Music therapy in parkinson's disease: Improvement of parkinsonian gait and depression with rhythmic auditory stimulation

Abstract

The effect of rhythmic auditory stimulation without gait training on parkinsonian gait was studied. The subjects included 25 outpatients with idiopathic Parkinson's disease and gait disturbance. The patient's task was simply to listen to rhythmic auditory stimulation (2 Hz) embedded in familiar styles of music at home, without gait training, for at least 1 h a day for 3–4 weeks. Following completion of the task, patients’ gait speed and stride length significantly improved ( p<0.0001, <0.001, respectively). The step cadence was not significantly changed, however, there was a tendency for the cadence rhythm below 2 Hz to approach the rhythm of auditory stimulation. The self-rating depression scale also significantly improved ( p<0.05). The self-assessment of patients regarding several symptoms after the task was also described. In conclusion, our study indicates that music embedded by rhythmic auditory stimulation without gait training is highly effective in treating gait disturbance and depression associated with Parkinson's disease. With regard to the mechanism by which rhythmic auditory stimulation improves the performance of such movements, in the absence of gait training, external stimulation may have enabled parkinsonian patients to reproduce the internal rhythmic generation of gait, thereby, allowing them to walk faster and more smoothly.