Individuals With Parkinson's Disease Retain Spatiotemporal Gait Control With Music and Metronome Cues.

The purpose of this study was to determine the difference in spatiotemporal gait measures induced by stepping to the beat of a metronome and to music cues of various frequencies in individuals with Parkinson's disease. Twenty-one participants with Parkinson's disease were instructed to time their steps to a metronome and music cues (at 85%, 100%, and 115% of overground cadence). The authors calculated cadence, cadence accuracy, and step length during each cue condition and an uncued control condition. The music and metronome cues produced comparable results in cadence manipulation, with reduced cadence accuracy noted at slower intended frequencies. Nevertheless, the induced cadence elicited a concomitant alteration in step length. The music and metronome cues produced comparable changes to gait, but suggest that temporal control is more limited at slower frequencies, presumably by the challenge of increasing the step length.

The effects of metronome frequency differentially affects gait on a treadmill and overground in people with Parkinson disease.

BACKGROUND: Treadmills and rhythmic auditory cueing can influence stepping rhythm for individuals with Parkinson disease (PD). Of concern, however, is that auditory cueing directly addresses the temporal features of gait, whereas adjusting step length may be more important for people with PD. Stepping to a faster cadence when walking overground may increase gait speed, but without requiring an increased step length. Furthermore, given the potentially valuable role of walking on a treadmill for individuals with PD, we are concerned that increasing cadence with rhythmic auditory cueing while walking at a constant treadmill speed will induce even shorter steps. RESEARCH QUESTION: What is the effect of different metronome cue frequencies on spatiotemporal gait parameters when walking overground compared to walking on a treadmill in people with PD? METHODS: Using a repeated-measures design, 21 people with PD (stage 1-3) walked overground and on a treadmill with and without metronome cues of 85 %, 100 %, and 115 % of their baseline cadence frequency for one minute each. We assessed step length, and cadence during all conditions. Gait speed was assessed during overground gait. RESULTS: An interaction effect between cue frequency and walking environment revealed that participants took longer steps during the 85 % condition on the treadmill only. When walking overground, metronome cues of 85 % and 115 % of baseline cadence yielded decreases and increases, respectively, in both cadence and gait speed with no associated change in step length. SIGNIFICANCE: These data suggest that people with PD are able to alter spatiotemporal gait parameters immediately when provided the appropriate metronome cue and walking environment. We propose to target shortened step lengths by stepping to the beat of slow frequency auditory cues while walking on a treadmill, whereas the use of fast frequency cues during overground walking can facilitate faster walking speeds.