Immediate effects of rhythmic auditory stimulation on gait kinematics in Parkinson's disease ON/OFF medication

Clin Neurophysiol. 2019 Oct;130(10):1789-1797. doi: 10.1016/j.clinph.2019.07.013. Epub 2019 Jul 25.

Abstract

Objective: Gait impairment is a highly disabling symptom for Parkinson's disease (PD) patients. Rhythmic auditory stimulation (RAS), has shown to improve spatio-temporal gait parameters in PD, but only a few studies have focused on their effects on gait kinematics, and the ideal stimulation frequency has still not been identified.

Methods: We enrolled 30 PD patients and 18 controls. Patients were evaluated under two conditions (with (ON), and without (OFF) medications) with three different RAS frequencies (90%, 100%, and 110% of the patient's preferred walking cadence). Spatial-temporal parameters, joint angles and gait phases distribution were evaluated. A novel global index (GPQI) was used to quantify the difference in gait phase distribution.

Results: Along with benefits in spatial-temporal parameters, GPQI improved significantly with RAS at a frequency of 110% for both ON and OFF medication conditions. In the most severe patients, the same result was observed also with RAS at 100%.

Conclusions: RAS administration, at a frequency of 110% of the preferred walking frequency, can be beneficial in improving the gait pattern in PD patients.

Significance: When rhythmic auditory stimulation is provided to patients with PD, the selection of an adequate frequency of stimulation can optimize their effects on gait pattern.

Keywords: Gait analysis; Kinematic; Parkinson disease; Personalized medicine; Rehabilitation; Rhythmic auditory stimulation.

MeSH terms

  • Acoustic Stimulation / methods*
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / therapeutic use*
  • Biomechanical Phenomena / physiology
  • Female
  • Gait / physiology*
  • Humans
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy*
  • Periodicity*
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa