Keynote Lecture
Prof.ssa ALICE NIEUWBOER
Alice Nieuwboer has been a full professor in the Department of Rehabilitation Sciences at KU Leuven (Belgium). Since October 2023, she has been its professor emeritus. With a clinical background as a physiotherapist, she established a research laboratory for rehabilitation in Parkinson's disease (PRO-lab); with her team she contributed to the study of gait and motor control, analyzing which deficits underlie the phenomenon of freezing of gait. He has performed several clinical trials on the effects of rehabilitation interventions. In collaboration with international partners, he is investigating whether digital mobility outcomes derived from walking in real-life conditions can measure freezing and whether it can be reduced with the use of cues and split-belt treatments.
What can exercise offer to help gait and balance problems in Parkinson’s Disease?
Gait and balance impairments are ubiquitous among persons with Parkinson's disease (PD) and contribute to the occurrence of freezing of gait and falls. Pharmacological and surgical treatments result in only modest gait improvements, highlighting the need for rehabilitation interventions. Subtle changes in gait, such as reduced arm swing, impaired turning, reduced step length, and increased variability, manifest during the early stages and progress to more disabling features. Gait and balance impairments reduce the amount, intensity, and quality of daily walking. In this session, I will first describe the underlying neuropathology of mobility problems in PD. Next, I will discuss novel and evidence-based exercise, strategy, and lifestyle interventions targeting compensatory networks to cope with gait dysfunction. I will also summarize the evidence on accessible technology for interventions targeting specific networks in the early and late stages of PD. Finally, emerging approaches to manage festination and freezing of gait will be highlighted.
Prof. DANIEL E. LIEBERMAN
Daniel Lieberman is the Edwin M. Lerner II of Biological Sciences and Chair of the Department of Human Evolutionary Biology at Harvard University.
He holds degrees from Harvard University and the University of Cambridge. He taught at Rutgers University and George Washington University before joining the Harvard faculty in 2001.
He studies and teaches how and why the human body is the way it is and how our evolutionary history affects the state of health and disease. He is best known for his research on the evolution of the skull and the evolution of running and walking, which he analyzes by combining experimental biomechanics, anatomy and physiology both in the laboratory and in the field. He has conducted research by traveling in person to Kenya, Rwanda and Mexico. He loves teaching and has published over 200 peer-reviewed articles, many in journals such as Nature, Science and PNAS, as well as three popular books, The Evolution of the Human Head (2011), The Story of the Human Body: Evolution, Health and Disease (2013), Exercised: Why Something We Never Evolved to Do Is Healthy and Rewarding (2021). In his spare time, he loves to run.
How humans evolved to first walk and then run, and why it matters
Humans evolved to be physically active, most especially to walk and run on two legs. In this lecture I will begin by outlining several key, fundamental principles for using evolutionary perspectives to study what makes human locomotion so special and why the way we walk and run are so important. I will then review the evidence for how and why climate change drove selection for adaptations to walk bipedally and consider why upright walking set the human lineage on a separate path from the African apes. Since humans also run, I will next review the evidence for how and why climate change drove selection for yet more adaptations for endurance running and hypothesize why long-distance running also played a key role in our evolutionary history. To conclude, I will use the lens of evolution to consider the modern phenomenon of exercise and the exercise paradox. Why is exercise healthy? And why do so few people exercise even though it promotes health and slows aging?
Prof. DERICK WADE
Visiting Professor at Oxford Brookes University.
Professor Derick Wade has been a consultant in neurological rehabilitation since 2007.
He is a professor and consultant (as a senior physician) in Neurological Rehabilitation at Oxford. He has been practicing and researching in the field of rehabilitation since 1980. He has published more than 300 papers on different aspects of rehabilitation, from basic clinical phenomena such as visual-spatial neglect to trials on different service delivery modalities. He is still clinically active in teaching, writing and managing research projects, runs the Rehabilitation Matters website and has been editor of the scientific journal Clinical Rehabilitation for more than 25 years. He is particularly interested in finding out what rehabilitation is and has recently published a "General Theory of Rehabilitation," the first theory to be conceived in which he links the biopsychosocial model of disease and the multiprofessional team approach to the adjustment process.
The global-local dilemma in rehabilitation. Does attention to detail prevent consideration of the person?
Rehabilitation is person-centred. People’s goals relate to ambitions that fulfil Maslow’s needs, usually the higher-order needs. They are concerned with long-term aspirations, usually framed as social roles or achievements. Rehabilitation is set in the holistic biopsychosocial model of illness and helps someone adapt to their illness, often requiring many specific actions to alleviate impairments or contextual factors. Sometimes, this requires detailed assessment to guide treatments. The challenge facing some clinicians is to ensure their detailed (local) evaluation and treatment are aligned with the person’s global goals. Clinicians risk pursuing a technology that interests them and may alleviate an identified impairment but does not help the person achieve their goals; this may waste time and other resources and carry unjustified risk. I will discuss some techniques for avoiding this.
Prof. MARCO SCHIEPPATI
He has taught Human Physiology and Neurophysiology at the Universities of Milan, Genoa and Pavia since 1980.
He received his medical degree from the University of Milan and then specialized in Neurology at the University of Pavia.
His career has developed through a constant commitment to teaching and a deep dedication to scientific research. He has also expanded his academic experience beyond national borders, in the role of professor at the University of Dijon (FR), d'Orsay (FR) and LUNEX (LU). He has been a member of more than 30 international doctoral dissertation committees, as well as a reviewer of research projects of national and international calls. He has been a member of several Editorial Boards for prestigious journals in the clinical field, continuing his research activity in human movement, from the understanding of its pathophysiological mechanisms to the study of motor control, pathology-induced alterations and new rehabilitation possibilities. He recently founded the company Prevent SRL to design, build and market a medical device (Step-Turn) to prevent falls, rehabilitate walking after osteosynthesis surgeries and train directional changes. His activities result in more than 200 scientific publications that place him in the Top Italian Scientist in Biomedical Sciences ranking. He was also included in PLOS Biology's 2021 ranking of Top Scientists worldwide.
Walking along non-linear paths: prevention of falls and targeted rehabilitation procedures
As the population ages, elderly and frail persons are set to increase. Falls during locomotion increase exponentially with age, and occur mostly during changes of direction. During walking along non-straight paths, symmetry is countermanded, steps have different lengths and trunk tilts toward the interior of the trajectory. Gravity is exploited and counteracted during curved walking by creating a medio-lateral torque. Turning strategies incorporate control of trunk (external and internal oblique muscles) and of pelvis and lower limb intra- and extra-rotation (muscles connecting pelvic bones to femur). Stepping-and-turning-in-place is a simple task that can be easily performed by elderly and fragile individuals and patients. Vestibular stimulation is avoided by a device featuring a rotating horizontal disc onto which persons ‘step-in-place’ with head and trunk stabilised by the grip of a fixed handrail.
Prof.ssa MAURA CASADIO
She is an associate professor in Biomedical Engineering at the University of Genoa.
She received his M.S. degree in Electronic Engineering from the University of Pisa in 2002, his M.S. degree in Bioengineering in 2007 and his Ph.D. degree in Robotics, Materials Science and Bioengineering in 2006 from the University of Genoa.
During 2006-2007, she worked as an engineer-researcher at the Don Gnocchi Foundation. From 2008 to 2011 she was a postdoctoral fellow at the Department of Physiology, Northwestern University, and the Robotics Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA. Her main research interests are in neural control of movement, neuromotor rehabilitation, development of novel devices and body-machine interfaces for functional assessment, assistance and rehabilitation.
Beyond Markers: Unveiling Human Motion Through Markerless Video Analysis
Understanding and measuring human motion is crucial across various fields, including neuroscience, rehabilitation, and sports biomechanics. Traditionally, this analysis has relied on marker-based techniques and motion capture systems, which, although precise and reliable, can be expensive, cumbersome, and time-consuming. In response to these challenges, recent advancements in markerless techniques have emerged, providing accessible alternatives for motion analysis in both everyday and clinical settings. Notably, significant progress has been made in the development and application of computer vision and machine learning algorithms that analyze standard video recordings of human movements. This innovative approach enables the extraction of both qualitative and quantitative features of motion, facilitating the detection, characterization, and understanding of motor behaviors and deficits associated with neurological conditions. This presentation will explore the potential and limitations of markerless human motion analysis based on RGB video recordings, with a particular focus on spontaneous movements in infants and gait patterns in individuals with neurological disorders.