Author ORCID Identifier
Document Type
Article
Publication Date
10-3-2016
Abstract
Introduction
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.Method
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 variability (LRC). Synchronization was not instructed.Results
The persistent correlation in gait was preserved only with stimuli with biological variability, equally for patients and controls (p's < 0.05). In contrast, cueing with isochronous or randomly varying inter-stimulus/beat intervals removed the LRC in the stride cycle. Notably, the individual's tendency to synchronize steps with beats determined the amount of negative effects of isochronous and random cues (p's < 0.05) but not the positive effect of biological variability.Conclusion
Stimulus variability and patients’ propensity to synchronize play a critical role in fostering healthier gait dynamics during cueing. The beneficial effects of biological variability provide useful guidelines for improving existing cueing treatments.DOI
https://doi.org/10.1016/j.gaitpost.2016.09.020
Journal Title
Gait & Posture
Volume
51
First Page
64
Last Page
69
Recommended Citation
Dotov DG, Bayard S, Cochen de Cock V, Geny C, Driss V, Garrigue G, ... & Dalla Bella S (2017) Biologically-variable rhythmic auditory cues are superior to isochronous cues in fostering natural gait variability in Parkinson’s disease. Gait & Posture, 51, 64–69. https://doi.org/10.1016/j.gaitpost.2016.09.020
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Files over 3MB may be slow to open. For best results, right-click and select "save as..."
Comments
This is an Accepted Manuscript of an article published by Elsevier in Gait & Posture on October 3, 2016, available online: https://doi.org/10.1016/j.gaitpost.2016.09.020