This study explored the viability and efficacy of integrating cadence-matched, salient music into a walking intervention for patients with Parkinson's disease (PD). Twenty-two people with PD were randomised to a control (CTRL, n = 11) or experimental (MUSIC, n = 11) group. MUSIC subjects walked with an individualised music playlist three times a week for the intervention period. Playlists were designed to meet subject's musical preferences. In addition, the tempo of the music closely matched (±10–15 bpm) the subject's preferred cadence. CTRL subjects continued with their regular activities during the intervention. The effects of training accompanied by “walking songs” were evaluated using objective measures of gait score. The MUSIC group improved gait velocity, stride time, cadence, and motor symptom severity following the intervention. This is the first study to demonstrate that music listening can be safely implemented amongst PD patients during home exercise.

No abstract

People with Parkinson's disease (PD) can exhibit disabling gait symptoms such as freezing of gait especially when distracted by a secondary task. Quantitative measurement method of this type of cognitive-motor abnormality, however, remains poorly developed. Here we examined whether stepping-in-place (SIP) with a concurrent mental task (e.g., subtraction) can be used as a simple method for evaluating cognitive-motor deficits in PD. We used a 4th generation iPod Touch sensor system to capture hip flexion data and obtain step height (SH) measurements (z axis). The accuracy of the method was compared to and validated by kinematic video analysis software. We found a general trend of reduced SH for PD subjects relative to controls under all conditions. However, the SH of PD freezers was significantly worse than PD non-freezers and controls during concurrent serial 7 subtraction and SIP tasking. During serial 7 subtraction, SH was significantly associated with whether or not a PD patient was a self-reported freezer even when controlling for disease severity. Given that this SIP-based dual-task paradigm is not limited by space requirements and can be quantified using a mobile tracking device that delivers specifically designed auditory task instructions, the method reported here may be used to standardize clinical assessment of cognitive-motor deficits under a variety of dual-task conditions in PD.

Many animal species use reaching for food to place in the mouth (reach-to-eat) with a hand, and it may be a primitive movement. Although researchers (I. Q. Whishaw, 2005; A. N. Iwaniuk & I. Q. Whishaw, 2000; M. Gentiluci, I. Toni, S. Chieffi, & G. Pavesi, 1994) have described visual guidance of reaching in both normal and brain-injured human and nonhuman primates, researchers have not described the contribution of vision during advance of the limb to grasp food and during withdrawal of the limb with food to the mouth. To evaluate visual contributions, the authors monitored eye movements in young adults as they reached for food with and without vision. Participants visually engaged the target prior to the 1st hand movement and disengaged it as the food was grasped. Visual occlusion slowed limb advance and altered digit shaping but did not affect withdrawal. The dependence on visual control of advance but not withdrawal suggests that the reach-to-eat movement is a composite of 2 basic movements under visual and tactile/proprioceptive guidance, respectively.

This study examined the efficacy of a novel reaching-and-grasping task in determining visuospatial abilities across adulthood. The task required male and female young (18–25 years) and older adults (60–82 years) to replicate a series of complex models by locating and retrieving the appropriate building blocks from an array. The task allows visuospatial complexity to be manipulated independently from the visuomotor demands. Mental rotation and spatial visualization abilities were assessed. The results showed that the time taken to complete the tasks increased with increased mental rotation complexity. Patterns of hand use were also influenced by the complexity of the models being constructed with right hand use being greater for the less complex models. In addition, although older adults consistently performed the visuomotor tasks slower than the younger adults, their performance was comparable when expressed as the percent change in task demands. This is suggestive that spatial abilities are preserved in older adults. Given the ecologically validity, the described task is an excellent candidate for investigating: (1) developmental; (2) sex-based; and (3) pathology-based differences in spatial abilities in the visuomotor domain.

Fear of falling is known to affect more than half of community-dwelling older adults over 60 years of age. This fear is associated with physical and psychological effects that increase the risk of falling. The authors' theory is that attentional processing biases may exist in this population that serve to perpetuate fear of falling and subsequently increase fall risk. As a starting point in testing this proposition, the authors examined selective attentional processing bias to fall-relevant stimuli among older adults. Thirty older adult participants (M(age) = 70.8 ± 5.8), self-categorized to be Fearful of Falling (FF, n = 15) or Non-Fearful of Falling (NF, n = 15) completed a visual dot-probe paradigm to determine detection latencies to fall-threatening and general-threat stimuli. Attentional processing was defined using three index scores: attentional bias, congruency index, and incongruency index. Bias indicates capture of attention, whereas congruency and incongruency imply vigilance and disengagement difficulty, respectively. Both groups showed an attentional bias to fall-threat words but those who were fearful of falling also showed an incongruency effect for fall-threat words. These findings confirm that selective attentional processing profiles for fall-relevant stimuli differ between older adults who exhibit fear of falling and those who do not have this fear. Moreover, in accordance with current interpretations of selective attentional processing, the incongruency effect noted among fall-fearful older adults presents a possibility for a difficulty disengaging from fall-threatening stimuli.

Abstract-Multitasking situations exacerbate gait impairments and increase the risk of falling among people with Parkinson disease (PD). This study compared obstacle negotiation among 10 subjects with PD and 10 nonparkinsonian control (CTRL) subjects in two test conditions differentiated by the presence of music played through a personal music player. Subjects walked the length of a 10 m walkway at a selfselected pace, crossing a 0.15 m obstacle placed at the midpoint of the walkway. The results indicated that subjects with PD crossed the obstacle slower than CTRL subjects and that concurrent music differentially altered obstacle crossing behaviors for the CTRL subjects and subjects with PD. Subjects with PD further decreased obstacle-crossing velocities and maintained spatial parameters in the music condition. In contrast, CTRL subjects maintained all spatiotemporal parameters of obstacle crossing with music. The alterations to crossing behaviors observed among the subjects with PD support our previous suggestion that listening to music while walking may be an attentionally demanding task.

Gait performance was differentially influenced by music salience. These results have implications for clinicians considering the use of commercially available music as an alternative to the traditional rhythmic auditory cues used in rehabilitation programs.