The Use of Rhythmic Auditory Stimulation on Gait Parameters in Parkinson’s Disease: A Systematic Review

Abstract

Introduction: Parkinson’s disease (PD) is a neurodegenerative disorder that commonly affects the basal ganglia dopaminergic signaling system, which can contribute to moderate-severe gait impairments in individuals. Many therapies have been proposed to mitigate this effect, however, there are often issues to consider such as the relative invasiveness of the procedure and other side effects. Rhythmic auditory stimulation (RAS) is a non-invasive therapeutic avenue with the potential to mitigate associated impairments in gait parameters. This review aims to evaluate the recent literature regarding the efficacy of this intervention in improving gait parameters in individuals with Parkinson’s disease. Methods: PubMed and OVID Medline databases were consulted to find nine randomized controlled trials (RCTs) written in the English language, published between 2012 and 2022 and subject to a strict inclusion criterion. Keywords included, but were not limited to, “Parkinson’s disease”, “rhythmic auditory stimulation”, and “gait”. Outcomes were critically analyzed, and their implications were evaluated in the context of existing research within this field. Results: Many of the studies showed a strong immediate improvement in several of the gait parameters, such as speed, stride length, cadence, balance, and falls, identified across a variety of RCT designs. However, many reviewed studies included a small sample size (n ≤ 30) and showed no significant outcomes in specific parameters, and several lacked an adequate follow-up period, limiting assessment of long-term efficacy. Discussion: The findings showed strong implications surrounding the use of rhythmic cues to prime the motor system to facilitate gait relearning and motor rehabilitation, at least in the short term. This method can be applied in future therapeutic avenues to address gait rehabilitation in a non-invasive manner. Conclusion: Existing literature demonstrates that RAS therapy is a promising method to incorporate into such therapeutic avenues; however, further research for the long-term efficacy of this approach is required.