Each year, over 36 million falls are reported among U.S. adults aged 65 and older, leading to more than 32,000 deaths and over $50 billion in medical costs (CDC, 2023). A leading intrinsic cause is age-related hyperkyphosis, an excessive forward curvature of the thoracic spine, seen in up to 40% of older adults (Kado et al., 2004). This condition reduces balance, gait stability, and mobility, increasing the risk of falls, related injuries, and death. Current solutions, such as rigid custom braces, require supervision or limit mobility, making them impractical for repeated daily use.

SynStride is a wearable Functional Electrical Stimulation (FES) system integrated into a self-adjustable garment that helps older adults maintain upright posture and reduce fall risk. It uses inertial measurement units (IMUs) to detect excessive forward flexion, typically beyond 40 degrees, and activates four embedded textile electrodes targeting key postural muscles, including the erector spinae and trapezius. SynStride delivers gentle, therapist-calibrated stimulation to engage the muscles progressively. This promotes muscle activation without discomfort, enabling the user to gradually build strength, improve endurance, and retrain neuromuscular pathways. Over time, the user becomes less reliant on the device and can sustain better posture independently for longer periods.

The system includes:

• A lightweight, breathable vest with 3D spacer polyester lining and a removable conductive, flexible TPU 
  E-Textile Panel.
• A removable ESP32 microcontroller and IMU module powered by a rechargeable 3.7V Li-ion battery
• Replacable, adhesive, conductive, and breathable glyhydrogel-coated e-textile electrodes that ensure safe and consistent skin contact during movement
• A removable lumbar-mounted electronics unit housed in memory foam for protection, lumbar support, and comfort

Users can independently don, doff, and recharge the device. Setup is guided initially by a physical therapist for electrode placement and calibration, after which the system operates autonomously and is activated via a companion mobile app.

A full-scale functional prototype using off-the-shelf electronics and standard wearable manufacturing materials has been developed (TRL:3). Materials are selected for washability, skin safety, and textile-based scalability, including canvas, elastic nylon webbing, and conductive stretch fabric. The garment design allows modular assembly, simplifying production and user maintenance.

By 2030, over 73 million Americans will be over 65 (U.S. Census Bureau, 2020). Fall-related injuries are expected to rise in tandem, with 20–40% of seniors showing kyphotic postures (Culham et al., 1994). SynStride offers a scalable, non-invasive alternative that supports aging-in-place, reduces dependence on professional care, and enhances user independence.

The device can also be used in tele-rehabilitation, offering posture data logs and remote progress tracking via Bluetooth. With growing demand for remote care and fall prevention technologies, SynStride addresses a critical healthcare gap with proven, scalable components.