Abstract
Objectives: To understand the benefits and feasibility of using supervised, home-based, music-cued training to improve gait speed and stability in community-dwelling people with Progressive Supranuclear Palsy.Design: Feasibility trial incorporating a single group repeated-measures design.Setting: Human movement laboratory and participants' homes.Interventions:Two training sessions per week, conducted by experienced physiotherapists over 4 weeks. Each home training session consisted of a range of activities in standing or walking, with, and without auditory cues. Rhythmic auditory cues were played via a portable digital music player and consisted of metronome beats and individually chosen, commercially available rhythmic music tracks.Main Outcome Measures: Spatiotemporal gait measures were recorded using an 8 m long GAITRite® mat. Participants walked without cues at self-selected comfortable pace. The Progressive Supranuclear Palsy and Unified Parkinson's Disease Rating Scales were administered at baseline. Addenbrooke's Cognitive Examination-III, Geriatric Depression Scale, Assessment of Personal Music Preference Scale, and Physiological Profile Assessment were administered at baseline and retest.Results: At baseline, two of the five community-dwelling participants with Progressive Supranuclear Palsy walked with normal speed and low gait variability. Of the remainder who walked with slower, more variable patterns, two walked faster at retest, one by a clinically meaningful amount. Four participants reduced their timing variability at retest and three reduced step length variability. All participants reported high satisfaction levels with the program.Conclusions: When delivered at home with the support of caregivers, music-cued gait training can provide a feasible approach to improving disorders of gait stability in people with this rare, degenerative condition. Movement to music is engaging and enjoyable which can facilitate adherence to therapy.Clinical Trial Registration : ANZCTR 12616000851460. http://www.anzctr.org.au/
Highlights
Progressive Supranuclear Palsy (PSP) is a debilitating and rare disease [1, 2]
As well as examining whether it was practical and feasible to deliver this intervention in the home setting, we examined whether gait variability, amplitude and timing improved with a supervised home program of music and metronome cued movements
Three were from the private caseload of a neurologist specializing in PSP management and two from a community physiotherapy program
Summary
Progressive Supranuclear Palsy (PSP) is a debilitating and rare disease [1, 2]. It has a reported prevalence of only five per 100,000 [3] or about 380,000 people worldwide, despite being the most frequently occurring form of atypical parkinsonism [1]. It is commonly misdiagnosed as Parkinson’s disease (PD) so this may be a conservative estimate [3]. Costs of care are significantly associated with symptom severity so interventions to improve mobility have the potential to reduce these costs [7]
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