent for open sharing has been obtained.
Authors:
Seemann, Jens; Beyme, Theresa John, Natalie Harmuth, Florian Giese, Martin A.; Schöls, Ludger Timmann, Dagmar Synofzik, Matthis Ilg, Winfried
Type of Publication:
Article
Full text: Online version
Laßmann, C., Schöls, L., Giese, M. A., Haeufle, D. & Ilg, W (2024). Quantifying the Restoration of a Norm-Like Gait Pattern from Mid-Foot Strike by Botulinum-Toxin-A Treatment in a Patient with Hereditary Spastic Paraplegia, pages 406-410.
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Quantifying the Restoration of a Norm-Like Gait Pattern from Mid-Foot Strike by Botulinum-Toxin-A Treatment in a Patient with Hereditary Spastic Paraplegia
Abstract:
Hereditary spastic paraplegia is characterized by progressive spasticity and muscle weakness, significantly impairing gait. In neuro-musculoskeletal models, gradually increasing hyperreflexia could simulate severity-related gait patterns. This shows a potential application of neuromusculoskeletal models in predicting outcomes of treatments managing spasticity. As a first step, this case-study investigates the efficacy of Botulinum-Toxin-A in improving gait kinematics in a 54-year-old male with HSP and impaired gait. Instrumented gait analysis was conducted before and after treatment using dynamic time warping to compare the participant’s gait to healthy controls. Post-treatment results showed increased segmental angle range of motions and gait speed. The dynamic time warping analysis revealed a 13% restoration towards a healthy gait, indicating that kinematic analyses effectively quantify BoNT-A treatment effects in HSP patients.
Type of Publication:
In Book
Pages:
406-410
Month:
12
ISBN:
978-3-031-77583-3
Renner, T. J., Gawrilow, C., Conzelmann, A., Giese, M. A., Kasneci, E., Swoboda, W. et al. (2024). Lessons learned from a multimodal sensor-based eHealth approach for treating pediatric obsessive-compulsive disorder. Frontiers in Digital Health, 6.
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Lessons learned from a multimodal sensor-based eHealth approach for treating pediatric obsessive-compulsive disorder
Authors:
Renner, Tobias J. Gawrilow, Caterina Conzelmann, Annette Giese, Martin A.; Kasneci, Enkelejda Swoboda, Walter Löchner, Johanna Bethge, Wolfgang A. Lautenbacher, Heinrich Thierfelder, Annika; Ilg, Winfried; Primbs, Jonas Seizer, Lennart Alt, Annika Kristin Kühnhausen, Jan Hollmann, Karsten Klein, Carolin S.
Type of Publication:
Article
Full text: PDF | Online version