Auditory observation of stepping actions can cue both spatial and temporal components of gait in Parkinson׳s disease patients (original) (raw)
Related papers
Neurological Sciences, 2010
Auditory cueing enhances gait in parkinsonian patients. Our aim was to evaluate its effects on spatiotemporal (stride length, stride time, cadence, gait speed, single and double support duration) kinematic (range of amplitude of the hip, knee and ankle joint angles registered in the sagittal plane) and kinetic (maximal values of the hip and ankle joint power) gait parameters using threedimensional motion analysis. Eight parkinsonian patients performed 12 walking tests: 3 repetitions of 4 conditions (normal walking, 90, 100, and 110% of the mean cadence at preferred pace cued walking). Subjects were asked to uniform their cadence to the cueing rhythm. In the presence of auditory cues stride length, cadence, gait speed and ratio single/double support duration increased. Range of motion of the ankle joint decreased and the maximal values within the pull-off phase of the hip joint power increased. Thus, auditory cues could improve gait modifying motor strategy in parkinsonian patients.
Neuropsychologia, 2016
Gait disturbances are a common feature of Parkinson's disease, one of the most severe being freezing of gait. Sensory cueing is a common method used to facilitate stepping in people with Parkinson's. Recent work has shown that, compared to walking to a metronome, Parkinson's patients without freezing of gait (nFOG) showed reduced gait variability when imitating recorded sounds of footsteps made on gravel. However, it is not known if these benefits are realised through the continuity of the acoustic information or the action-relevance. Furthermore, no study has examined if these benefits extend to PD with freezing of gait. We prepared four different auditory cues (varying in action-relevance and acoustic continuity) and asked 19 Parkinson's patients (10 nFOG, 9 with freezing of gait (FOG)) to step in place to each cue. Results showed a superiority of action-relevant cues (regardless of cue-continuity) for inducing reductions in Step coefficient of variation (CV). Acoustic continuity was associated with a significant reduction in Swing CV. Neither cue-continuity nor action-relevance was independently sufficient to increase the time spent stepping before freezing. However, combining both attributes in the same cue did yield significant improvements. This study demonstrates the potential of using action-sounds as sensory cues for Parkinson's patients with freezing of gait. We suggest that the improvements shown might be considered audio-motor 'priming' (i.e., listening to the sounds of footsteps will engage sensorimotor circuitry relevant to the production of that same action, thus effectively bypassing the defective basal ganglia).
Effects of visual and auditory cues on gait in individuals with Parkinson's disease
Journal of the Neurological Sciences, 2004
The purpose of this study was to determine if combining visual and auditory cues has a greater effect on the gait pattern of patients with Parkinson's disease (PD) than the cues applied individually. Twenty-four individuals with idiopathic PD were recruited. Patients, while off antiparkinsonian medications, were measured on a 7.62-m walkway during two trials for each of four conditions performed in random order: without cues, with a visual cue, with an auditory cue and with both cues simultaneously. The auditory cue consisted of a metronome beat 25% faster than the subject's fastest gait speed. Brightly colored parallel lines placed along the walkway at intervals equal to 40% of a subject's height served as the visual cue. Average gait speed, cadence and stride length were calculated for each condition. Gait velocity, cadence and stride length significantly improved ( p < 005) when cues were used. Visual and auditory cues improved gait performance in patients with PD, but they did so in different ways. Auditory cueing significantly improved cadence, but visual cueing improved stride length. The simultaneous use of auditory and visual cues did not improve gait significantly more than each cue alone. D
Gait & posture, 2016
Rhythmic auditory cueing improves certain gait symptoms of Parkinson's disease (PD). Cues are typically stimuli or beats with a fixed inter-beat interval. We show that isochronous cueing has an unwanted side-effect in that it exacerbates one of the motor symptoms characteristic of advanced PD. Whereas the parameters of the stride cycle of healthy walkers and early patients possess a persistent correlation in time, or long-range correlation (LRC), isochronous cueing renders stride-to-stride variability random. Random stride cycle variability is also associated with reduced gait stability and lack of flexibility. To investigate how to prevent patients from acquiring a random stride cycle pattern, we tested rhythmic cueing which mimics the properties of variability found in healthy gait (biological variability). PD patients (n=19) and age-matched healthy participants (n=19) walked with three rhythmic cueing stimuli: isochronous, with random variability, and with biological variabil...
Parkinson's disease, 2015
In this randomized controlled study we analyse and compare the acute and chronic effects of visual and acoustic cues on gait performance in Parkinson's Disease (PD). We enrolled 46 patients with idiopathic PD who were assigned to 3 different modalities of gait training: (1) use of acoustic cues, (2) use of visual cues, or (3) overground training without cues. All patients were tested with kinematic analysis of gait at baseline (T0), at the end of the 4-week rehabilitation programme (T1), and 3 months later (T2). Regarding the acute effect, acoustic cues increased stride length and stride duration, while visual cues reduced the number of strides and normalized the stride/stance distribution but also reduced gait speed. As regards the chronic effect of cues, we recorded an improvement in some gait parameters in all 3 groups of patients: all 3 types of training improved gait speed; visual cues also normalized the stance/swing ratio, acoustic cues reduced the number of strides and i...
Rhythmic auditory stimulation modulates gait variability in Parkinson's disease
European Journal of Neuroscience, 2007
Patients with Parkinson's disease (PD) walk with a shortened stride length and high stride‐to‐stride variability, a measure associated with fall risk. Rhythmic auditory stimulation (RAS) improves stride length but the effects on stride‐to‐stride variability, a marker of fall risk, are unknown. The effects of RAS on stride time variability, swing time variability and spatial‐temporal measures were examined during 100‐m walks with the RAS beat set to 100 and 110% of each subject's usual cadence in 29 patients with idiopathic PD and 26 healthy age‐matched controls. Carryover effects were also evaluated. During usual walking, variability was significantly higher (worse) in the patients with PD compared with the controls (P < 0.01). For the patients with PD, RAS at 100% improved gait speed, stride length and swing time (P < 0.02) but did not significantly affect variability. With RAS at 110%, reductions in variability were also observed (P < 0.03) and these effects persi...
Gait & Posture, 2004
Researchers have suggested that sensory cues can improve gait initiation in persons with Parkinson's disease (PD); however, there is little research that documents the effects of sensory cues on gait initiation. The purpose of this study was to examine the effects of auditory and cutaneous sensory cues on maximal speed gait initiation in person's with PD and healthy elderly. Seven persons with PD of moderate severity (mean age = 69 years) and seven age, gender, and height matched healthy elders participated. Temporal, kinematic and center of pressure (COP) data were recorded as participants performed eight trials within four randomly ordered conditions (no cue (NC), a single auditory cue (SA), repetitive auditory cues (RA), and repetitive cutaneous cues (RC)). In each condition, participants were instructed to perform each gait initiation trial at their maximal speed. In all conditions, person's with PD reacted more slowly and moved less far than did the matched elders. Relative to conditions with NCs, sensory cueing resulted in decreased double limb support (DLS), and increased COP displacement and velocity in both groups. However, in both groups, displacements and velocities of the swing limb and sacrum during the sensory-cued conditions were less than those during the NC condition. These results suggest that when movement speed is a primary goal, sensory cues may interfere with swing limb and body movement outcomes during the gait initiation task in both person's with PD and healthy elders. (L.E. Dibble).
2006
Purpose. To study the effect of rhythmic auditory cues on gait in Parkinson's disease subjects with and without freezing and in controls. Method. A volunteer sample of 20 patients (10 freezers, 10 non-freezers) and 10 age-matched controls performed five randomized cued walking conditions in a gait-laboratory. Auditory cues were administered at baseline frequency, at an increased step frequency of 10 and 20% above baseline and at a decreased step frequency of 10 and 20% below baseline. Mean step frequency, walking speed, stride length and double support duration were collected. Results. Rhythmical auditory cueing induced speed changes in all subjects. Stride length was not influenced by rhythmical auditory cues in controls, whereas patients showed a larger stride length in the 710% condition (p 5 0.01). Freezers and non-freezers showed the same response to rhythmical auditory cues. Within group analysis for stride length showed different cueing effects. Stride length decreased at the þ10% condition for freezers (p 5 0.05), whereas it increased for nonfreezers.