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Brazilian Journal of Motor Behavior
Obituary:
Tribute to Lilian Gobbi
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The trajectory of Lilian Teresa Bucken Gobbi (1956-2022): an eminent researcher of gait
and posture
RENATO MORAES
1
| VERONICA MIYASIKE-DASILVA
2
| DIEGO ORCIOLI-SILVA³ | RODRIGO VITÓRIO
4
| FABIO A.
BARBIERI
5
| CAROLINA SILVEIRA
6
1
School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
2
Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.
3
Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (Unesp), Rio Claro, SP, Brazil.
4
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdon.
5
Human Movement Research Laboratory (MOVI-LAB), School of Sciences, Department of Physical Education, São Paulo State University (Unesp), Bauru, SP, Brazil.
6
Lawson Health Research Institute, London, Canada.
Correspondence to: Renato Moraes, Ph.D., Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto,
SP, Brasil, 14040-907, +55 (16) 3315-8784
email: renatomoraes@usp.br
https://doi.org/10.20338/bjmb.v16i5.338
ABBREVIATIONS
LEPLO Posture and Gait Studies
Laboratory
PD Parkinson’s disease
PROFIT Physical Activity Program for Older
Adults
PROPARKI Physical Activity Program for
People with Parkinson’s Disease
tDCS Transcranial Direct Current
Stimulation
UNESP São Paulo State University
PUBLICATION DATA
Received 03 12 2022
Accepted 10 12 2022
Published 15 12 2022
ABSTRACT
Lilian Teresa Bucken Gobbi, or simply Lilian, a beloved friend of many of us, died unexpectedly on October 20, 2022. We wrote
this tribute to recognize her legacy in science. We reviewed Lilian’s education and career and her contributions to the research
on balance and locomotion in children, older adults and people with Parkinson’s disease. We also acknowledged her pioneering
work on physical activity interventions for people with Parkinson’s disease. Finally, but not least important, we tried to show a
little bit about the wonderful human being who Lilian was beyond her scientific contributions.
KEYWORDS: Gait | Posture | Parkinson’s disease | Motor development | Adaptative gait
Lilian Teresa Bucken Gobbi, or simply Lilian, a beloved friend of many of us, died
unexpectedly on October 20, 2022.
EDUCATION
Lilian’s relationship with physical activity began in childhood as an avid swimmer. In
Lilian’s words: “After hundreds of medals, a few trophies and youth spent in the water,
vocational tests revealed Physical Education and Teaching as the most suitable for me.”
i
,1
.
Thus, being as determined and objective as she was, Lilian enrolled in two programs
simultaneously, graduating in Physical Education at the School of Physical Education and
Sports of Paraná and in Education at the Federal University of Paraná in 1977.
After a period working as a Physical Education teacher and swimming instructor,
she felt the need to strengthen her knowledge to improve her professional practice. Lilian
then started a Specialization in Physical Education Teaching at the Federal University of
!
i
Free translation of the following Portuguese text: “Após uma centena de medalhas, alguns troféus e uma adolescência
vivida dentro da água, os testes vocacionais apontaram a Educação Física e o Magistério como mais recomendáveis.”
(Gobbi
1
, p. 4).!
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Paraná, where she met the late Professor Jefferson Thadeu Canfield. This program was
critical to awakening her interest in Science
1
. She then completed a Master’s degree in
Human Movement Science at the Federal University of Santa Maria in 1987 under the
supervision of Professor Canfield. Initially in her career, Lilian had a great interest in motor
behavior in children. This interest led to her Master’s thesis entitled “A capacidade da
memória de curta duração para informações motoras amplas em crianças de 7 a 10 anos”
[Short-term memory capacity for broad motor information in children aged 7 to 10 years]
2
.
Then, five years later, she started her doctoral studies at the University of Waterloo, Canada.
Pursuing professional progress and learning more advanced experimental procedures were
Lilian’s main motivation for continuing her research training. During her Ph.D., she wrote a
dissertation about the development of obstacle avoidance strategies in children,
emphasizing the contribution of visual information and intersegmental dynamics to gait
control. She completed her Ph.D. in 1997 under the supervision of the late Professor Aftab
E. Patla, with the dissertation entitled “Developmental trends in skilled locomotor behavior
over uneven terrain”
3
. This experience was a turning point in Lilian’s research career. She
always shared with many of us such great stories from that period. We think that the
relevance of this experience to her was the reason to encourage several of us to pursue
education abroad.
UNIVERSITY CAREER
Following the conclusion of her Master’s in Human Movement Science, Lilian joined
the São Paulo State University (UNESP) in 1987 as an Assistant Professor in the
Department of Physical Education, Rio Claro campus. The undergraduate program was
starting in Rio Claro at that period (the Department was formally created in 1986), and she
was one of the first academics to arrive and help build the tradition of that program. In 2008,
Lilian was promoted to Adjunct Professor (equivalent to the Associate Professor rank as in
several universities worldwide) with the thesis “Locomoção adaptativa e doença de
Parkinson” [Adaptive locomotion and Parkinson’s disease]
4
. More recently, in 2019, she
became a Full Professor.
Lilian spent all of her career with the Department of Physical Education, where she
served in several administrative roles and contributed to the Movement Science Graduate
Program to achieve a high level of recognition by CAPES/Ministry of Education/Brazil. Lilian
was the chair of the graduate program in several opportunities, and, more recently, she
returned to this role in July 2021. She used to say that if we want to change things, we must
participate in the decision-making committees. During her 30-plus years in higher education,
Lilian taught the undergraduate course “Growth and Motor Development” to several
generations of Physical Education professionals. She was also responsible for several
graduate courses such as “Posture”, “Locomotion”, “Neurosciences”, and “Biomechanics
and Motor Behavior”. Lilian was an outstanding and inspiring teacher and mentor.
Throughout her career, Lilian mentored 31 Master’s and 11 Ph.D. students. She
also supervised three postdoctoral fellows. Several of her former students are widespread
throughout Brazil and in different parts of the world, including Canada, Europe, and Australia.
For many of us, she continued to be our mentor and provided advice during crucial moments
of our careers. She was highly committed to her students and touched the lives of so many
of them. She taught them that the horizon was so much further than they thought; she
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believed in them sometimes more than they did themselves. Therefore, it is no coincidence
that some of them ended up in different parts of the world.
RESEARCH CAREER
Lilian leaves a legacy of contributions to the field of locomotion and posture research.
Her research program was dedicated to understanding the mechanisms of adaptive
locomotion and postural control across the lifespan and in Parkinson’s disease (PD).
After completing her Ph.D. in Canada in 1997, Lilian returned to Brazil and
established the Posture and Gait Studies Laboratory (LEPLO). The lab was housed in a tiny
room at the UNESP Rio Claro campus and, per her own words, it was equipped with “only
one computer, great attitude and energy”
1
. During the next 25 years, the LEPLO expanded
not only in physical space and research infrastructure but turned into a site for high-quality
research training, multidisciplinary collaboration, and research output.
The initial research endeavors at the LEPLO focused on studying locomotor
behavior over the course of the lifespan. Most of these studies were led by undergraduate
students, who often moved to the graduate program under Lilian’s supervision. Lilian’s
original interest in motor development influenced many studies focusing on locomotor
behavior of typical and atypical developing individuals
5–15
. Along with motor development
research in children, Lilian was also active in aging research. Lilian’s research program on
aging shed light on sensory mechanisms involved in the control of locomotion in challenging
terrains and the effects of physical activity on mobility in older adults
16–19
.
In the early 2000s, Lilian conducted a series of studies comparing the motor
development of children with their actual chronological age. In collaboration with local
schools, undergraduate students were trained on a motor skill assessment battery and
conducted tests in pre-school and elementary school children under Lilian’s and her
research team’s supervision. In the end, individual reports were generated comparing motor
and chronological ages for each child in all motor skills assessed, and Lilian met with school
representatives to review the results. Research produced from these experiences included
assessing children’s motor development longitudinally
5
, testing the construct validity of the
assessment scale
6
, and evaluating the role of extra-curricular activities in children’s motor
development
7
. While the research on motor development had been prolific, in 2003, a new
line of research focused on PD would forever change Lilian’s research program.
In 2003, Lilian initiated a new line of research about the influence of PD on gait and
balance. This decision was driven by her scientific curiosity to better understand the
underlying mechanisms of motor symptoms of PD, which profoundly impact patients’
mobility and quality of life. The first experimental study investigated the effects of levodopa
(i.e., the typical pharmacological treatment for PD) on gait and obstacle avoidance in people
with PD
20
. Although levodopa had a positive effect, it did not restore kinematic parameters
of gait and obstacle avoidance to the level of healthy individuals. These findings intrigued
Lilian: if medication was not enough, what could we do to help patients live better? The
answer was quite obvious to her: exercise! Given her experience with exercise interventions
in older adults, Lilian’s team investigated the effects of exercise as a complementary
intervention for PD. The initial project on exercise took years to complete (due to limited
access to people with PD at that time) and was published in 2009: “Exercise programs
improve mobility and balance in people with Parkinson’s disease”
21
. Lilian was amazed by
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finding evidence that exercise could help people with PD. The two seminal studies
mentioned above marked the start of the most intense line of research in Lilian’s career, with
85 publications involving PD.
Lilian’s research team became well known for their studies applying portable brain
imaging technologies, namely electroencephalography and functional near-infrared
spectroscopy. This new line of research in Lilian’s lab emerged from the need to incorporate
measures of brain activity to better explain PD-related deficits in gait and balance and the
effects of interventions. On multiple occasions during the peer-review process, reviewers
had questions that could not be answered by biomechanical or clinical outcomes. Then, in
2015, Lilian challenged her recently graduated Ph.D. student, Rodrigo Vitorio, to pursue the
incorporation of measures of brain activity into the lab’s research. After careful literature
screening, they proposed the application of electroencephalography and functional near-
infrared spectroscopy as these techniques allow recordings of brain activity during actual
movement, providing greater ecological validity than other neuroimaging techniques that
require subjects to remain immobile. In multiple projects over the last seven years, Lilian’s
team has identified aging- and PD-related changes in cortical brain activity during walking
and standing
22,23
, and neural mechanisms underlying improvements achieved with
interventions in people with PD (e.g., exercise, sensory cueing, medication, non-invasive
brain stimulation)
24–27
.
In the most recent years, Lilian’s research has been focused on understanding the
effects of transcranial Direct Current Stimulation (tDCS) on gait, balance and cognition in
PD. Brain areas identified as affected by PD during walking and balance tasks are targeted
by tDCS protocols (i.e., non-invasive brain stimulation through electrodes placed on the
scalp). Lilian’s team has demonstrated that tDCS can provide benefits to gait, balance and
cognition as a stand-alone intervention and when combined with exercise
25,26,28–30
.
Although Lilian became a world reference in PD locomotion, she continued studying
other aspects affecting gait and posture control. She had productive collaborations with
Professor Jaap van Diëen (Vrije University, The Netherlands) and Professor Tibor
Hortobágyi (University of Groningen, The Netherlands). The collaborations resulted in
studies about the effects of fatigue on gait and posture in younger adults, older adults and
people with PD (~12 studies). She supervised several undergraduate and graduate students
in this line of research, including two Ph.D. students in the Netherlands. The main findings
from these studies relate to describing motor behavioral changes following muscular and
mental fatigue
31,32
and the long-term effect of fatigue (more than 20 minutes) on gait
parameters
33
. It was also shown that the influence of fatigue started earlier than expected
in individuals aged 40 years old
34
. Another research line Lilian was interested in was the
influence of asymmetry on gait and posture control. She investigated how contextual (e.g.,
obstacle avoidance) and individual (e.g., aging and disease) aspects affect gait and posture
symmetry. Her team demonstrated in approximately ten studies that more challenging
walking and postural tasks
35–37
and non-faller individuals showed increased gait and posture
asymmetry
38,39
.
Lilian’s research agenda profoundly contributed to understanding several aspects
of gait and postural control in different populations, mainly in people with PD. Her
commitment to cutting-edge research topics and her resolute dedication to excellence in
science is a legacy for the coming generation of researchers.
COMMUNITY OUTREACH: PROPARKI AND RELATED ACTIVITIES
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Lilian devoted much of her academic career to PD research, including investigating
the role of exercise interventions in people with PD. But basic science research in PD was
not enough for Lilian. She wanted means to apply the knowledge gained through research
into practice for the benefit of as many people with PD as possible. Then, in 2004/2005,
Lilian created an exercise group for people with PD as part of the Physical Activity Program
for Older Adults (PROFIT) offered at her academic department. The news that people with
PD attending this exercise group were obtaining impressive benefits spread through the city
and region, attracting more and more patients. With the growing demand for the service, in
2008, Lilian founded a specific outreach program for people with PD known as PROPARKI
(Program of Physical Activity for People with Parkinson's disease).
Lilian directed PROPARKI from 2008 until her death. During these years, Lilian was
dedicated to understanding the benefits of different types of exercise for people with PD.
Multimodal exercises, locomotion exercises, balance exercises (including slackline training),
resistance exercises, respiratory exercises and dance were offered. A total of 346 individuals
with PD participated free of charge in the PROPARKI. But not only the participants were
touched by PROPARKI. Due to the pioneering and excellence of the program in Brazil,
professionals from all around the country visited Rio Claro to learn how to design and
implement exercise programs for people with PD.
In order to reach as many people as possible and offer support material for other
health professionals who deal with people with PD, Lilian, together with her undergraduate
and graduate students authored a book
40
and book chapters detailing some of the physical
activity programs offered by PROPARKI
41–44
. In addition, between 2012 and 2018, Lilian
organized the annual scientific event “Jornada de Estudos da doença de Parkinson”
[Workshop on Parkinson's Disease] to discuss the current state of the art in PD with
undergraduate and graduate students, health professionals and researchers from Brazil.
With the goal of sharing with the participants from PROPARKI and their families the motor,
clinical and cognitive benefits arising from their participation in the program, Lilian also
coordinated the event “Encontro PROPARKI” [PROPARKI Meeting], which took place
annually between 2010 and 2019.
Lilian’s commitment to offering the best possible exercise program for people with
PD had the single objective of providing a better quality of life for this population. She left an
immeasurable legacy at UNESP Rio Claro, where hundreds of patients were able to
experience a high-quality exercise program. Dozens of undergraduate and graduate
students had the opportunity to study, research and understand PD impairments and the
effects of exercise on PD supervised by the great researcher and mentor Lilian was.
PERSONALITY
Lilian was a transparent person and unapologetically herself. She was assertive,
sincere, and direct. At the same time, she was warm and protective of those around her.
Lilian was an inspiration and an influence to students through her passion and commitment
to work. She introduced many of us to the academic career where we discovered our own
passion for teaching, research, and community outreach. She was knowledgeable but had
no problem acknowledging what she did not know, being unafraid of troughing herself into
new personal and academic challenges. Lilian had clear goals and was not intimidated by
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hard work. She was a skillful leader. Her successful leadership was on display in the
management of LEPLO and PROPARKI, as well as in her role as chair of graduate studies
(multiple times), coordinating research groups, and collaborative projects.
She was a thoughtful mentor, welcoming students and helping them to develop their
professional and personal potential. Despite her busy schedule, she had an unconditional
willingness to listen and talk to students. Her office, famously located in the Anatomy Building,
had an “open door policy”, and students were welcomed to fierce academic debates and
editorial work in their writing, as well as to share experiences and receive advice. She
discouraged comparisons between students and encouraged people to be the best version
of themselves. Lilian encouraged students to take a stand, participate in decision-making
processes, and work diligently and ethically. People mattered to Lilian, and she was
committed to providing a safe and welcoming environment to students and community
participants while ensuring outstanding quality and respect in the work conducted.
She was the “life of the party”. Her contagious positivity, sense of humor, and loud
laugh were cherished by so many of us. She loved dancing, singing, playing cards, and
hosting friends at her house. There were famous barbecues and feijoadas (which she
cooked herself). In the early 2000s, lab social events that included karaoke required two
microphones, as one of them was exclusive for Lilian to sing along to all songs. She was a
voracious reader, reading from fantasy books to medical literature. Some of us dove into her
collection of Oliver Sacks books available at the LEPLO’s library. Lilian was a lifelong
swimmer and a champion of her sport. She loved traveling and often would travel with her
students to conferences (on a trip in 2001, she stated that from that moment on, she would
only travel to conferences with students as it was much more fun to be around students than
other professors!) For former LEPLO members, it was a treasured moment meeting her at
conferences to learn and laugh together. Breaks at conferences were time to tour, shop and
enjoy a nice meal, and it was tough to match her energy level in these activities. Lilian met
our parents and spoke highly of us; She attended our weddings; She met and cuddled our
children. Yet, and above all, Lilian adored her family: Sebastião, Ronaldo, and Peri. There
was no limit to her support and love for them. The way she managed to live meaningfully all
aspects of her life is an inspiration to her students. Her professionalism and warm personality
did not compete; Lilian mastered being both and will be deeply missed.