Effects of rhythmic sensory stimulation (auditory, visual) on gait in Parkinson’s disease patients

Abstract

This study has focused on how sensory stimulation affects gait in Parkinson's disease (PD). The kinematic parameters of gait [cadence, step amplitude, velocity, coefficient of variation of stride time (CV(stride-time)), and the coefficient of variation of the step amplitude (CV(step-amplitude))] were analysed in 25 PD patients and 10 control subjects. Step amplitude, velocity and CV(stride-time) were altered in the patients with PD. However, when kinematic parameters were analysed as a function of disease severity, none of the parameters differed between early PD (I-II Hoehn and Yahr) and the controls. Nevertheless, more severely affected PD patients (III-IV Hoehn and Yahr) walked with a reduced step amplitude, lower velocity, higher CV(stride-time), and higher CV(step-amplitude) than the controls. The administration of auditory stimulation at a frequency matching the preferred walking cadence led to a decrease in the CV(stride-time) in PD(III-IV) patients, and to an increase in step amplitude in PD(III-IV )and controls. Visual stimulation at the same frequency did not modify any of the altered kinematic parameters in PD(III-IV )patients. When different stimulation frequencies were utilised, auditory stimulation significantly changed some of the altered walking parameters in Parkinson patients. Frequencies matching preferred walking cadence or above this, up to the fastest walking, were those that seem to interact most effectively with the abnormal kinematic parameters in PD(III-IV )patients. Visual stimulation negatively modulated cadence in PD(III-IV) in the frequency range used. Sensory stimulation facilitates gait in PD. Studies using sensory stimulation as a tool to facilitate walking should take into account the grade of disability of the patients.

The Effects of Integrated Visual and Auditory Stimulus Speed on Gait of Individuals with Stroke

“…In a study analyzing the gait parameters of Parkinson disease patients provided visual and auditory stimulation, Arias and Cudeiro reported that lower gait velocity, cadence, and step amplitude and higher coefficient of variation in stride time and step amplitude were shown at the lower speed of stimulation 14) . In this study, we found that gait velocity, step length, and stride length increased significantly when visual and auditory stimulation were provided at 150% of patients' normal walking speed compared to stimulation at 50% of their normal walking speed, which is similar to the findings of the abovementioned study.…”

Antagonist muscle co-activation during straight walking and its relation to kinematics: Insight from young, elderly and Parkinson's disease

“…Afterwards, and in order to modulate gait velocity, cadence and step length, subjects were asked to walk matching their steps to a metronome, which was set at different percentages of each subject's fast walking cadence (from 50 to 110% FWcadence; order of presentation was randomized). This procedure has been shown tomodulate gait patterns in advance PD without freezing, and in healthy controls (Arias and Cudeiro, 2008); a stimulation condition including a frequency matching PW cadence was also included.…”

“…Therefore these patients were asked to walk at their preferred un-stimulated cadence and also in the presence of a metronome 10 and 20% faster than the PW cadence. Having into account the previous data that shows that auditory stimulation matching PW cadence induces gait patterns with lower cadence tan un-stimulated PW cadence (Arias and Cudeiro, 2008), this condition was included in order to modulate cadence downwards. 12 of the healthy controls performed only this protocol in order to match controls for the different subsets of PD's protocols.…”

“…Subjects were asked to walk in synchrony to a metronome beat. This approach has been useful to modulate a whole range of velocities, step lengths, and step cadences in a previous study (Arias and Cudeiro, 2008).…”

Wireless Sensing System for Long-Time Assistance in the Parkinson’s Disease

“…For this reason, FoG is reported as the main cause of falls of PD patients. It has been demonstrated that a rhythmic sensory stimulation can release the involuntary block [2]. Therefore, a non-invasive wearable system able to provide a reliable detection of the FoG in any context, and timely give a sensorial stimulation would be extremely useful for reducing the catastrophic consequences of falls.…”