PhysioBiometrics Inc. has launched Heel2Toe, a wearable therapeutic device designed to assess and train older adults to walk with a proper gait. The product can help reduce strain on joints and muscles, prevent falls, and make walking easier.

The Heel2Toe sensor attaches to the side of a shoe and beeps with each “good” step—i.e., one that begins with a strong heel strike. Heel2Toe has proven beneficial for older adults, including those with orthopedic or neurological conditions such as Parkinson’s disease, according to the company. It also is reportedly the only wearable that provides real-time feedback for every step.

The Class 1 medical device is available worldwide through Shopify.

“Many older adults do not walk well enough to gain health benefits from walking. Out of a fear of falling or low confidence in their walking, they often change their gait and take little shuffling steps that increase their fall risk,” PhysioBiometrics President/CEO Dr. Nancy Mayo said. “Heel2Toe is a game-changer for helping older adults age well because when your gait is better, you can walk farther. By intervening early enough to correct poor gait, older adults reduce fall risk, increase physical activity, improve joint and muscle health, and ultimately stay in their homes longer.”

An optimal gait starts with a strong heel strike, followed by placing the foot flat, pushing off, swinging the leg, and repeating the process with little stride variability. With poor gait, people tend to shuffle—they don’t put their heel down first, don’t lift their foot, and the foot scuffs, increasing the risk of tripping. Gait tends to deteriorate in older adults due to neurological or orthopedic conditions, psychomotor slowing, and fear of falling.

As physiotherapists, Dr. Mayo and her co-founders set out to automate the encouragement therapists give people to walk heel-first. With support from McGill’s Biomedical Engineering Department, they developed the Heel2Toe sensor, which mimics the positive feedback by beeping each time a step begins with a strong heel strike. The beep works to improve the gait pattern by giving the brain a “reward” each time people take a good step. After repeated use, the brain anticipates the beep and automatically guides the body to keep walking in the improved way to get the reward. 

“Essentially, Heel2Toe harnesses the power of the brain to change gait from the top down, so individuals re-learn to walk optimally,” stated Dr. Mayo, a Distinguished James McGill Professor in the Department of Medicine and the School of Physical and Occupational Therapy at McGill University. “Clients say that once they start using the sensor, they continue to ‘hear’ the beep even when not wearing it. They know which foot movement produces the sound.”

Heel2Toe is a therapy tool that can be used independently at home with instructional videos, an exercise book and a web-based dashboard showing walking analytics, or under a therapist’s supervision. Its three embedded inertial measurement units accurately assess walking patterns across the gait cycle. When a step begins with a strong heel strike, it provides positive, real-time auditory feedback, training an optimal gait. Focused practice—six minutes, twice a day—is recommended for best results.

Tamila Barab, an active 81-year-old retired nurse practitioner who now volunteers, recently had several falls, including one in her retirement residence hallway where she stepped toe-first and caught her foot on the flooring. She joined a PhysioBiometrics study in summer 2025 testing the independent use of Heel2Toe at home for one month. With the device, she learned to walk heel first.

“When I walk now, I’m conscious of going from heel to toe—I hear that voice in my head,” said Barab, who continues to practice with Heel2Toe. “I find walking much easier this way, and I have more confidence in my walking.”

A pilot study in individuals with Parkinson’s found greater gait improvements with home training with the Heel2Toe device as compared to exercise recommendations alone. Walking capacity was the primary outcome: 13 of 14 participants in the Heel2Toe group improved on the six-minute walk test, while none of seven in the exercise-only group did.

PhysioBiometrics is also using the Heel2Toe as part of its Walk-BEST Program, an in-person group training program combined with at-home practice. The program is currently offered to older adults in the Montreal area.

Brenda Hatch, 68, joined the Walk-BEST Program because both arthritis and plantar fasciitis made walking properly difficult and sometimes painful. “When I started using the Heel2Toe device, I walked with my head down to watch for tripping hazards. With Heel2Toe, I made steady improvement with my walking and it allowed me to go on my Italy trip without concerns about keeping up with five hours of daily walking,” Hatch commented.

AGE-WELL, Canada’s technology and aging network, has funded Dr. Mayo’s work through several research programs. In 2019, PhysioBiometrics (then Walk-Well Universe) won the Montreal regional competition of the AGE-WELL National Impact Challenge.

“AGE-WELL has supported Dr. Mayo from the early development of Heel2Toe through to its launch, giving Canadians access to this device,” AGE-WELL CEO Bridgette Murphy said. “Heel2Toe exemplifies AGE-WELL’s commitment to delivering products that benefit older adults, while driving Canada’s AgeTech sector.”

PhysioBiometrics was co-founded by Dr. Mayo, Dr. Ted Hill, Dr. Helen Dawes, Dr. Ahmed Abou-Sharkh and Dr. Kedar Mate. The company has also received funding from McGill’s Healthy Brains, Healthy Lives, McGill Innovation Fund, and MEDTECH, and won the 2020 McGill Dobson Cup.

AGE-WELL is Canada’s Technology and Aging Network. As a dynamic pan-Canadian network with global reach, AGE-WELL has mobilized researchers, older adults, caregivers, partner organizations and future leaders to accelerate the delivery of technology-based solutions that make a meaningful difference in the lives of older Canadians and their caregivers. AGE-WELL serves as a catalyst for technological innovation that supports healthy aging while driving Canada’s growing agetech sector. AGE-WELL’s programs are government funded through Innovation, Science and Economic Development Canada, Health Canada, and the Canadian Institutes of Health Research.