Effects of external rhythmical cueing on gait in patients with Parkinson's disease: a systematic review

Lim, Inge; Wegen, Erwin E. H. van; Goede, C. de; Deutekom, Marije; Nieuwboer, Alice; Willems, An; Jones, Diana; Rochester, Lynn; Kwakkel, Gert

doi:10.1191/0269215505cr906oa

Cited by 424 publications

(348 citation statements)

References 39 publications

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“…studies have shown that rhythmic auditory stimulation (RAS) can improve the spatiotemporal features of gait in patients with PD (Lim et al, 2005;Rubenstein, Giladi, & Hausdorff, 2002). When using RAS, administered in the form of a metronome, gait speed and stride length improved in PD patients both at 'on' and 'off' states (McIntosh, Brown, Rice, & Thaut, 1997;Willems et al, 2006).…”

Section: Rhythmic Auditory Stimulation (Ras) Improves Gait Rhythmicitmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

729

594

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Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk -gait dynamics -may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomtion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.

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Section: Rhythmic Auditory Stimulation (Ras) Improves Gait Rhythmicitmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

729

594

View full text Add to dashboard Cite

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“…By providing an external clock that helps to set the pace and comes in place of the impaired internal rhythmicity in PD, RAS can apparently improve, at least in the short term, many of the spatiotemporal features of gait in patients with PD. [118][119][120][121] When using RAS, administered in the form of a metronome, gait speed and stride length generally increase ͑become more normal͒ in PD patients, both in the on and off states. 122 When RAS is administered at a rate either equal to the patients' baseline step rate ͑cadence͒ or 10% higher, double support time is reduced and stride length increases.…”

Section: Effects Of Rhythmic Auditory Stimulationmentioning

confidence: 99%

Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling

Hausdorff

2009

Chaos: An Interdisciplinary Journal of Nonlinear Science

507

409

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Parkinson’s disease (PD) is a common, debilitating neurodegenerative disease. Gait disturbances are a frequent cause of disability and impairment for patients with PD. This article provides a brief introduction to PD and describes the gait changes typically seen in patients with this disease. A major focus of this report is an update on the study of the fractal properties of gait in PD, the relationship between this feature of gait and stride length and gait variability, and the effects of different experimental conditions on these three gait properties. Implications of these findings are also briefly described. This update highlights the idea that while stride length, gait variability, and fractal scaling of gait are all impaired in PD, distinct mechanisms likely contribute to and are responsible for the regulation of these disparate gait properties.

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“…It is well recognized that auditory, visual, or tactile stimuli can improve gait in patients with PD [2]. As a result, devices that exploit the sensory cueing-related modification of gait in patients with PD have been proposed with limited success for ongoing use [3][4].…”

Section: Introductionmentioning

confidence: 99%

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Espay¹,

Baram²,

Dwivedi³

et al. 2010

JRRD

135

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Abstract-Shuffling and freezing while walking can impair function in patients with Parkinson disease (PD). Open-loop devices that provide fixed-velocity visual or auditory cues can improve gait but may be unreliable or exacerbate freezing of gait in some patients. We examined the efficacy of a closedloop, accelerometer-driven, wearable, visual-auditory cueing device in 13 patients with PD with off-state gait impairment at baseline and after 2 weeks of twice daily (30 minute duration) at-home use. We measured gait velocity, stride length, and cadence using a validated electronic gait-analysis system. Subjects underwent standard motor assessment and completed a self-administered Freezing of Gait Questionnaire (FOGQ) (range 0-24; lower is better). After training, device use enhanced walking velocity (61.6 ± 20.1 cm/s to 72.6 ± 26.5 cm/s, p = 0.006) and stride length (74.3 ± 16.4 cm to 84.0 ± 18.5 cm, p = 0.004). Upon device removal, walking velocity (64.5 ± 21.4 cm/s to 75.4 ± 21.5 cm/s, p < 0.001) and stride length (79.0 ± 20.3 cm to 88.8 ± 17.7 cm, p = 0.003) exhibited a greater magnitude of change, suggesting immediate residual benefits. Also upon device removal, nearly 70 percent of subjects improved by at least 20 percent in either walking velocity, stride length, or both. An overall improvement in gait was measured by the FOGQ (14.2 ±1.9 to 12.4 ± 2.5, p = 0.02). Although issues related to compliance and response variability render a definitive interpretation of study outcome difficult, devices using closed-loop sensory feedback appear to be effective and desirable nonpharmacologic interventions to improve walking in selected individuals with PD.

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Effects of external rhythmical cueing on gait in patients with Parkinson's disease: a systematic review

Cited by 424 publications

References 39 publications

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

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