The effect of external rhythmic cues (auditory and visual) on walking during a functional task in homes of people with Parkinson's disease
ABSTRACT To evaluate (1) the influence of rhythmic cues on gait interference during a functional activity and (2) the relationship of clinical symptoms to gait interference.
Twenty subjects with idiopathic Parkinson's disease (PD) and a control group of 10 age-, sex-, and education-matched subjects.
Subjects performed a simple functional task that included a walking component and a dual-motor task. The functional task was performed with and without external rhythmic (auditory and visual) cues.
Walking speed, mean step length, and step frequency were compared during trials of the tasks. In addition, tests of cognitive executive function (Hayling and Brixton tests), anxiety and depression (Hospital Anxiety and Depression Scale), and fatigue (Multidimensional Fatigue Inventory) were undertaken.
The use of auditory cues during a dual task involving gait reduced the interference effect on the task; significant increases in step length were observed in PD subjects ( P =.018), representing an increase of 19%.
External auditory cues may be useful in reducing interference and maintaining gait performance during more complicated functional activities. Clinical symptoms, such as depression and fatigue, could influence the ability to focus attention and may increase gait interference during the performance of complex tasks, with subsequent implications for functional walking and safety.
SourceAvailable from: Jessica Adrienne Grahn[Show abstract] [Hide abstract]
ABSTRACT: Rhythmic auditory stimulation (RAS) is a gait rehabilitation method in which patients synchronize footsteps to a metronome or musical beats. Although RAS with music can ameliorate gait abnormalities, outcomes vary, possibly because music properties, such as groove or familiarity, differ across interventions. To optimize future interventions, we assessed how initially familiar and unfamiliar low-groove and high-groove music affected synchronization accuracy and gait in healthy individuals. We also experimentally increased music familiarity using repeated exposure to initially unfamiliar songs. Overall, familiar music elicited faster stride velocity and less variable strides, as well as better synchronization performance (matching of step tempo to beat tempo). High-groove music, as reported previously, led to faster stride velocity than low-groove music. We propose two mechanisms for familiarity's effects. First, familiarity with the beat structure reduces cognitive demands of synchronizing, leading to better synchronization performance and faster, less variable gait. Second, familiarity might have elicited faster gait by increasing enjoyment of the music, as enjoyment was higher after repeated exposure to initially low-enjoyment songs. Future studies are necessary to dissociate the contribution of these mechanisms to the observed RAS effects of familiar music on gait. © 2015 New York Academy of Sciences.Annals of the New York Academy of Sciences 03/2015; 1337(1). DOI:10.1111/nyas.12658 · 4.31 Impact Factor
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ABSTRACT: Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple step elements. Adapted tango involves movement initiation and cessation, multi-directional perturbations, varied speeds and rhythms. Focus on foot placement, whole body coordination, and attention to partner, path of movement, and aesthetics likely underlie adapted tango's demonstrated efficacy for improving mobility and balance. In this paper, we describe the methodology to disseminate the adapted tango teaching methods to dance instructor trainees and to implement the adapted tango by the trainees in the community for older adults and individuals with Parkinson's Disease (PD). Efficacy in improving mobility (measured with the Timed Up and Go, Tandem stance, Berg Balance Scale, Gait Speed and 30 sec chair stand), safety and fidelity of the program is maximized through targeted instructor and volunteer training and a structured detailed syllabus outlining class practices and progression.Journal of Visualized Experiments 01/2014; DOI:10.3791/52066