The feasibility of singing to improve gait in Parkinson disease

Abstract

Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD.

White Matter Connectivity Reflects Success in Musical Improvisation

“…By combining behavioral informatics with diffusion tensor imaging, we detect individual differences in brain connectivity that reflect individual differences in creative behavior. Results may have clinical applications by informing the design of creative music therapy programs as a form of neurorehabilitation for those recovering from neurological and/or communication disorders (Altenmüller & Schlaug;Bringas et al, 2015;Francois, Grau-Sanchez, Duarte, & Rodriguez-Fornells, 2015;Harrison, McNeely, & Earhart, 2017;Ripolles et al, 2015). Most generally, these results may be informative about what creativity entails, how the human brain enables creativity, and how we can learn to be more creative.…”

Dance at Home for People With Parkinson's During COVID-19 and Beyond: Participation, Perceptions, and Prospects

“…Dance programs for PD often incorporate these through exercises such as mirroring and the use of analogy/metaphor images [e.g., (14)], which have been proposed to contribute to beneficial physical and non-physical effects for people with PD (20). Dance also provides other forms of internal and external cues, such as temporal patterning through music, singing and rhythmic counting, that may facilitate movement for people with PD (21)(22)(23)(24). These elements may differ between in-person classes and digital participation, which may result in different outcomes.…”

Exercise and physical activity for people with Progressive Supranuclear Palsy: a systematic review

“…8 For idiopathic Parkinson's disease, high-dosage sustained exercises and select movement strategies appear to be beneficial in the short term. [9][10][11][12][13][14][15][16] In the early stages of disease progression, therapeutic exercises can improve mobility [17][18][19][20][21] and prevent falls. 12,13 There is also growing evidence that exercise can modify disease progression in early Parkinson's disease.…”