I didn’t plan on becoming a biomechanics researcher.
Back when I was a collegiate athlete, I wanted to major as an athletic training major, but balancing both commitments was challenging so I was advised to major in exercise science. That’s when I was introduced to the biomechanics lab by a professor who encouraged volunteering and I never left the lab since.
Those early experiences opened my eyes to how much information is hidden in the way we move. I earned my master’s in exercise science at the University of Nebraska-Omaha (UNO) and my PhD through the Medical Sciences Interdepartmental Area at the University of Nebraska Medical Center (UNMC), all while continuing collaborative research at UNO. Over time, I’ve come to appreciate not only the science itself, but the people who are colleagues, students and clinicians at our local medical institutions who share a commitment to improving lives.
That journey is what led me to view gait as a powerful signature of functional health, one that can reveal changes in the body long before symptoms appear.
Similar to how blood pressure or heart rhythm gives a signature of cardiovascular health, gait could be considered a signature for functional health. Walking is essential for so many aspects of our lives. Movement triggers physiological processes that are good for our bodies, our minds and even our social‑emotional health.
What’s especially fascinating is how our gait changes when something else is going wrong in the body, often before other symptoms appear. That early change is a window into health that we haven’t fully leveraged in clinical practice.
When I started doing research back in 2004, studying gait in a clinical environment was challenging. We used VHS cameras and manually digitized nine markers on the side of the leg, point by point. Before that, researchers used film photos and developed them in a photo lab next door. Eventually, we moved to systems where we could put 30 to 100 markers on someone, know the exact location of each marker in 3D space and take a thousand pictures per second.
Today, battery technology and sensor innovation allow us to essentially put an advanced lab into a tiny sensor people can wear 24 hours a day.
That evolution is what makes Grasshopper Health’s work possible.
One of the longest running projects in our biomechanics group has focused on gait in patients with peripheral artery disease (PAD). For 20 to 25 years, our team has collaborated with vascular surgeons which is the first partnership of its kind.
Before our work, physicians believed that people with PAD walked normally until they developed claudication pain, the ischemic cramping that occurs when muscles don’t get enough blood flow.
But our research showed that their gait changes in their very first steps, even before pain onset.
That discovery shifted clinical understanding of PAD. It also created an enormous dataset: force against the ground, joint positions, limb movements and thousands of pictures per second across hundreds of gait cycles. We shared discrete gait points like center‑of‑mass fluctuations, ankle angles and joint powers across nearly a thousand data collections.
Grasshopper Health Co-Founder and Chief Technology Officer Dr. Fadi Alsaleem used numerous AI tools to analyze this data. Those tools have different advantages depending on the types of data, and together they helped identify which gait features most accurately distinguish someone with PAD from a healthy older adult. As AI evolves, the opportunity for the Grasshopper sensor to be even more accurate will continue to improve.
In the lab, we might analyze ten, twenty steps, maybe a hundred. But if someone wears a sensor 24 hours a day for a couple of weeks, we’re getting thousands of steps in their daily life, under normal conditions. It’s much more representative of an individual’s actual gait.
That richness allows us to identify progression, subtle changes and other signals that might alert a physician to a potential problem that impacts gait. It also opens the door to earlier identification of conditions like PAD, sarcopenia and frailty, all of which often go unnoticed until they significantly affect mobility.
I hope gait can be used to help improve people’s quality of life. That starts with earlier identification of problems that impact gait, but it also includes monitoring treatment effectiveness. When someone has PAD, Parkinson’s disease or any chronic condition that affects movement, gait data can help determine whether a treatment is delaying progression or helping them walk better. If not, physicians can pivot sooner.
Ultimately, I would love to see gait become a regularly used screening tool like blood pressure or even an echocardiogram. Establishing baseline gait and measuring it regularly could help primary care providers catch changes early and refer patients to specialists.
Most of us in biomechanics don’t have medical backgrounds, but our projects seek to have clinical and translational impact. I’m a native Nebraskan, and I’m proud of the collaborations we’ve built with local medical centers. My hope is that innovations like Grasshopper’s *Axis PatchTM will continue to evolve in ways that support better quality of life for individuals facing chronic disease as well as those who want to stay active and healthy as they age.
The Axis Patch™ is currently intended for research use only.