Abstract
Gait abnormalities, such as shuffling steps, start hesitation, and freezing, are common and often incapacitating symptoms of Parkinson’s disease (PD) and other parkinsonian disorders. Pharmacological and surgical approaches have only limited efficacy in treating these gait disorders. Rhythmic auditory stimulation (RAS), such as playing marching music and dance therapy, has been shown to be a safe, inexpensive, and an effective method in improving gait in PD patients. However, RAS that adapts to patients’ movements may be more effective than rigid, fixed-tempo RAS used in most studies. In addition to auditory cueing, immersive virtual reality technologies that utilize interactive computer-generated systems through wearable devices are increasingly used for improving brain–body interaction and sensory–motor integration. Using multisensory cues, these therapies may be particularly suitable for the treatment of parkinsonian freezing and other gait disorders. In this review, we examine the affected neurological circuits underlying gait and temporal processing in PD patients and summarize the current studies demonstrating the effects of RAS on improving these gait deficits.
Highlights
Gait disorders, freezing of gait (FOG), are among the most disabling features of Parkinson’s disease (PD) [1]
Research has shown that music helps patients recover from stroke but may improve gait in patients with PD, and learning to play a musical instrument may induce neuroplastic changes that may translate into improved motor and cognitive function [7]
Several studies have shown that FOG in patients with PD correlates with poor quality of life, disease severity, apathy, and exposure to anticholinergic drugs; it may, but not always, improve with DA therapy [49]
Summary
Freezing of gait (FOG), are among the most disabling features of Parkinson’s disease (PD) [1]. Research has shown that music helps patients recover from stroke but may improve gait in patients with PD, and learning to play a musical instrument may induce neuroplastic changes that may translate into improved motor and cognitive function [7]. Humans’ natural musical rhythmic preferences may have been influenced by their natural spontaneous gait rhythm This powerful connection between rhythm and locomotion has led rhythmic entrainment to be clinically employed for gait rehabilitation in patients with neurological disorders including stroke, traumatic brain injury, cerebral palsy, and PD [7, 19]. Several studies have shown that FOG in patients with PD correlates with poor quality of life, disease severity, apathy, and exposure to anticholinergic drugs; it may, but not always, improve with DA therapy [49]
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