Walking with Music Is a Safe and Viable Tool for Gait Training in
Parkinson's Disease: The Effect of a 13-Week Feasibility Study on
Single and Dual Task Walking

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Abstract

This study explored the viability and efficacy of integrating cadence-matched, salient music into a walking intervention for patients with Parkinson's disease (PD). Twenty-two people with PD were randomised to a control (CTRL, n = 11) or experimental (MUSIC, n = 11) group. MUSIC subjects walked with an individualised music playlist three times a week for the intervention period. Playlists were designed to meet subject's musical preferences. In addition, the tempo of the music closely matched (±10–15 bpm) the subject's preferred cadence. CTRL subjects continued with their regular activities during the intervention. The effects of training accompanied by “walking songs” were evaluated using objective measures of gait score. The MUSIC group improved gait velocity, stride time, cadence, and motor symptom severity following the intervention. This is the first study to demonstrate that music listening can be safely implemented amongst PD patients during home exercise.

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Most cited references 43

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A physical activity questionnaire for the elderly.

L. Voorrips, A C J Ravelli, P Dongelmans … (1991)

A validated physical activity questionnaire for young adults was adapted and validated for use in free living, apparently healthy people, aged 63-80 yr. Test-retest reliability of the questionnaire on 29 participants was 0.89 as determined by Spearman's correlation coefficient. Further classification by tertiles of activity resulted in 72% of the participants being correctly classified and 0% grossly misclassified on two separate occasions. In a similar group of 31 subjects, classifications based on questionnaire activity scores were compared with classifications obtained by repeated 24-h activity recalls and pedometer measurements, showing Spearman's correlations of 0.78 and 0.73, for both methods, respectively. Seventy-one and 67% of the subjects, respectively, were classified in the same activity tertile for both methods. It is concluded that the questionnaire provides a reliable and valid method for classifying elderly subjects into categories of high, medium, and low physical activity.

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Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait.

Belinda Bilney, Meg Morris, Kate E. Webster (2003)

The GAITRite is a portable gait analysis tool for automated measurement of spatiotemporal gait parameters. Although frequently used for clinical and research purposes, the concurrent validity of GAITRite has not been validated against a criterion measure. The aim of this experiment was to investigate the concurrent validity and test retest reliability of the GAITRite carpet walkway system for quantification of spatial and temporal parameters of the footstep pattern. Twenty-five healthy adults aged 21-71 years (mean 40.5 years, S.D. 17.2) performed three walk trials at self-selected pace, three at fast pace and three at slow pace. For each trial, data were simultaneously collected from the GAITRite and a Clinical Stride Analyzer, which has established reliability and validity. At preferred, slow and fast walking pace there were very high correlations between the two measurement systems for gait speed (ICC (2,1)=0.99), stride length (ICC (2,1)=0.99) and cadence (ICC (2,1)=0.99). Correlations between the electronic carpet and the stride analyser were moderate to high for single limb support (SLS) time (ICC (2,1)=0.69-0.91) and weak for the proportion of the gait cycle spent in double limb support (ICC (2,1)=0.44-0.57). The reliability of repeated measures for the GAITRite was good at preferred and fast speed for speed (ICC (3,1)=0.93-0.94), cadence (ICC (3,1)=0.92-0.94), stride length (ICC (3,1)=0.97), single support (ICC (3,1)=0.85-0.93) and the proportion of the gait cycle spent in double limb support (ICC (3,1)=0.89-0.92). The repeatability of the GAITRite measures were more variable at slow speed (ICC (3,1)=0.76-0.91). These results indicate that the GAITRite system has strong concurrent validity and test retest reliability, in addition to being a portable, simple clinical tool for the objective assessment of gait.

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The pathogenesis of gait hypokinesia in Parkinson's disease.

M E Morris, R Iansek, T A Matyas … (1994)

To identify the fundamental deficit in gait hypokinesia in Parkinson's disease (PD) we conducted a series of experiments that compared PD subjects with age- and height-matched controls in their capacity to regulate either stride length, cadence (steps per minute) or both parameters to three conditions. In the first condition the spatial and temporal parameters of gait were documented for slow, normal and fast walking. The second condition compared parkinsonian gait with the walking pattern of elderly controls whilst controlling for two movement speeds: fast (control preferred) speed and slow (PD preferred) speed. In the third condition we examined the ability of PD subjects to regulate one parameter (e.g. stride length) when the other two parameters (e.g. velocity and cadence) were held at control values. A total of 34 PD subjects and 34 matched controls were tested using a footswitch stride analysis system that measured the spatial and temporal parameters of gait for a series of 10 m walking trials. Parkinsonian subjects exhibited marked gait hypokinesia in each of the experiments. Although they retained the capacity to vary their gait velocity in a similar manner to controls, their range of response was reduced. Within the lower velocity range, PD subjects could vary their speed of walking by adjusting cadence and, to a lesser extent, stride length. However, when the speed of walking was controlled, the stride length was found to be shorter and the cadence higher in PD subjects than in controls. Stride length could not be upgraded by internal control mechanisms in response to a fixed cadence set for age and height-matched velocity. In contrast, cadence was readily modulated by external cues and by internal control mechanisms when stride length was fixed to the values obtained for age- and height-matched controls. It was concluded that regulation of stride length is the fundamental problem in gait hypokinesia and the relative increase in cadence exhibited by PD subjects is a compensatory mechanism for the difficulty in regulating stride length. These findings are discussed in the context of the hypothesized role of the basal ganglia in generating internal cues for the maintenance of the gait sequence and in relation to the structuring of movement rehabilitation strategies.

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Author and article information

Journal

Journal ID (nlm-ta): Parkinsons Dis

Journal ID (publisher-id): PD

Title: Parkinson's Disease

Publisher: SAGE-Hindawi Access to Research

ISSN (Electronic): 2042-0080

Publication date Collection: 2010

Publication date (Electronic): 13 July 2010

Volume: 2010

Electronic Location Identifier: 483530

Affiliations

¹Department of Kinesiology, University of Lethbridge, 4401 University Drive, Lethbridge, AB, Canada T1K 3M4

²Faculty of Health Professions, Dalhousie University, Halifax, NS, Canada B3H 1R2

³Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1

⁴Department of Medical Genetics, University of Calgary, Calgary, AB, Canada T2N 4N1

Author notes

*Bin Hu: hub@ 123456ucalgary.ca and

*Lesley A. Brown: l.brown@ 123456uleth.ca

Academic Editor: Pablo Martinez-Martin

Article

DOI: 10.4061/2010/483530

PMC ID: 2957229

PubMed ID: 20976086

SO-VID: 6ee465a5-71ec-4ca8-a4f6-76de5abf071a

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 12 November 2009

Date revision received : 19 March 2010

Date accepted : 8 June 2010

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Walking with Music Is a Safe and Viable Tool for Gait Training in Parkinson's Disease: The Effect of a 13-Week Feasibility Study on Single and Dual Task Walking

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Most cited references 43

A physical activity questionnaire for the elderly.

Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait.

The pathogenesis of gait hypokinesia in Parkinson's disease.

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