Neurodynamics & Gait Research Laboratory

Research & Development

About the Laboratory

Our long-term goals are:

  1. to improve the understanding of the control of gait, balance mobility and other movement disorders in the context of aging and neurological disease;
  2. to develop new, sensitive tools for quantifying mobility and motor control in the clinic, lab and at-home settings; 
  3. to develop novel therapeutic approaches to enhance motor control and mobility, to maximize functional independence, and to reduce the risk of falls among older adults, patients with Parkinson's disease, and other at-risk populations.


Our research interests focus on movement disorders and locomotion, especially gait dynamics and falls in the elderly; the analysis of normal and pathophysiological control mechanisms; the study of nonlinear dynamics and fractals in physiology and medicine; cardiovascular regulation and its changes with aging and disease; the development of new methods for the analysis of physiologic fluctuations; and the development of new methods for clinical monitoring. In addition, we develop and assess novel approaches to enhancing motor and cognitive function, based in part on the findings from the more basic studies and applying techniques like Virtual Reality and principles of motor and cognitive learning, in order to improve functional mobility and related clinical outcomes.

Current Research

  1. Investigations of how aging and pathology contribute to postural control and gait, especially the role of cognitive function and the interaction between gait and mental function.
  2. Studies of the physiology and pathologic mechanisms underlying bilateral coordination and freezing of gait.
  3. Development of new algorithms and "wearable" systems for the automated detection and measurement of gait, balance, and fall risk in the home setting.
  4. Development and evaluation of new intervention modalities for treating gait disturbances based on motor learning, "virtual reality" and "auditory bio-feedback".
  5. Investigations of potential bio-markers of Parkinson's disease.
  6. Imaging studies designed to understand the patho-physiology that leads to distinct subsets of patients with Parkinson's disease.
  7. Investigations of freezing of gait mechanisms and novel therapies.

 

B Bloem et al Mov Dis 2004

 

Research Services

A unique setup allows for study of gait and mobility while subjects walk a) on a motorized medical treadmill with a harness, b) with or without the addition of a virtual reality environment, and c) over-ground with a harness to prevent falls in the presence of obstacles and challenges.

 

Equipment available includes an insole pressure distribution system for measuring system for the monitoring of local loading of the foot inside a shoe or bare foot, a tilt table and associated equipment, gait monitoring equipment, video cameras, balance platforms, equipment for measuring upper and lower extremity movements, EMG equipment, as well as accelerometers and gyroscopes for long-term ambulatory monitoring.

 

The laboratory is also equipped with an array of computers and software for out-of-the box and tailor-made signal processing and nonlinear analyses. Analytical approaches include methods based on time series analyses, frequency domain, non-linear and fractal methods.

 

Based on data collected using wearable computers and body-fixed sensors, algorithms developed are designed to quantify and investigate: a) gait variability, b) missteps, c) falls, d) freezing of gait, e) arm swing, f) regularity, g) sit-to-stand and stand-to-sit; h) turns; i) at-home activity; j) asymmetry and bilateral coordination.

 


 

 

Unique Contributions and Resources

Our lab has advanced the understanding of gait, balance and movement disorders in several areas. Papers on stride-to-stride variability and its relationship to fall risk reported novel insights into gait dynamics and fall risk and paved the way for many studies in this area.

One of the key papers on gait dynamics was already cited more than 100 times. We have also been instrumental in advancing the study of the relationship between mobility, mental health and cognitive function. More recently, we generated new insights into the regulation of the bi-lateral coordination introducing a novel index for quantifying this aspect of motor control. Further, our report at a recent international congress on virtual-reality based training in patients with Parkinson's disease generated much interest that seems likely to cause a paradigm shift. 
 

Unique resources include a research setting that allows us to carry out our research as an almost integral part of the clinic. The resultant diversity of research and clinical expertise has created an environment that cultivates the unraveling of the neuroscience of movement, mobility and related functions.

Other resources include novel software and hardware based on wearable computing and prospective data in patient and aging populations that can be used to investigate longitudinal changes in motor and cognitive control and to explore potential bio-markers of Parkinson's disease.Acceleration derived signals during 3 near falls, as labeled, and during other gait intervals. A-C) Derivatives in three axes. D) Signal Vector Magnitude, calculated as the root of the square sums of the 3 axes acceleration signals, E) Vertical Maximal acceleration. F) Vertical maximum peak-to-peak acceleration derivative.

All signals display indications of the near falls.

J Gerontol A Biol Sci Med Sci. 2010 Oct;65(10):1086-92


 

 

Hausdorff Journal of NeuroEngineering and Rehabilitation 2005 2:19   doi:10.1186/1743-0003-2-19

 

 

Outline of Methods and Approaches
• Clinical studies (prospective, longitudinal and cross-sectional)
• Ambulatory monitoring of gait mobility (i.e., "wearable" devices for the automated detection and measurement of gait, balance and fall risk in the home setting)
• Imaging studies ( i.e., DTI , fMRI )
• Genetic studies ( i.e., mutations of Parkinson's disease LRRK2 in relation to motor and non-motor functions)
• Pharmacologic investigations
• Virtual reality augmented treadmill training

 

 

Financial resources/ Grants

Recent research in the lab has been sponsored in part by the Israel Ministry of Healthy, the National Parkinson Foundation, the Israel Science Foundation, the Michal J Fox for Parkinson Research, the Israel Ministry of Veterans Affairs, The US National Institutes of Health, The European Union, The  Israeli Ministry of Absorption, The Parkinson Disease Foundation.

 

Team

Dr. Meir Plotnik
Dr. Anat Mirelman
Dr. Keren Rosenberg
Dr. Gil Zoizner
Ms. Talia Herman
Ms. Aner Weiss
Ms. Marina Brozgol
Mr. Leor Gruendlinger
Ms. Yael Jacob
Mr. Avinoam Jacobs
Ms. Moran Dorfman
Mr.Alexey Nesterov
Ms. Noa Raphaely Beer

 

Collaborations

Luigi Ferrucci, MD, PhD
Editor, Journals of Gerontology: Medical Sciences
National Institutes of Health
National Institute on Aging
Baltimore, MD 21225-1233
Sample Joint Publication: Age-associated differences in the gait pattern changes of older adults during fast-speed and post-activity conditions - Results from the Baltimore Longitudinal Study of Aging. Age & Ageing (in press)

 

Prof. Neil B. Alexander, MD
Director, Mobility Research Center
Professor, Division of Geriatric Medicine, Department of Internal Medicine
University of Michigan Geriatrics Center
1500 E. Medical Center Drive
Ann Arbor, MI 48109-0920
Sample Joint Publication: Linking thinking, walking, and falling. J Gerontol A Biol Sci Med Sci. 2008

 

Prof. Lewis A. Lipsitz, MD
Chief of Gerontology, Beth Israel Deaconess Medical C
Vice President for Academic Medicine, Hebrew SeniorLife,
Professor of Medicine, Harvard Medical School
Boston, MA 02215
Sample Joint Publication:  Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA 2009

 

Prof. Ary L. Goldberger
Professor of Medicine, Harvard Medical School
Director, Margret and H.A. Rey Laboratory for Nonlinear Dynamics in Medicine
Beth Israel Deaconess Medical Center
Boston, MA USA
Sample Joint Publication: Multi-scale entropy analysis of human gait dynamics. Physica A 2003

 

Prof. Lorenzo Chiari, PhD
Biomedical Engineering Group
DEIS - University of Bologna
Bologna – ITALY
Sample Joint Publication: Audio-Biofeedback training for posture and balance in Patients with Parkinson's disease ( JNER in press)

 

Judith E. Deutsch, PhD
Professor and Director Rivers Lab
Department of Developmental and Rehabilitative Sciences
University of Medicine and Dentistry of New Jersey
Newark N.J. 07101
Sample Joint Publication: Virtual reality for gait training: Can it induce motor learning to enhance complex walking and reduce fall risk in patients with Parkinson's disease? JGMS 2010

 

Prof. Suzanne G. Leveille, PhD
College of Nursing and Health Sciences
University of Massachusetts Boston
Boston, MA 02125-3393
Sample Joint Publication:  Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA 2009

 

Prof. Bastiaan R. Bloem, MD, PhD
University Medical Centre St Radboud
Department of Neurology
Nijmegen
The Netherlands
Sample Joint Publication:  Is heart rate variability related to gait impairment in patients with Parkinson's disease? Parkinsonism Relat Disord. 2009

 

Dr. JW Kantelhardt
Institut f¨ur Physik
Martin-Luther-Universit¨at Halle-Wittenberg
Halle, Germany
Sample Joint Publication: Fluctuation and synchronization of gait intervals and gait force profiles distinguish stages of Parkinson’s disease. Physica A 2007

 

Prof. Clemens Becker
Department of Clinical Gerontology
Robert-Bosch-Hospital,
Stuttgart, Germany
Sample Joint Publication: Comparison of acceleration signals of simulated and real-world backward falls (in press)

 

Dr. Daniel Roggen
Wearable Computing Lab
Swiss Federal Institute of Technology Zurich (ETH Zurich)
Switzerland
Sample Joint Publication: Wearable assistant for Parkinson’s disease patients with the freezing of gait symptom.  IEEE Transactions on Information Technology in BioMedicine 2010

Publications

For a listing of recent publications, refer to PubMed, a service provided by the National Library of Medicine
Contact information

Phone: + 972-3-6974958

Fax: + 972-3-6977514

Email: gaitlab@hotmail.com


Location

Sourasky Building, Ground Floor, wing F

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