Current Evidence for Rhythmic Cueing and its Effects on Walking Ability in Individuals With Parkinson's Disease

Abstract

<h3>Objective(s)</h3> To summarize the current evidence of rhythmic cueing (RC) and its effects on walking in Parkinson's disease (PD) to help guide clinicians in clinical application. <h3>Data Sources</h3> PubMed and GoogleScholar were searched using "Parkinson's Disease", "cueing", and "movement" MeSH terms. The search was filtered to include full-text articles from the last 10 years and to exclude articles not in English or done in animals. <h3>Study Selection</h3> Inclusion criteria: idiopathic PD; investigated the effects of RC on walking, and described type and application of RC. Two researchers independently screened and extracted data, a third researcher was used for consensus. Initial search identified 371 articles, and 44 were included after full-text review. <h3>Data Extraction</h3> A data extraction table was used and once completed, was further categorized by type of RC (auditory only, visual only, tactile only, comparative). <h3>Data Synthesis</h3> All but 3/44 included studies reported improvements in spatiotemporal parameters and freezing of gait. Positive results were seen acrossed types of RC but primarily demonstrated when integrated into a weekly gait training or exercise program over time; cue rates set between -80% to +25% of a participant's baseline cadence, and when RC was salient to participants. <h3>Conclusions</h3> Cueing provides a well-established technique as an adaptive strategy that has been shown to improve freezing and spatiotemporal parameters of gait in PD when implemented through a variety of methods and types that should be individualized. Despite the reported effectiveness of RC found within this review, future studies should explore characteristics training dosage, transferability, and responsiveness based on one's learning style. <h3>Author(s) Disclosures</h3> No conflicts to declare