Effect of musical cues on gait in individuals with Parkinson disease with comorbid dementia.

BACKGROUND: Individuals with Parkinson disease and comorbid dementia (PDD) demonstrate gait impairments, but little is known about how these individuals respond to interventions for gait dysfunction. Rhythmic auditory stimulation (RAS), which utilizes music or other auditory cues to alter gait, has been shown to be effective for improving gait in individuals with PD without dementia, but has not been explored in individuals with PDD. RESEARCH QUESTION: Can individuals with PDD modulate their gait in response to music and mental singing cues? METHODS: This single center, cross-sectional, interventional study included 17 individuals with PDD. Participants received Music and Mental singing cues at tempos of 90 %, 100 %, 110 %, and 120 % of their uncued walking cadence. Participants were instructed to walk to the beat of the song. Gait variables were collected using APDM Opal sensors. Data were analyzed using mixed effect models to explore the impact of tempo and cue type (Music vs Mental) on selected gait parameters of velocity, cadence, and stride length. RESULTS: Mixed effects models showed a significant effect of tempo but not for cue type for velocity (F=11.51, p < .001), cadence (F=11.13, p < .001), and stride length (F=5.68, p = .002). When looking at the marginal means, velocity at a cue rate of 90 % was significantly different from 100 %, indicating participants walked slower with a cue rate of 90 %. Participants did not significantly increase their velocity, cadence, or stride length with faster cue rates of 110 % and 120 % SIGNIFICANCE: Individuals with PDD appear to be able to slow their velocity in response to slower cues, but do not appear to be able to increase their velocity, cadence, or stride length in response to faster cue tempos. This is different from what has been reported in individuals with PD without dementia. Further research is necessary to understand the underlying mechanism for these differences.

The Effectiveness of Classical Ballet as a Therapeutic Intervention: A Narrative Review.

There has been increasing research on the impact of dance as a therapeutic intervention and alternative exercise for improving physical health and psychosocial outcomes. Prior reviews center on specific populations, such as those living with Parkinson's disease or older adults, but few center on a specific dance style such as classical ballet. This review aims to synthesize the current literature on classical ballet as a therapeutic intervention for novices and analyze its effects on movement outcomes, perceived value, and other health outcomes to inform future research directions. In total, 23 articles were identified using PubMed and Scopus from inception through March 2022; 14 that met the inclusion criteria are discussed in this review. Altogether, the literature is extremely mixed-spanning different populations, intervention protocols, doses, and measurement tools-making comparisons difficult. Overall, classical ballet appears to be a safe and feasible intervention for multiple populations. Engaging in classical ballet may be associated with improvements in balance and postural control and has a high perceived value among participants and instructors, but the evidence is limited and of poor quality. Rigorous research is required to provide stronger, more credible evidence on the potential value of classical ballet as a therapeutic intervention.