Model-based cueing-as-needed for walking in Parkinson's disease: A randomized cross-over study

Correcting of the lack of regularity in steps is a key component of gait rehabilitation in Parkinson's disease. We proposed to introduce adaptive spatial auditory cueing (ASAC) based on verbal instruction “lengthen the step” automatically delivered when the stride length decreased below a prede...

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Bibliographic Details
Published in:Revue neurologique 2024-10, Vol.180 (8), p.798-806
Main Authors: Hutin, E., Poirier, T., Meimoun, M., Mardale, V., Ghédira, M.
Format: Article
Language:English
Subjects:
Acoustic Stimulation - methods
Aged
Basal fanglia diseases
Cross-Over Studies
Cues
Exercise therapy
Exercise Therapy - methods
Female
Gait - physiology
Gait analysis
Gait Disorders, Neurologic - etiology
Gait Disorders, Neurologic - physiopathology
Gait Disorders, Neurologic - rehabilitation
Gait speed
Humans
Male
Middle Aged
Parkinson Disease - complications
Parkinson Disease - physiopathology
Parkinson Disease - rehabilitation
Walking - physiology
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Summary:Correcting of the lack of regularity in steps is a key component of gait rehabilitation in Parkinson's disease. We proposed to introduce adaptive spatial auditory cueing (ASAC) based on verbal instruction “lengthen the step” automatically delivered when the stride length decreased below a predetermined threshold. The present study compared the effect of usual rhythmic auditory cueing versus ASAC used during a walking training in Parkinson's disease. Fifteen patients with Parkinson's disease performed both interventions in randomized order, one week apart: a 20-minute walking training with rhythmic auditory cueing, in form of a metronome adjusted on 110% of the patient's own cadence, or ASAC delivered when the stride length is less than 110% of the patient's own stride length. Assessment criteria were walking distance covered during the intervention, speed, step length, cadence, coefficients of variation of step length and step duration, and indexes of spatial and temporal asymmetry during a walking test before and just after the intervention. The walking distance is higher with ASAC compared with rhythmic auditory cueing (rhythmic auditory cueing, 905 (203) m, mean (standard deviation); ASAC, 1043 (212) m; P=0.002). Between-intervention comparison showed some similar effects on walking after the intervention including free speed and step length increases (P
ISSN:0035-3787
DOI:10.1016/j.neurol.2024.05.003