Effects of auditory or visual stimuli on gait in Parkinsonic patients: a systematic review

Abstract

Background: External stimuli can improve gait performance in Parkinsons Disease (PD): auditory stimuli can increase velocity and visual stimuli may act at step length.Objective: To systematize the scientific evidence about the effects of auditory or visual stimuli on gait in patients with PD.Methods: From January 2016 to December 2018, a systematic literature research was conducted in the PubMed/Medline and Web of Science databases. Study designs considered were randomized controlled trials (RCTs) and observational studies, which evaluated the effects of auditory or visual stimuli on gait in PD. The methodological quality was assessed by the Critical Appraisal Skills Program.Results: Five articles were included with 232 participants and a methodological rank of mean of 10.3 on the cohort studies (n = 3), 8 on the case control studies (n = 1), and 6 on the RCTs (n = 1). Although 3 evaluated the effects of auditory stimuli on gait in PD, 2 analyzed those of visual stimuli. Based on these, it was verified a significant improvement of diverse gait parameters. Conclusion:The application of auditory or visual stimuli have beneficial effects on gait parameters. Further investigation is required.

The effects of visual cues from optical stimulation devices on gait disturbance in patients with Parkinson’s disease

“…Recent studies support the idea that cueing can be an effective component of locomotor therapy for patients with PD and gait disturbance, that auditory cueing is most effective for influencing the temporal parameters of gait only, and that visual cueing has been used to improve the spatial parameters 10,11) and reduce step/stride length variability and asymmetry 11) . Focusing on the effects of cueing on FOG in patients with PD, Lee et al compared the effects of visual and auditory cues on patients with PD who were experiencing FOG, and found that visual cues reduced FOG increased stride length and gait speed, and improved lower extremity joint movements during walking 12) .…”

(Zu-)Hören mit alterndem Gehirn – eine kognitive Herausforderung

“…Although auditory stimuli and music are used for the treatment of Parkinson-related gait disorders and postural instability 190 191 192 , the importance of auditory rehabilitation for Parkinson patients is not discussed in therapy studies.…”

“…Obwohl auditorische Reize und Musik zur Behandlung von Parkinson-bedingten Gangstörungen und posturaler Instabilität eingesetzt werden 190 191 192 wird in Therapiestudien die Bedeutung der Hörrehabilitation für Parkinsonpatienten nicht diskutiert.…”

Os efeitos da reabilitação baseada em exercícios sobre a marcha de pacientes com doença de Parkinson: uma revisão sistemática

“…Mais de 85% das pessoas com DP desenvolvem dificuldades de locomoção dentro de 3 anos após o diagnóstico, devido à alteração dos sintomas motores [4]. Os distúrbios da marcha são considerados os sintomas motores mais incapacitantes da DP, levando a um declínio substancial na mobilidade e independência, uma alta taxa de quedas e uma redução na qualidade de vida [5].…”

“…Estudos confirmam que os pacientes com DP precoce e avançada apresentam comprometimento da marcha e que o padrão específico da marcha anormal é caracterizado por redução da velocidade da marcha [5][6][7], redução do comprimento do passo [5], comprimento da passada reduzida [6][7][8] e diminuição da rotação do tronco combinada com uma cadência aumentada [5,6]. Devido a essas deficiências, existe uma grande tendência de pacientes com DP terem uma redução da capacidade de andar, o que determina a redução da função motora [8].…”