Rosie Morris

Northumbria University

Eye movement assessment is a key component of neurological evaluation, offering valuable insights into neural deficits and underlying mechanisms. This narrative review explores the emerging subject of digital eye-movement outcomes (DEMOs) and their potential as sensitive biomarkers for neurological impairment. Eye tracking has become a useful metho...

Research investigating aging and neurological disorders that affect gait and balance aim to increase the understanding of the underlying neural mechanisms involved in task performance. Traditional brain-imaging techniques are restricted in their use in studies assessing brain activity during real-time balance and walking tasks, often restrained to...

Ocular microtremor (OMT) is a fixational eye movement that cannot be seen with the naked eye but is always present, even when the eye appears motionless/still. The link between OMT and brain function provides a strong rationale for investigation as there lies potential for its use as a biomarker in populations with neurological impairments. OMT fre...

Purpose: To evaluate the usability and acceptability of a free, tablet-based application “Keep on Keep Up” (KOKU) for people with Parkinson’s. KOKU is a tablet-based strength and balance exercise programme that incorporates the safety features and progressive intensity levels of the evidence-based Otago Exercise Program. KOKU has been specifically...

Falls in people with Parkinson's disease (PwPD) under- score the need for precise sensing tools to robustly assess gait and deliver tailored rehabilitation. Using wearable inertial measurement units (IMUs) offers a practical alternative to assess gait and intervene in any location. This study develops a robust and innovative smartphone application/...

OBJECTIVE: Vestibular/ocular deficits occur with mild traumatic brain injury (mTBI). The vestibular/ocular motor screening (VOMS) tool is used to assess individuals post-mTBI, which primarily relies upon subjective self-reported symptoms. Instrumenting the VOMS (iVOMS) with technology may allow for more objective assessment post-mTBI, which reflect...

Poster presentation of a systematic literature review of neural correlates of balance in people with Parkinson's disease.

Wearable inertial measurement units (IMUs) are being used to quantify gait characteristics that are associated with increased fall risk, but the current limitation is the lack of contextual information which would clarify IMU data. Use of wearable video-based cameras would provide a comprehensive understanding of an individual’s habitual fall risk,...

Background Visual cues can improve gait in Parkinson’s disease (PD), including those experiencing freezing of gait (FOG). However, responses are variable and underpinning mechanisms remain unclear. Visuo-cognitive processing (measured through visual exploration) has been implicated in cue response, but this has not been comprehensively examined. O...

Objective: To determine the feasibility and preliminary efficacy of a home-based, technological visuo-cognitive training (TVT) intervention using a mobile application and exercise with stroboscopic glasses compared to standard care in people with Parkinson’s disease (PD). Background: There is currently no pharmacological treatment for visuo-cognit...

Objective: This study aims to examine OMT in people with PD (PwPD) compared to healthy older adults. Identifying OMT as a PD biomarker could better support clinical assessment, enabling improved provision of care to patients with advanced disease monitoring. Background: Ocular microtremor (OMT) is a fixational eye movement that cannot be seen with...

Ocular microtremor (OMT) is the smallest of three involuntary fixational micro eye movements, which has led to it being under researched in comparison. The link between OMT and brain function generates a strong rationale for further study as there is potential for its use as a biomarker in populations with neurological injury and disease. This stru...

Visual problems are common in people who have neurological injury or disease, with deficits linked to postural control and gait impairment. Vision therapy could be a useful intervention for visual impairment in various neurological conditions such as stroke, head injury, or Parkinson’s disease. Stroboscopic visual training (SVT) has been shown to i...

Introduction: The relationship between mobility and cognition has been studied in the aging population and associations have been also reported in people with Parkinson's disease (PD). Objective: To compare different aspects of gait and balance between individuals with PD who have normal cognition and those with impaired cognition, using both cl...

Background Physical activity is encouraged for people with Multiple Sclerosis. Yoga is a popular form of physical activity and is chosen by some people with Multiple Sclerosis. However, little is known about the impact of yoga for this population, alongside what influences ongoing engagement. Aim The aim of this study is to qualitatively explore t...

Background: Cognitive impairment is a common non-motor feature of Parkinson’s disease (PD). Mobile applications delivering multidomain cognitive rehabilitation offer a potential means of delaying the worsening of cognitive deficits, but evidence for their feasibility of implementation in people with PD is limited. Aim: This pilot study evaluated th...

Ocular microtremor (OMT) is a fixational eye movement that cannot be seen with the naked eye but is always present, even when the eye appears motionless/still. The link between OMT and brain function generates a strong rationale for investigation as there lies potential for its use as a biomarker in populations of neurological impairments. OMT freq...

Objective: The purpose of this study was to coproduce a smart-phone application for digital falls reporting in people with Parkinson disease (PD) and to determine usability using an explanatory mixed-methods approach. Methods: This study was undertaken in 3 phases. Phase 1 was the development phase, in which people with PD were recruited as co-r...

Background Mobile applications and technology (e.g., stroboscopic glasses) are increasingly being used to deliver combined visual and cognitive (termed visuo-cognitive) training that replaces standard pen and paper-based interventions. These ‘technological visuo-cognitive training’ (TVT) interventions could help address the complex problems associa...

Unlabelled: Although the multifactorial nature of falls in Parkinson's disease (PD) is well described, optimal assessment for the identification of fallers remains unclear. Thus, we aimed to identify clinical and objective gait measures that best discriminate fallers from non-fallers in PD, with suggestions of optimal cutoff scores. Methods: Ind...

Background: Gait and balance impairments are among the most troublesome and heterogeneous in Parkinson's disease (PD). This heterogeneity may, in part, reflect genetic variation. The apolipoprotein E (APOE) gene has three major allelic variants (ε2, ε3 and ε4). Previous work has demonstrated that older adult (OA) APOE ε4 carriers demonstrate gait...

Walking/gait quality is a useful clinical tool to assess general health and is now broadly described as the sixth vital sign. This has been mediated by advances in sensing technology including instrumented walkways and three-dimensional motion capture. However, it is wearable technology innovation that has spawned the utmost growth in instrumented...

Running gait assessment is essential for development of technique optimization strategies as well as to inform injury prevention and rehabilitation. Currently, running gait assessment relies on (i) visual assessment, exhibiting subjectivity and limited reliability, or (ii) use of instrumented approaches, which often carry high costs and can be intr...

Background: Turning is a complex measure of gait that accounts for over 50% of daily steps. Traditionally, turning has been measured in a research grade la-boratory setting, however, there is demand for a low-cost and portable solution to measure turning using wearable technology. This study aimed to determine the suitability of a low-cost inertial...

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...

Dopaminergic activity decreases in older adults (OAs) with normal aging and is further reduced in Parkinson’s disease (PD), affecting cortical motor and sensorimotor pathways. Levodopa is the prevailing therapy to counter dopamine loss in PD, though not all PD motor signs improve with levodopa. The purpose of this preliminary study was to explore t...

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...

A single dose of L-dopa does not affect cortical sensorimotor inhibition or mobility in OAs. However, sensorimotor inhibition of the cortex is related to postural control in both gait and quiet stance in OAs, and the relationships are affected by dopamine. Since dopamine replacement therapy in people with PD impairs sensorimotor inhibition and post...

BACKGROUND AND AIM: Cortical dopaminergic activity decreases in normal aging, with an exacerbated decrease observed in Parkinson's disease (PD). Levodopa (L-dopa), a dopamine replacement medication, is the prevailing therapy to treat PD. Although the pace of gait improves with L-dopa, postural sway may not improve or may worsen. Additionally, corti...

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...

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...

Gait assessment is essential to understand injury prevention mechanisms during running, where high-impact forces can lead to a range of injuries in the lower extremities. Information regarding the running style to increase efficiency and/or selection of the correct running equipment, such as shoe type, can minimize the risk of injury, e.g., matchin...

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...

Running gait assessment and running shoe recommendation is important for the injury prevention of runners who exhibit different skill-levels and running styles. Traditionally, running gait assessment for shoe recommendation relies upon a combination of trained professionals (e.g., sports-therapists, physiotherapists) and complex equipment such as m...

Eye movements are an important aspect of neurological clinical assessment, as abnormal eye movements can indicate underlying neurological and disease processes. Eye-tracking recordings are also often performed following neurological injury or disease in order to study the underlying neurological mechanisms involved in controlling eye movement. The...

The extent to which the heterogeneity of gait and balance problems in PD may be explained by genetic variation is unknown. Variants in the glucocerebrosidase (GBA) gene are the strongest known genetic risk factor for PD and are associated with greater motor and cognitive severity. However, the impact of GBA variants on comprehensive measures of gai...

Background Yoga has multiple benefits for individuals living with Multiple Sclerosis (MS), including reduced pain, depression, fatigue, strength, and improved quality of life. During the COVID-19 pandemic, home-based delivery of yoga increased. However, no studies to date have explored online home-based yoga for individuals living with MS, more spe...

Running gait assessment is critical in performance optimization and injury prevention. Traditional approaches to running gait assessment are inhibited by unnatural running environments (e.g., indoor lab), varied assessor (i.e., subjective experience) and high costs with traditional reference standard equipment. Thus, development of valid, reproduce...

Participating in habitual physical activity (HPA) may slow onset of dependency and disability for people with Parkinson’s disease (PwP). While cognitive and physical determinants of HPA are well understood, psychosocial influences are not. This pilot study aimed to identify psychosocial factors associated with HPA to guide future intervention devel...

Purpose Impairments while turning are among the most common mobility impairments in people with Parkinson’s disease (PD). In addition, turning is often a trigger for freezing of gait (FOG) episodes and has implications for falls risk. There are currently limited interventions to ameliorate turning deficit in PD. Visual cues have been shown to impro...

Purpose Walking and eye movement impairments are common in Parkinson’s disease (PD) and are linked to increased falls risk. Visual cues (transverse taped lines on the floor to step over) are a physiotherapy intervention to improve gait in PD, particularly in those who report freezing of gait (FOG). However, the response to visual cues is variable i...

Purpose: Gait characteristics such as turning are commonly impaired in neurological conditions such as Parkinson’s disease and traumatic brain injury (TBI). Traditionally, these characteristics have been measured in a laboratory setting using expensive 3D motion capture or research-grade inertial sensor systems, such as the Opal (APDM Inc., Portlan...

Purpose: Visual and cognitive impairments are common non-motor symptoms (NMS) in people with Parkinson’s (PwP). These NMS impact on balance and gait impairments, leading to reduced quality of life and increased risk of falls, hospitalisation, and mortality. There is limited evidence for rehabilitation of visual or cognitive impairment in PwP, with...

This pilot study will contribute to our understanding of the effects of technological visuo-cognitive training (TVT) in people with Parkinson's and provide preliminary data to support a larger, multi-centre trial. If TVT is demonstrated to be feasible and effective, it presents the possibility of a novel, non-pharmological rehabilitation strategy t...

Running gait assessment for shoe type recommendation to avoid injury often takes place within commercial premises. That is not representative of a natural running environment and may influence normal/usual running characteristics. Typically, assessments are costly and performed by an untrained biomechanist or physiotherapist. Thus, use of a low-cos...

As clinical characterization of mobility abnormalities can be highly dependent on examiners’ expertise, wearable technologies have the potential to access aspects of mobility measured in free-living. Over the past 20 years, advances in wireless and miniaturized technologies have emerged as viable tools to move from laboratory-based measures of mobi...

Background Gait disturbance is an early, disabling feature of Parkinson's disease (PD) that is typically refractory to dopaminergic medication. The cortical cholinergic system, originating in the nucleus basalis of Meynert of the basal forebrain, has been implicated. However, it is not known if degeneration in this region relates to a worsening of...

Few exercise interventions practice both gait and balance tasks with cognitive tasks to improve functional mobility in people with PD. We aimed to investigate whether the Agility Boot Camp with Cognitive Challenge (ABC-C), that simultaneously targets both mobility and cognitive function, improves dynamic balance and dual-task gait in individuals wi...

Background Reduced cortical sensorimotor inhibition is associated with mobility and cognitive impairments in people with Parkinson’s disease (PD) and older adults (OAs). However, there is a lack of clarity regarding the relationships among sensorimotor, cognitive, and mobility impairments. The purpose of this study was to determine how cortical sen...

Background: Gait disturbance is an early, cardinal feature of Parkinson’s disease (PD) associated with falls and reduced physical activity. Progression of gait impairment in Parkinson’s disease is not well characterized and a better understanding is imperative to mitigate impairment. Subtle gait impairments progress in early disease despite optimal...

Objective: To characterize response to thalamic deep brain stimulation (DBS) in a patient with medically refractory orthostatic tremor using instrumented measures of tremor and mobility. Background: Orthostatic tremor (OT) is a disabling disorder characterized by a high frequency tremor in the lower limbs upon standing. Electrophysiologic studies...

Objective: Determine whether levodopa replacement or cholinergic augmentation improve automaticity of walking in people with Parkinson's disease (PD). Background: Degradation of dopaminergic striatal mechanisms of motor control in PD may be initially supplemented by increased cognitive control mediated by cortical cholinergic mechanisms. This shif...

Background: Mobility and sensorimotor inhibition impairments are heterogeneous in Parkinson's disease (PD). Genetics may contribute to this heterogeneity since the apolipoprotein (APOE) ε4 allele and glucocerebrosidase (GBA) gene variants have been related to mobility impairments in otherwise healthy older adult (OA) and PD cohorts. The purpose of...

Freezing of gait (FoG) is a brief, episodic absence or marked reduction of forward progression of the feet, despite the intention to walk, that is common in people with Parkinson’s disease (PD). We hypothesized that not only motor, but higher level cognitive and attention areas may be impaired in freezers. In this study, we aimed to characterize di...

Objectives Degradation of striatal dopamine in Parkinson’s disease (PD) may initially be supplemented by increased cognitive control mediated by cholinergic mechanisms. Shift to cognitive control of walking can be quantified by prefrontal cortex (PFC) activation. Levodopa improves certain aspects of gait and worsens others, and cholinergic augmenta...

Freezing of gait (FOG) is common in people with Parkinson’s disease (PD) which is extremely debilitating. One hypothesis for the cause of FOG episodes is impaired cognitive control, however, this is still in debate in the literature. We aimed to assess a comprehensive range of cognitive tests in older adults and people with Parkinson’s with and wit...

Background: Whiplash associated disorder (WAD) is a common musculoskeletal condition that frequently occurs following a road traffic collision. Physiotherapy is often prescribed to help with the symptoms and injuries. Research evidence has demonstrated that acupuncture may be beneficial, but no studies have examined the routine clinical use of acup...

Introduction Mild traumatic brain injury (mTBI) can impact gait, with deficits linked to underlying neural disturbances in cognitive, motor and sensory systems. Gait is complex as it is comprised of multiple characteristics that are sensitive to underlying neural deficits. However, there is currently no clear framework to guide selection of gait ch...

Objective: This study aimed to characterize turning performance and clinical characteristics in people with definite, probable or no Freezing of Gait (FoG) in a cohort of people with Parkinson's disease (PD). Background: FoG is common and debilitating in people with Parkinson's disease (PD). Both clinical decision‐making and pathophysiology resear...

Objective: Gait provides a sensitive measurement for signs of aging and neurodegenerative conditions. Measurement of gait is transitioning from the laboratory environment to the clinic with the use of inertial measurement units, providing a simple and cost-effective assessment tool. However, such assessments first need validation against reference...

Introduction: Gait and balance impairments are cardinal features of Parkinson's disease (PD) that require cognitive input. However, the extent to which specific gait and balance characteristics relate to cognition in PD is unclear. In addition, independent models of gait and balance have not been developed from the same cohort. We aimed to i) deve...