The literature on gait analysis in Vascular Parkinsonism (VaP), addressing issues such as variability, foot clearance patterns, and the effect of levodopa, is scarce. This study investigates whether spatiotemporal, foot clearance and stride-to-stride variability analysis can discriminate VaP, and responsiveness to levodopa. Fifteen healthy subjects, 15 Idiopathic Parkinson's Disease (IPD) patients and 15 VaP patients, were assessed in two phases: before (Off-state), and one hour after (On-state) the acute administration of a suprathreshold (1.5 times the usual) levodopa dose. Participants were asked to walk a 30-meter continuous course at a self-selected walking speed while wearing foot-worn inertial sensors. For each gait variable, mean, coefficient of variation (CV), and standard deviations SD1 and SD2 obtained by Poincaré analysis were calculated. General linear models (GLMs) were used to identify group differences. Patients were subject to neuropshychological evaluation (MoCA test) and Brain MRI. VaP patients presented lower mean stride velocity, stride length, lift-off and strike angle, and height of maximum toe (later swing) (p<.05), and higher %gait cycle in double support, with only the latter unresponsive to levodopa. VaP patients also presented higher CV, significantly reduced after levodopa. Yet, all VaP versus IPD differences lost significance when accounting for mean stride length as a covariate. In conclusion, VaP patients presented a unique gait with reduced degrees of foot clearance, probably correlated to vascular lesioning in dopaminergic/non-dopaminergic cortical and subcortical non-dopaminergic networks, still amenable to benefit from levodopa. The dependency of gait and foot clearance and variability deficits from stride length deserves future clarification.

Manufacturing processes are based on human labour and the symbiosis between human operators and machines. The operators are required to follow predefined sequences of movements. The operations carried out at assembly lines are repetitive, being identified as a risk factor for the onset of musculoskeletal disorders. Ergonomics plays a big role in preventing occupational diseases. Ergonomic risk scores measure the overall risk exposure of operators however these methods still present challenges: the scores are often associated to a given workstation, being agnostic to the variability among operators. Observation methods are most often employed yet require a significant amount of effort, preventing an accurate and continuous ergonomic evaluation to the entire population of operators. Finally, the risk's results are rendered as index scores, hindering a more comprehensive interpretation by occupational physicians. This dissertation developed a solution for automatic operator risk exposure in assembly lines. Three main contributions were presented: (1) an upper limb and torso motion tracking algorithm which relies on inertial sensors to estimate the orientation of anatomical joints; (2) an adjusted ergonomic risk score; (3) an ergonomic risk explanation approach based on the analysis of the angular risk factors. Throughout the research, two experimental assessments were conducted: laboratory validation and field evaluation. The laboratory tests enabled the creation of a movements' dataset and used an optical motion capture system as reference. The field evaluation dataset was acquired on an automotive assembly line and serve as the basis for an ergonomic risk evaluation study. The experimental results revealed that the proposed solution has the potential to be applied in a real environment. Through direct measures, the ergonomic feedback is fastened, and consequently, the evaluation can be extended to more operators, ultimately preventing, in long-term, work-related injuries.

Imbalance and tripping over obstacles as a result of altered gait in older adults, especially in patients with Parkinson’s disease (PD), are one of the most common causes of falls. During obstacle crossing, patients with PD modify their behavior in order to decrease the mechanical demands and enhance dynamic stability. Various descriptions of dynamic traits of gait that have been collected over longer periods, probably better synthesize the underlying structure and pattern of fluctuations in gait and can be more sensitive markers of aging or early neurological dysfunction and increased risk of falls. This confirmation challenges the clinimetric of different protocols and paradigms used for gait analysis up till now, in particular when analyzing obstacle crossing. The authors here present a critical review of current knowledge concerning the interplay between the cognition and gait in aging and PD, emphasizing the differences in gait behavior and adaptability while walking over different and challenging obstacle paradigms, and the implications of obstacle negotiation as a predictor of falls. Some evidence concerning the effectiveness of future rehabilitation protocols on reviving obstacle crossing behavior by trial and error relearning, taking advantage of dual-task paradigms, physical exercise, and virtual reality have been put forward in this article.

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