Abstract

Previous studies have demonstrated that physical therapy accompanied by Rhythmic Auditory Stimulation (RAS) can improve the motor skills of patients with Parkinson’s disease and, in particular, their gait disturbances. In the present work we describe the neurological bases and perceptual-motor deficits generally associated with Parkinson’s disease, with a specific focus on gait disturbances. Within this framework, we review the role of auditory cueing in the modulation of patients’ gait, addressing this issue from the cognitive, neurological and biomechanical perspectives. In particular, we focus on the new frontiers of both assessment and intervention. With regards to the assessment, we describe the advantages of the three-dimensional quantitative multifactorial gait analysis. As concerns the intervention, we illustrate the potential impact of the administration of ecological footstep sounds as rhythmic cues.

Highlights

  • Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder whose symptoms consist of the gradual loss of motor and non-motor functions [1]

  • All the Gait Variable Score (GVS) values increased, with the exception of hip rotation and foot progression. Summarizing, these studies have shown that the Gait Profile Score (GPS)/GVS-based approach appears suitable in describing differences in gait patterns between individuals with PD and healthy subjects, and in assessing the effectiveness of pharmacologic/rehabilitative treatments or the alterations in gait associated with the effect of specific cognitive loads

  • Physical therapy accompanied by rhythmic auditory stimulation has been proven effective in improving gait patterns

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Summary

INTRODUCTION

Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder whose symptoms consist of the gradual loss of motor and non-motor functions [1]. Among the non-motor symptoms, previous studies report hyposmia (altered sense of smell), depression, cognitive decline, psychiatric and sleep disorders [2]. It appears that some non-motor symptoms may occur early in the course of the disease, even at a premotor stage [3, 4], contrary to previous beliefs that PD was solely a disorder of movement [1]. Among the aforementioned motor symptoms, gait disturbance probably represents the main impairment of PD patients. We illustrate the most recent and advanced approaches both for the quantitative assessment of gait in PD patients and for their gait modulation through the RAS method

Timing Mechanisms in PD
Effects of Rhythmic Auditory Stimulation on Motor Performance
Auditory Cues Versus Other Modalities
How Does Rhythmic Auditory Stimulation Work?
NEW APPROACHES FOR ASSESSMENT
Gait Kinematics in Individuals with PD
Summary of Measures of Gait Kinematics
Kinetics and Muscular Activation
Gait Analysis as a Tool to Verify the Effectiveness of the RAS Approach
NEW APPROACHES FOR INTERVENTION
Neurophysiological Bases
Theoretical Bases
Empirical Evidence in Perceptual and Motor Studies
Empirical Evidence on Parkinson
CONCLUSION
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