Effects of cadence-compatible melodic rhythmic auditory stimulation implementation on gait in patients with Parkinson’s disease

Abstract

Purpose Progressive loss of dopaminergic neurons in basal ganglia is blamed as the main source of gait disturbance in Parkinson's disease (PD). It is known that the normal step pattern does not disappear in PD, but there is a problem in activating the correct step response. The aim of this study was to investigate the effect of Rhythmic Auditory Stimulation (RAS), which is an external stimulus, on gait in individuals with PD. Materials and methods Twenty-six individuals, 13 in the PD group and 13 in the control group, participated in the study. All individuals were asked to walk under four different RAS conditions configured with beat frequency and melodic variations. Time–distance parameters and gait performance of the individuals were evaluated. Results RAS significantly increased the gait speed of the individuals with PD compared to the control group. RAS set to 10% increase in the cadence of the patient with melody (10 M+) was found to be more effective than the RAS set to normal cadence of the patient without melody (0 M-) (p < 0.05). While all RAS implementations increased the stride length of the individuals with PD (p < 0.05), there was no change in the control group. RAS did not affect the return time in both groups. Conclusions Our study has shown that RAS implementation improves gait in individuals with PD both in terms of time–distance parameters and performance, especially when set to 10% more than the patient's gait cadence. It was concluded that cadence-compatible melodic RAS can be safely included in PD rehabilitation programs.