No abstract

Rhythm-based therapeutic interventions have widely been used in patients with neurologic disorders to address motor and quality of life outcomes. Although group drumming has been explored in several pilot studies of patients with Parkinson disease (PD) and Huntington disease (HD), caregiver burden and their quality-of-life outcomes have received less attention. Therefore, we aimed to evaluate the impact of group drumming on quality of life and motor symptoms in PD and HD patients as well as their caregivers. A total of 17 participants (PD = 6, caregivers of PD = 6, HD = 3, caregivers of HD = 2) attended the 60-minute drum-based group music therapy intervention twice a week for 12 weeks. Participants were assigned to two drumming intervention groups based on their diagnosis:1) patients diagnosed with PD and their study partners, 2) patients diagnosed with HD and their study partners. In group drumming sessions, both patients and caregiver participants utilized a variety of percussion instruments based on their personal preferences or physical abilities to facilitate movement skills and group cohesion. They were asked to complete questionnaires about quality of life and motor functioning at baseline, 6 weeks, 12 weeks, and 18 weeks (6 weeks post-intervention completion). Caregivers burden scores were also collected at these time points. Furthermore, all participants completed simple exit interview questionnaires in their follow-up visit. The PD participants and their caregivers showed an opposite trend in social role satisfaction. From baseline to 6 weeks, there were significant differences in social role satisfaction between PD participants and PD caregivers where PD participants reported a decrease in social satisfaction (Mean = -2.30, Standard Deviation = 1.64) while PD caregivers experienced an increase (M = 3.80, SD = 3.08), p = .02. In contrast, a different pattern was shown from 12 weeks to 18 weeks, where PD participants showed an increase in social satisfaction (M = 2.53, SD = 1.29), while PD caregivers demonstrated a decrease in social satisfaction (M = -2.10, SD = 3.35), p =.03. Drumming in a group setting may serve as an effective tool to enhance movement and promote social cohesion through rhythmic auditory-motor entrainment, thereby supporting quality of life in PD; further studies in HD are indicated as well.

Rhythmic auditory cueing (RAC) can improve gait parameters in neurological disorders such as Parkinson's disease and stroke. However, there is a lack of research on the effects of RAC in patients with atypical parkinsonian disorders (APD). Using a smartphone metronome application, we aimed to investigate the immediate effects of RAC in patients with clinically diagnosed APD, namely Progressive Supranuclear Palsy (PSP-Richardson Syndrome and other variants, PSP-nonRS), Corticobasal Syndrome (CBS), Multiple System Atrophy (MSA), and Dementia with Lewy Bodies (DLB). A total of 46 APD participants (25 PSP, 9 CBS, 8 MSA and 4 DLB; age: mean = 70.17, standard deviation = 7.15) walked at their preferred pace for 2 min without any rhythmic auditory cueing (RAC). Participants then walked the same path for another 2 min with RAC set at a tempo 10% faster than the baseline cadence of each participant. After a 10–15-min break, participants walked the same path for another 2 min without RAC to observe for carryover effects. Gait parameters [cadence (steps/minute), gait velocity (meters/minute), and stride length (centimeters)] were collected at baseline, during RAC, and post-RAC. There was a significant improvement in cadence in all participants from baseline to during RAC and post-RAC (corrected p-values = 0.009 for both). Gait velocity also improved from baseline to during RAC and post-RAC in all participants, although this improvement was not significant after correcting for multiple comparisons. The changes in cadence and gait velocity were most pronounced in PSP. In addition, our exploratory analysis showed that the cadence in the suspected TAU group (PSP+CBS) showed a significant improvement from baseline to during RAC and post-RAC (corr. p-value = 0.004 for both). This pilot study using short-term RAC in APD patients demonstrated improvements in cadence and velocity. There is an urgent need for effective gait rehabilitation modalities for patients with APD, and rhythmic cueing can be a practical and useful intervention to improve their gait pattern.