Original articleThe Effect of External Rhythmic Cues (Auditory and Visual) on Walking During a Functional Task in Homes of People With Parkinson’s Disease
Section snippets
Participants
We studied 20 people with idiopathic PD (12 men, 8 women; mean age, 64.6±7.96y) and a control group of 10 healthy subjects matched for age, sex, and premorbid intelligence quotient (IQ) (6 men, 4 women; mean age 63.5±7.03y). PD subjects had a median disease severity score of 2.5 (minimum, 1.5; maximum, 4) on the Hoehn and Yahr Scale and a mean disease duration of 10±1.6 years. Ethics approval for the study was granted by the Newcastle and North Tyneside Health Authority Joint Ethics Committee,
Participant details
Subjects’ demographic and clinical details are shown in table 1. We used independent 2-tailed t tests to compare the PD and control groups. There were no significant differences in age, sex, or premorbid IQ. There was a significant difference in the MMSE scores, however, with all subjects scoring above 26, indicating the absence of dementia. PD subjects had significantly higher scores for the Hayling and Brixton tests and the fatigue and depression tests. Results of t tests are shown in table 1
Discussion
Use of auditory cues facilitated a significant increase in mean step length during a dual-motor task that was also substantial from a clinical perspective, representing a difference of 19%. There was also a trend toward an increase in walking speed during the dual-motor task with auditory cues. Visual rhythmic cues also resulted in a trend toward improved walking speed during a dual-motor task. Other clinical symptoms that could compete for attention were correlated with walking speed.
Conclusions
The present study provides some evidence that use of auditory rhythmic cues in the context of the home environment and during functional activities leads to improvements in walking speed and mean step length in subjects with PD. Subjects were able to integrate rhythmic cues into a functional task immediately. These results provide information about the influence of cue use during complex functional tasks that has not previously been described. The results support the utility of external
Acknowledgments
We thank David Burn, MD, and Richard Walker, MD, for their help and support recruiting subjects for the study.
References (34)
- et al.
Goal-directed secondary motor taskstheir effects on gait in subjects with Parkinson’s disease
Arch Phys Med Rehabil
(2000) - et al.
Attending to the taskinterference effects of functional tasks on walking in Parkinson’s disease and the roles of cognition, depression, fatigue, and balance
Arch Phys Med Rehabil
(2004) - et al.
Interaction of the basal ganglia and supplementary motor area in the elaboration of movement
- et al.
Mental fatigue and the control of cognitive processeseffects on perseveration and planning
Acta Psychol
(2003) - et al.
“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue
J Psychosom Res
(1995) - et al.
The use of advance information for motor preparation in Parkinson’s diseaseeffects of cueing and compatibility between warning and imperative stimuli
Brain Cogn
(1998) - et al.
The differential effects of cueing on recall in Parkinson’s disease and normal subjects
Brain Cogn
(1998) - et al.
Contingent and non-contingent auditory cueing in Parkinson’s disease
Neuropsychologia
(1995) - et al.
The pathogenesis of gait hypokinesia in Parkinson’s disease
Brain
(1994)
Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanisms
Brain
Rhythmic auditory stimulation in gait training for Parkinson’s disease patients
Mov Disord
Stride length regulation in Parkinson’s diseasethe use of extrinsic, visual cues
Brain
Dual task interference during gait in people with Parkinson’s diseaseeffects of motor versus cognitive secondary tasks
Phys Ther
Exacerbated physical fatigue and mental fatigue in Parkinson’s disease
Mov Disord
A central executive deficit in patients with Parkinson’s disease
J Neurol Neurosurg Psychiatry
Cognitive disturbances in Parkinsonian patients with depression
Neuropsychiatry Neuropsychol Behav Neurol
Cited by (201)
Synchronization performance affects gait variability measures during cued walking
2022, Gait and PostureRobot-assisted gait training with auditory and visual cues in Parkinson's disease: A randomized controlled trial
2022, Annals of Physical and Rehabilitation MedicineDual-task intervention based on trail making test: Effects on Parkinson's disease
2021, Journal of Bodywork and Movement Therapies
Supported by the European Commission Framework V funding (grant no. QLRT-2001-00120).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.