Abstract
Parkinson’s Disease patients suffer from gait impairments such as reduced gait speed, shortened step length, and deterioration of the temporal organization of stride duration variability (i.e., breakdown in Long-Range Autocorrelations). The aim of this study was to compare the effects on Parkinson’s Disease patients’ gait of three Rhythmic Auditory Stimulations (RAS), each structured with a different rhythm variability (isochronous, random, and autocorrelated). Nine Parkinson’s Disease patients performed four walking conditions of 10–15 min each: Control Condition (CC), Isochronous RAS (IRAS), Random RAS (RRAS), and Autocorrelated RAS (ARAS). Accelerometers were used to assess gait speed, cadence, step length, temporal organization (i.e., Long-Range Autocorrelations computation), and magnitude (i.e., coefficient of variation) of stride duration variability on 512 gait cycles. Long-Range Autocorrelations were assessed using the evenly spaced averaged Detrended Fluctuation Analysis (α-DFA exponent). Spatiotemporal gait parameters and coefficient of variation were not modified by the RAS. Long-Range Autocorrelations were present in all patients during CC and ARAS although all RAS conditions altered them. The α-DFA exponents were significantly lower during IRAS and RRAS than during CC, exhibiting anti-correlations during IRAS in seven patients. α-DFA during ARAS was the closest to the α-DFA during CC and within normative data of healthy subjects. In conclusion, Isochronous RAS modify patients’ Long-Range Autocorrelations and the use of Autocorrelated RAS allows to maintain an acceptable level of Long-Range Autocorrelations for Parkinson’s Disease patients’ gait.
Highlights
Several physiological signals, apparently randomly organized, are governed by dynamic phenomena organized between order and disorder (Goldberger et al, 2002; Hu et al, 2004)
No significant difference was found between each condition for gait speed [F(3, 8): 1.427; p = 0.260], gait cadence [F(3, 8): 0.709; p = 0.556], step length [F(3, 8): 1.224; p = 0.323], and mean stride duration [F(3, 8): 0.674; p = 0.577] (Table 2)
This study investigated the extent to which auditory stimuli with different temporal organizations could influence Parkinson’s Disease (PD) gait
Summary
Apparently randomly organized, are governed by dynamic phenomena organized between order and disorder (Goldberger et al, 2002; Hu et al, 2004) This complex self-organization is the result of multiple interactions between different elements of the system (Delignieres and Marmelat, 2012; Stergiou, 2016). Such complexity of organization is visible in the study of the temporal organization of human gait (Hausdorff et al, 2001; Ivanov et al, 2009; Stergiou and Decker, 2011). Some authors have suggested that LRA are markers of healthy stable but still adaptive gait and a breakdown of LRA would be a sign of gait disorders and loss of adaptability as suggested in Parkinson’s Disease (PD) (Goldberger et al, 2002; Stergiou and Decker, 2011; Cavanaugh et al, 2017)
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