Rodrigo Vitório

Northumbria University · Faculty of Health and Life Sciences

Advancements in Microelectromechanical systems (MEMS) have enabled the manufacture of affordable and efficient wearable devices. In sensor-based gait analysis, motion and biofeedback sensor devices are easily attached to different parts of the body. Instrumentation of gait using different sensor technologies enables researchers and clinicians to ca...

Introdução: os comprometimentos do andar em idosos com doença de Parkinson (DP) estão associados à elevada ocorrência de quedas e à redução dos níveis de independência. O objetivo do estudo foi comparar a resposta dos parâmetros do andar em idosos com doença de Parkinson (DP), durante, imediatamente após e até uma hora após o término de uma sessão...

We tested the feasibility of one session of treadmill training using a novel physical therapist assisted system (Mobility Rehab) using wearable sensors on the upper and lower limbs of 10 people with Parkinson’s disease (PD). Participants performed a 2-min walk overground before and after 15 min of treadmill training with Mobility Rehab, which inclu...

Background Although much is known about the multifactorial nature of falls in Parkinson's disease (PD), optimal classification of fallers remains unclear. Objective To identify clinical (demographic, motor, cognitive and patient-reported) and objective mobility (balance and gait) measures that best discriminate fallers from non-fallers in PD. Met...

Various cueing strategies (internal and external) have been used to alleviate gait deficits in Parkinson’s disease (PD). However, it remains unclear which type of cueing strategy is most effective at different disease stages or with more severe walking impairment, such as freezing of gait (FOG). The underlying neural mechanisms of response to cuein...

Visual and cognitive dysfunction are common in Parkinson’s disease and relate to balance and gait impairment, as well as increased falls risk and reduced quality of life. Vision and cognition are interrelated (termed visuo-cognition) which makes intervention complex in people with Parkinson’s (PwP). Non-pharmacological interventions for visuo-cogni...

Introduction: Following mild traumatic brain injury (mTBI), patients are often advised to restrict physical activity until full symptom resolution followed by gradual return to activity. However, extended rest periods may prolong recovery and contribute to persistent symptoms. Emerging evidence suggests early active rehabilitation that increases he...

Objective: To examine the neural activity during turning in Parkinson’s disease (PD). Background: Turning is impaired in PD with links to freezing of gait (FOG) and falls risk. Specifically, turning is slow and elicits FOG episodes in PD, which can be worsened by performing a secondary task when turning (i.e., dual-tasking). The neural mechanism...

Objective: To explore experiences of people with Parkinson’s (PwP) in using technology as part of a home-based visuo-cognitive training programme compared to traditional approaches to rehabilitation. Background: Visual and cognitive dysfunction are common in PwP, and relate to mobility impairment and increased falls risk. Novel technologies and mo...

Postural instability is common in neurological diseases. Although transcranial direct current stimulation (tDCS) seems to be a promising complementary therapy, emerging evidence indicates mixed results and protocols' characteristics. We conducted a systematic review and meta-analysis, on PubMed, EMBASE, Scopus, and Web of Science, to synthesize key...

Turning is a common impairment of mobility in people with Parkinson’s disease (PD), which increases freezing of gait (FoG) episodes and has implications for falls risk. Visual cues have been shown to improve general gait characteristics in PD. However, the effects of visual cues on turning deficits in PD remains unclear. We aimed to (i) compare the...

Background and Aim Individuals with Parkinson’s disease (PD) with and without freezing of Gait (FoG) may respond differently to exercise interventions for several reasons, including disease duration. This study aimed to determine whether both people with and without FoG benefit from the Agility Boot Camp with Cognitive Challenges (ABC-C) program....

Background and aim: The study of the neural underpinnings of movement in neurological conditions has traditionally been conducted with associative studies that have used static imaging techniques, such as functional magnetic resonance imaging or positron emission tomography. Previous work correlated movement outcomes with imaging or assessed ass...

Introduction: Gait impairment occurs across the spectrum of traumatic brain injury (TBI); from mild (mTBI) to moderate (modTBI), to severe (sevTBI). Recent evidence suggests that objective gait assessment may be a surrogate marker for neurological impairment such as TBI. However, the most optimal method of objective gait assessment is still not we...

Visual information is crucial for safe locomotion because it allows individuals to adjust their stepping patterns to deal with environmental demands. Deficits in the ability to visually sample the environment expose walkers to an increased risk of falling, which have motivated researchers to investigate the visual control of locomotion. Portable ey...

Introduction Transcranial direct current stimulation (tDCS) improves postural response to perturbation in patients with Parkinson's disease (PwPD). However, the influence of baseline characteristics such as clinical/cognitive and postural performance on the response to tDCS remains unclear. Objective To investigate whether baseline level of postur...

Introduction: Mobility impairments are among the main causes of falls in older adults and patients with neurological diseases, leading to functional dependence and substantial health care costs. Feedback-based interventions applied in controlled, laboratory environments have shown promising results for mobility rehabilitation, enhancing the benefit...

Age-related changes may affect the performance during fast walking speed. Although, several studies have been focused on the contribution of the prefrontal cortex (PFC) during challenging walking tasks, the neural mechanism underling fast walking speed in older people remain poorly understood. Therefore, the aim of this study was to investigate the...

Background: Since people with Parkinson disease (PD) rely on limited prefrontal executive resources for the control of gait, interventions targeting the prefrontal cortex (PFC) may help in managing PD-related gait impairments. Transcranial direct current stimulation (tDCS) can be used to modulate PFC excitability and improve prefrontal cognitive f...

Background Dopaminergic medication improves gait in people with Parkinson disease (PD). However, it remains unclear if dopaminergic medication modulates cortical activity while walking. Objective We investigated the effects of dopaminergic medication on cortical activity during unobstructed walking and obstacle avoidance in people with PD. Method...

Introduction Cholinergic dysfunction contributes to mobility deficits in Parkinson’s disease (PD). People with PD rely on limited prefrontal executive-attentional resources for the control of locomotion, including turning. Cortical and behavioral responses to cholinergic augmentation during turning remains unclear. We examined prefrontal cortex (PF...

Falls are associated with impairment in postural control in people with Parkinson's disease (PwPD). We aimed to predict the fall risk through models combining postural responses with clinical and cognitive measures. Also, we compared the center of pressure (CoP) between PwPD fallers and non-fallers after unpredictable external perturbations. We exp...

Background: There is a lack of recommendations for selecting the most appropriate gait measures of Parkinson's disease (PD)-specific dual-task costs to use in clinical practice and research. Objective: We aimed to identify measures of dual-task costs of gait and turning that best discriminate performance in people with PD from healthy individual...

Background Walking abnormalities in people with Parkinson’s disease (PD) are characterized by a shift in locomotor control from healthy automaticity to compensatory prefrontal executive control. Indirect measures of automaticity of walking (eg, step-to-step variability and dual-task cost) suggest that freezing of gait (FoG) may be associated with r...

Background: Habituation of postural response to perturbations is impaired in people with Parkinson's disease (PD) due to deficits in cortico-basal pathways. Although transcranial direct current stimulation (tDCS) modulate cortico-basal networks, it remains unclear if it can benefit postural control in PD. Objective: To analyze the effect of diff...

Background: Functional near-infrared spectroscopy (fNIRS) is increasingly used in the field of posture and gait to investigate patterns of cortical brain activation while people move freely. fNIRS methods, analysis and reporting of data vary greatly across studies which in turn can limit the replication of research, interpretation of findings and c...

Objective: To investigate the influence of freezing of gait (FoG) on automaticity of walking in people with Parkinson's disease (PD). Background: A hallmark of healthy walking is automaticity, defined as the ability of the nervous system to successfully control movement with minimal use of executive‐attentional resources. It has been proposed that...

Background Declines in gait parameters are common with aging and more pronounced in tasks with increased executive demand. However, the neural correlates of age-related gait impairments are not fully understood yet. Objectives To investigate ( a) the effects of aging on prefrontal cortex (PFC) activity and gait parameters during usual walking, obs...

Parkinson's disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different between PD subtypes, which leads to differences in motor behaviour. However, the influence of PD subtype on cortical activity during walking remains poorly understo...

Currently, there are major EU-based projects to better utilise wearables as useful diagnostic aids/tools in clinical settings as well for deployment in the home to capture ageing processes. To date, there has been little investigation of the translation of those tools beyond the geographical regions in which they were developed and implemented. Our...

Background: Pharmacologic therapy is the primary treatment used to manage Parkinson's disease (PD) symptoms. However, it becomes less effective with time and some symptoms do not respond to medication. Complementary interventions are therefore required for PD. Recent studies have implemented transcranial direct current stimulation (tDCS) in combin...

Background. Although dopaminergic medication improves dual task walking in people with Parkinson disease (PD), the underlying neural mechanisms are not yet fully understood. As prefrontal cognitive resources are involved in dual task walking, evaluation of the prefrontal cortex (PFC) is required. Objective. To investigate the effect of dopaminergic...

Technology is advancing at an extraordinary rate. Continuous flows of novel data are being generated with the potential to revolutionize how we better identify, treat, manage, and prevent disease across therapeutic areas. However, lack of security of confidence in digital health technologies is hampering adoption, particularly for biometric monitor...

Currently, there are major EU-based projects to better utilise wearables as useful diagnostic aids/tools in clinical settings as well for deployment in the home to capture ageing processes. To date, there has been little investigation of the translation of those tools beyond the geographical regions in which they were developed and implemented. Our...

Gait asymmetry during unobstructed walking in people with Parkinson’s disease (PD) has been well documented. However, under complex situations, such as environments with double obstacles, gait asymmetry remains poorly understood in PD. Therefore, the aim of this study was to analyze inter-limb asymmetry while crossing a single obstacle and double o...

UNSTRUCTURED Technology is advancing at extraordinary rates with novel data being generated which could potentially revolutionary different therapeutic areas of medicine. However, adoption is medicine is hampered by a lack of trust, particularly for biometric monitoring technologies (BioMeTs) where a key question facing frontline healthcare profess...

INTRODUCTION: Postural instability during walking and tripping over obstacles are the main causes of falls in people with Parkinson's disease (PD). Preliminary limited evidence suggests that the length of the prospective follow-up period affects falls prediction in PD, with shorter periods leading to more accurate prediction. Thus, the primary aim...

Aim: The aim of the present study was to analyze the association of depressive and anxiety symptoms with usual walking and obstacle avoidance in patients with Parkinson's disease. Methods: Patients were divided into three groups: without depressive and anxiety symptoms (n = 28); depressive symptoms only (n = 15); and depressive and anxiety sympt...

BACKGROUND AND AIM: Walking speed has been described as the "sixth vital sign" as it is reflective of overall health status and physical function [1]. Walking speed reduces with age [2] and is predictive of life expectancy and mortality [2, 3]. Fast walking is considered to reflect maximal capacity and may be more useful than preferred gait speed w...

Different clinical subtypes of Parkinson’s disease (PD) have long been recognized. Recent studies have focused on two PD subtypes: Postural Instability and Gait Difficulty (PIGD) and Tremor Dominant (TD). PIGD patients have greater difficulties in postural control in relation to TD. However, knowledge about the differences in reactive adjustment me...

Postural control asymmetry is an important aspect of Parkinson’s disease (PD) that may be associated with falls. The aim of this study was to compare the postural control asymmetry during postural tasks between fallers and non-fallers in people with PD and neurological healthy age-matched controls (CG). Individuals with idiopathic PD (n = 24) and C...

Eye-tracking devices have become widely used as clinical assessment tools in a variety of applied-scientific fields to measure saccadic eye movements. With the emergence of multiple static and dynamic devices, the concurrent need for algorithm development and validation is paramount. This review assesses the prevalence of current saccade detection...

This study investigated the effects of Parkinson’s Disease (PD) on the perceptive judgment of stair step height using both exteroceptive visual and exproprioceptive judgments. We invited 14 individuals with PD and 14 neurologically healthy older adults (OA) to perform perceptual judgment tasks for first step stairway heights of 11 and 20 cm. Initia...

Performance of several tasks simultaneously (dual-tasks) is common in everyday walking. Studies indicate that dual-task walking performance declines with age together with cognitive function, but neural mechanisms underpinning deficits remain unclear. Recent developments in mobile imaging techniques, such as functional near infrared spectroscopy (f...

Background: Cholinergic networks, from the pedunculopontine nucleus in the brainstem and the subcortical nucleus basalis of Meynert, influence postural control, gait and cognition [1]. Most activities involve dual tasks (DTs), such as walking and talking. Optimal DT performance requires both networks to be functional. However, in Parkinson’s diseas...

Background: Aging is associated with declining mobility, which negatively affects quality of life and incurs substantial economic costs. Techniques to maintain safe mobility in older adults are therefore essential. Rhythmic auditory cueing (RAC) can improve walking patterns in older adults. However, the neural correlates associated with RAC, how t...

People with Parkinson's disease (PD) have decreased arm swing movements during walking, which can be related to PD motor signs and symptoms. In this context, the aim of this study was to determine the effects of an increased arm swing frequency or amplitude on the gait parameters in people with PD and healthy older adults. Seventeen individuals wit...

An emerging body of literature has examined cortical activity during walking and balance tasks in older adult and Parkinson’s disease (PD) participants, specifically using functional near infrared spectroscopy (fNIRS) or electroencephalography (EEG) devices. This review aimed to provide an overview of this developing area, in order to inform diseas...

This study aimed to determine the relationship between postural asymmetry and falls in Parkinson's disease (PD). In total, 28 patients with PD were included. Postural control was analyzed in bipedal, tandem, and unipedal standing. Center of pressure (CoP) parameters were calculated for both limbs, and asymmetry was assessed using the asymmetry inde...

Background: Objective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance. Research question: This study aimed to inve...

The literature presents the benefits of physical activity programs for people with intellectual disabilities (ID), but aspects such as those related to physical exercise prescription, benefits of the type of exercise program, the most recommended exercises, load control, and limitations of the interventions for adults with ID are subjects awaiting...

This systematic review aims to (i) evaluate functional near infrared spectroscopy (fNIRS) walking study design in young adults, older adults and people with Parkinson’s disease (PD); (ii) examine signal processing techniques to reduce artefacts and physiological noise in fNIRS data; and (iii) provide evidence-based recommendations for fNIRS walking...

The aim of this study was to analyze the motor and visual strategies used when walking around (circumvention) an obstacle in patients with Parkinson's disease (PD), in addition to the effects of dopaminergic medication on these strategies. To answer the study question, people with PD (15) and neurologically healthy individuals (15 - CG) performed t...

The presence of a second obstacle changed the planning and adjustments for obstacle avoidance performance, but this context is poorly understood in Parkinson's disease (PD). The aim of this study was to investigate the walking behavior over multiple obstacles in people with PD. Nineteen people with PD and 19 healthy individuals walked across an 8m...

Background and aim: Most previous studies using functional near-infrared spectroscopy (fNIRS) during walking have assessed the prefrontal cortex only. However, recording of multiple cortical areas allows identification of potential compensatory or other cortical mechanisms related to increased cognitive, sensory and/or motor demands of walking. Thi...

Background and aim: The use of functional near infra-red spectroscopy (fNIRS) to investigate cortical activity during walking is emerging and may provide information regarding the neural correlates of mobility impairments caused by ageing and Parkinson’s disease (PD). However, there is a need for standardizing methodological procedures. This struct...

This book is an attempt to advance the discussion and improve our understanding about the effects of aging and movement disorders on motor control during walking and postural tasks. Despite these activities are performed daily, there is a high requirement of motor and neural systems in order to perform both tasks efficiently. Both walking and postu...

Vision is intricately linked with action and plays an essential role in guiding safe locomotion in humans. However, vision can influence locomotion of people with Parkinson’s disease (PD) in two distinct manners. While visual information such as doorways can trigger “freezing” episodes during which the patient feels as if the feet are glued to the...

A doenca de Parkinson compromete o equilibrio e a mobilidade funcional. A atividade fisica tem um importante papel se contrapondo aos efeitos da doenca, podendo promover beneficios na mobilidade de pacientes. O estudo teve como objetivo comparar o desempenho em equilibrio e mobilidade funcional de pacientes com doenca de Parkinson ativos e inativos...

The aim of this study was to verify whether patients with Parkinson's disease (PD) are able to adjust their motor behavior according to restrictions imposed by the task instruction during walking with obstacle crossing. Eighteen elderly people (moderate motor compromise) with a diagnosis of PD walked on a pathway and cross an obstacle according to...

Plantar cutaneous stimulation has been shown to improve gait in Parkinson's disease (PD), but the effects of different types of insoles have not been tested. We evaluated the immediate effect of different types of insoles on gait in PD patients and healthy older adults. Nineteen PD patients and nineteen healthy older adults performed and performed...

This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson’s disease, taking into account disease severity and gender. Twenty-three patients with Parkinson’s disease (PD) were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observ...

This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson’s disease, taking into account disease severity and gender. Twenty-three patients with Parkinson’s disease (PD) were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observ...

This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson's disease, taking into account disease severity and gender. Twenty-three patients with Parkinson's disease (PD) were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observ...

The aim of this study was to investigate obstacle clearance and its variability in individuals with Alzheimer dementia (AD) as well as healthy elderly individuals while they approached and crossed an obstacle in their path. Fifteen people with AD and 15 age-matched/sex-matched healthy individuals (control group) participated in this study. Clinical...

Visual exproprioception refers to information of the body relative to the environment and may be the critical piece of sensory information that explains why gait improvements can be achieved with visual step cues in people with Parkinson's disease (PD). The primary aim of current study was to investigate the role of visual exproprioception in the p...