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Walking with neurodegeneration – PhD interview with Magnus Lindh-Rengifo

Magnus Lindh-Rengifo and his thesis. Collage.
Magnus Lindh-Rengifo defends his thesis 16 December 2022.

Walking is probably more cognitively demanding than you think. Magnus Lindh-Rengifo defends his thesis about walking aspects in neurodegenerative disorders on December 16. Read about his experiences as a Ph.D student at MultiPark.

Tell us about your research!

“Walking capability can be a key feature to being able to participate in meaningful activities in your daily life. Meeting patients with neurodegenerative disorders as a physiotherapist, I realized that different aspects related to walking difficulties were significant issues for them to maintain life quality. That is why I decided to investigate different aspects of walking in patients with Parkinson’s disease or mild cognitive impairment.

Walking is much more complex than you may think at first sight. There are several ways of assessing gait in research. You may focus both on objective measurements, such as what ability the patient shows while observed, and subjective measurements, like how the patient perceives their own walking capability.

During my thesis project, I examined objective and subjective measurements in patients from the Motor-ACT (linked to BioFINDER-2) and the HHPD (Home and health in people ageing with Parkinson's disease) studies. We categorized walking into four components: variability, pace/stability, rhythm, and asymmetry. Using a computerized electronic walkway, we monitored temporal and spatial details when patients walked on it, in different settings, such as during single task, dual task as well as fast gait speed.”

Did you make any surprising discoveries?

“Patients with mild cognitive impairment had more difficulties with walking than expected. This indicates that cognitive ability is probably more related to walking capability than previously thought. Walking has been viewed as a semi-automatized, repetitive task. Still, it requires a fair amount of cognitive involvement, especially when walking is combined with doing something else simultaneously, such as carrying a glass of water, something that we refer to as a “dual task” in research. We have seen that subjectively perceived walking difficulties  correlate rather poorly with objective measures, even though both tend to aggravate with time as the disease progresses. As such, they seem to target different perspectives on walking capability.”

What difference could your project make for patients?

“Unless you are immobilized or sitting in a wheelchair, walking is needed for most of your daily tasks. It can enable participation in meaningful activities. Let’s take an example! If you are afraid of falling, for example, you may avoid certain activities, and this may eventually lead to loss of capability, which in turn increases the risk of falling. If healthcare can support these patient groups to adhere to their daily activities, they may maintain capabilities and life quality longer.

Also, walking parameters may be used to predict conversion from mild cognitive impairment into full-blown dementia.”

Do you think walking parameters may be used as a marker like the blood-based biomarkers discovered in the BioFINDER study?

“That is an exciting idea! In the BioFINDER projects, molecular biomarkers, like the phosphorylated Tau protein, have been proven to predict conversion to dementia within the next couple of years. The levels of these aggregating proteins are incorporated together with the results from cognitive tests into an algorithm with impressive predictive accuracy. From a health science perspective, it would be tempting to add walking parameters to their predictive algorithms to get a wider perspective. At the same time, mild cognitive impairment patients are a very heterogeneous group.”

Can you tell us more about the cover of your thesis?

“A friend of mine has created the cover. I asked him to draw a nerve cell and footprints representing a walking pattern. There is also a white silhouette of an older man walking. And a darker shadow behind him. The light man represents the objective aspects of walking, and the darker visualizes his subjective perception of walking.”

How did you end up at MultiPark?

“I had worked for eight years as a physiotherapist when I saw a Ph.D. position announced by Maria H Nilsson. During my clinical duty, I have met many patients with neurodegenerative disorders, not the least those with Parkinson’s disease. Thus, I knew very well that walking was crucial to these patient groups and needed to be explored more. I felt that doing a Ph.D. was necessary for me to offer my patients greater support.”

What did you like the most during your thesis work at MultiPark?

“Personally, I feel that I learned a lot during the neuroscience graduate school lunch seminars. And the travel grants available to MultiPark junior researchers made it possible for me to attend an international conference.”

What have been the most challenging during your Ph.D.?

“Well, to be honest, I was a bit naïve when I enrolled as a Ph.D. student. To take on pathological aspects of neurodegenerative disorders is not done in the blink of an eye. Molecular pathways, biomarkers, and experimental models has been a huge challenge for me to grasp. But still, extremely fascinating!” 

And the most rewarding?

“It is linked to the challenges. Increasing my knowledge about the pathological and molecular aspects of the disorders my patients are suffering from has been stimulating. It is like a whole new world for me. And I really believe this increased understanding makes me a better physiotherapist in the end.”

What are you most proud of?

Hmm… (After some silence) I suffer a lot from imposter syndrome, so I have a hard time patting myself on the bat for anything. But, given that you force me to answer, I would say that is again linked to the challenge here. I am proud that I undertook the challenge it meant to pursue a Ph.D. project in a multidisciplinary environment and my personal development during this time. I am hopeful that it will lead to improved clinical assessment and rehabilitation in the future.”

What do you like to do when you are not at work?

“I have two kids and a house renovation project. Before the pandemic, I frequently went to group exercises, which I really miss now and wish to find my way back to.”

What advice do you want to give to new Ph.D. students?

“Haha, the same advice I got (which I was not listening to so much, to begin with). Take pauses from work! Cherish your spare time! It is “only” your work. In other words, it is easy to be absorbed and to drown in research, which actually never comes to an end. There are always more things to investigate, new papers to read, and more things to control for.”

What happens after your defence?

“First of all, I am going to take some time off. After that I will partially return to clinical practice as a physiotherapist, where I want to implicate what I have learnt. At the same time, I will keep some of my research interests up and running. For instance, I will continue my involvement in the Motor-ACT project.”

More about Magnus Lindh-Rengifo's thesis

Magnus Lindh-Rengifo will defend his Ph.D. thesis titled "Objective and subjective aspects related to walking in people with neurodegenerative disorders" in auditorium H01 at Health Science Centre in Lund on 16th December at 09:00.

Read more about the event in the calendar.  

Link to follow the defence via zoom:

Read the Ph.D. thesis "Objective and subjective aspects related to walking in people with neurodegenerative disorders".


Fast five with Magnus Lindh-Rengifo


My sambo Sanna and our two kids Adrian (5y) and Maja (1y)


Exercise. I used to do Crossfit and play football.

Best time of your day:

I am a morning person, so around 6-9 am, when I got started, and the day is still young

Best conference:

World Parkinson’s congress in Kyoto 2019

Need help with:

 Want to learn how to use the statistical software R

Magnus Lindh-Rengifo. Photo.

Magnus Lindh-Rengifo

Ph.D. student at Rehab/Motor aspects 

magnus [dot] lindh-rengifo [at] med [dot] lu [dot] se (magnus[dot]lindh-rengifo[at]med[dot]lu[dot]se)

Link to Magnus Lindh-Rengifo's profile in the LU Research Portal