I am a postdoctoral research fellow in the Neurology department of Oregon Health &Science University (OHSU), with a Ph.D. in Bioengineering from University of Bologna, Italy. My current research projects in Dr. Fay Horak's laboratory focus on quantifying prescribed balance and gait tasks with body-worn sensors in subjects with Parkinson's Disease (PD) and Multiple Sclerosis (MS). My long-term career goal is to establish my own independent laboratory, and objectively characterize, understand, and monitor mobility impairments in patients with neurological disorders by means of wearable sensors, in order to develop tailored rehabilitation interventions, such as biofeedback-based solutions. The current project aims to characterize gait disturbances in PD, such as Freezing of Gait (FoG), and apply a vibrotactile biofeedback as a rehabilitation intervention. The K99 phase of the proposed project will perform laboratory studies in healthy control subjects and subjects with PD to characterize locomotion, FoG episodes (Aim I) and to determine the effects of enhanced proprioception, with phase-dependent vibrotactile biofeedback, on gait disturbances (Aim II). The K00 phase of the project will then translate results of the K99 phase to characterize locomotion and FoG in PD subjects'home environment (Aim III) and explore the possibility of improving locomotion with biofeedback during normal daily activities (Aim IV). To achieve my goal, I need to gain expertise in issues related to clinical and translational research, in the pathophysiology of Parkinson's disease, and to refine my signal processing skills. I also need additional training in grantsmanship and writing related to clinical problems. My experienced team of mentors will be critical to the success of this project. Dr. Fay Horak, Ph.D., PT, and Dr. John Nutt, MD, are two of the preeminent researchers in the study of balance and gait disorders in Parkinson's disease, with a long history of productive collaboration, continuous NIH funding, and successful mentoring. Dr. James McNames, Ph.D., is an electrical engineer with expertise in signal process of body motion to develop objective measures of motor dysfunction using inertial sensors. The outstanding research environment provided by Oregon Health &Science University is a perfect match for my career goals. Important resources available to me at OHSU include the Oregon Clinical and Translational Research Institute (which provides research assistance and statistical consultation), the Human Investigations Program (which provides courses in all aspects of clinical research), the Parkinson's Center of Oregon (which provides access to patients with PD and a journal club for discussing cutting-edge research), the Balance Disorders Laboratory (which provides equipment, space and research assistance).

Public Health Relevance

Gait disturbances such slow gait and Freezing of Gait (FoG) are associated with increased risk for falls in Parkinson's disease (PD), interferes with daily activities, and significantly impairs quality of life~ also the physiology of gait disturbances inPD is not fully understood. The goals of this project are: to characterize the physiology of gait disturbances during locomotion with body-worn sensors and to determine whether vibrotactile biofeedback improves such gait disturbances in PD in a laboratory environment~ also to characterize gait disturbances in PD patients in a home environment. This project will identify objective, portable mobility measures to assess the severity and onset of gait disturbances for our long-term goal of a clinical rehabilitation intervention study for FoG.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Career Transition Award (K99)
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Pediatrics Subcommittee (CHHD)
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Cruz, Theresa
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Oregon Health and Science University
Schools of Medicine
United States
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Mancini, Martina; Weiss, Aner; Herman, Talia et al. (2018) Turn Around Freezing: Community-Living Turning Behavior in People with Parkinson's Disease. Front Neurol 9:18
Gilat, Moran; Ehgoetz Martens, Kaylena A; Miranda-Domínguez, Oscar et al. (2018) Dysfunctional Limbic Circuitry Underlying Freezing of Gait in Parkinson's Disease. Neuroscience 374:119-132
Bonora, Gianluca; Mancini, Martina; Carpinella, Ilaria et al. (2017) Investigation of Anticipatory Postural Adjustments during One-Leg Stance Using Inertial Sensors: Evidence from Subjects with Parkinsonism. Front Neurol 8:361
Mancini, Martina; Smulders, Katrijn; Cohen, Rajal G et al. (2017) The clinical significance of freezing while turning in Parkinson's disease. Neuroscience 343:222-228
de Souza Fortaleza, Ana Claudia; Mancini, Martina; Carlson-Kuhta, Patty et al. (2017) Dual task interference on postural sway, postural transitions and gait in people with Parkinson's disease and freezing of gait. Gait Posture 56:76-81
Harrington, Will; Greenberg, Andrew; King, Edward et al. (2016) Alleviating Freezing of Gait using phase-dependent tactile biofeedback. Conf Proc IEEE Eng Med Biol Soc 2016:5841-5844
Mellone, Sabato; Mancini, Martina; King, Laurie A et al. (2016) The quality of turning in Parkinson's disease: a compensatory strategy to prevent postural instability? J Neuroeng Rehabil 13:39
Mancini, Martina; Schlueter, Heather; El-Gohary, Mahmoud et al. (2016) Continuous Monitoring of Turning Mobility and Its Association to Falls and Cognitive Function: A Pilot Study. J Gerontol A Biol Sci Med Sci 71:1102-8
Mancini, Martina; Horak, Fay B (2016) Potential of APDM mobility lab for the monitoring of the progression of Parkinson's disease. Expert Rev Med Devices 13:455-62
Curtze, Carolin; Nutt, John G; Carlson-Kuhta, Patricia et al. (2015) Levodopa Is a Double-Edged Sword for Balance and Gait in People With Parkinson's Disease. Mov Disord 30:1361-70

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