The effects of pulsed auditory stimulation on various gait measurements in persons with Parkinson's Disease

Abstract

The purpose of this study was to examine the Functional Ambulation Performance Score (FAP; a quantitative gait measure) in persons with Parkinson's Disease (PD) using the auditory stimulation of a metronome (ASM). Participants (n = 16; 5F/11M; range 60-84 yrs.) had a primary diagnosis of PD and were all independent ambulators. Footfall data were collected while participants walked multiple times on an electronic walkway under the following conditions: 1) PRETEST: establishing baseline cadence, 2) ASM: metronome set to baseline cadence, 3) 10ASM: metronome set to 10% above baseline cadence, 4) POSTTEST. FAP scores increased between PRETEST and POSTTEST. PRE/POSTTEST comparisons also indicated decreases in cycle time and double support and increases in step length and step-extremity ratio (step length/leg length). The results confirm prior findings that auditory stimulation can be used to positively influence the gait of persons with PD and suggest beneficial effects of ASM as an adjunct to dopaminergic therapy to treat gait dysfunctions in PD.

Rhythmic auditory stimulation modulates gait variability in Parkinson's disease

“…Consistent with previous reports (Blin et al, 1990;Morris et al, 1994;Hausdorff et al, 1998;Ebersbach et al, 1999a;Schaafsma et al, 2003;Giladi et al, 2005;Sofuwa et al, 2005;Baltadjieva et al, 2006), the patients with PD in this study walked with a reduced gait speed and swing time compared with an age-matched control group and with an increased stride-to-stride variability under the usual walking (no-RAS) condition. The effects of RAS on average gait speed, stride length and swing time were also generally similar to those reported earlier (McIntosh et al, 1997;Freedland et al, 2002;Rubenstein et al, 2002;Howe et al, 2003;Lim et al, 2005;Willems et al, 2006). For the patients with PD, RAS increased gait speed, stride length and swing time, both when RAS was set to the usual step rate and when it was 10% higher.…”

“…When using RAS, administered in the form of a metronome, gait speed and stride length improved in PD patients in both 'on ' and 'off' states (McIntosh et al, 1997). When RAS was administered at a rate either equal to the patient's baseline step rate or 10% higher, it reduced the double support time and increased stride length (Freedland et al, 2002). Similarly, gait speed increased when RAS was set higher than the usual step rate (Howe et al, 2003;Willems et al, 2006).…”

“…Given the association between stride-to-stride variability and falls (Nakamura et al, 1996;Hausdorff et al, 2001;Schaafsma et al, 2003; and the importance of learning more about the motor control of PD and the potential clinical utility of RAS, the primary objective of the present study was to test the hypothesis that RAS reduces stride-to-stride variability in patients with PD. Following the example of previous investigations, which demonstrated that improvements in gait speed and stride length may be rate dependent (Freedland et al, 2002;Howe et al, 2003;Willems et al, 2006), we studied the effects of RAS when it was set to 100 and 110% of the usual step rate. We also examined possible carryover effects, compared the effects in PD with those of a group of healthy controls and studied the effects of RAS on spatiotemporal parameters.…”

The possible price of auditory cueing: Influence on obstacle avoidance in Parkinson's disease

“…Our results alleviate theoretical concerns that cueing (evidence‐based treatment in PD)20, 25–27 could have adverse effects under complex, attention‐demanding circumstances. This ability to profit from cueing while maintaining successful obstacle avoidance was present even though we measured patients off medication.…”

Facilitación de la actividad motora por estímulos sensoriales en la enfermedad de Parkinson

“…Estas señales auditivas pueden tener un carácter rítmico, y utilizarse para la caracterización de la estabilidad temporal en la ejecución motora de los movimientos anteriormente mencionados [6,18,[29][30][31][32][33][34][35][36][37][38][39][40][41], o bien tratarse de sonidos simples utilizados como señales preparativas o imperativas para el estudio del tiempo de reacción [42][43][44]. En el primer caso, la utilización de señales auditivas rítmicas (SAR) como marcador que obliga al sujeto a intentar sincronizar sus movimientos con dicha señal, como por ejemplo mediante el golpeo con el dedo índice, se ha comprobado beneficioso en los pacientes con EP, dado que mejora la estabilidad temporal de este movimiento, efecto que no se ha obtenido en los sujetos sanos [6,45].…”