title: Auditory cues can modify the gait of persons with early-stage Parkinson's disease: a method for enhancing parkinsonian walking performance?
abstract: OBJECTIVE
  To investigate whether systematically adjusting the rate of auditory cues induces corresponding modulations of the temporal and spatial parameters of gait of patients with early-stage Parkinson's disease.
  
  
  METHODS
  Subjects performed a series of 15 9-metre walks along a level floor under uncued and four cued conditions; the order of cued conditions was randomized.
  
  
  METHODS
  A physiotherapy gymnasium, Manchester, UK.
  
  
  METHODS
  Eleven subjects with early-stage idiopathic Parkinson's disease.
  
  
  METHODS
  Preferred pace was established from the initial three uncued walks. The rate of auditory cues delivered throughout subsequent walks was systematically adjusted for each subject, representing 85, 92.5, 107.5 and 115% of their mean cadence at preferred walking pace.
  
  
  METHODS
  Mean cadence, mean stride length and mean velocity.
  
  
  RESULTS
  Repeated measures ANOVA indicated that the mean velocity and mean cadence of subjects' gait significantly (p < or = 0.01) increased relative to baseline values at cue rates of 115 and 107.5% of cadence at preferred pace and decreased at cue rate of 85%. Mean stride length was unaffected by variations in cue rate.
  
  
  CONCLUSIONS
  The rate of auditory cues, within the range tested, can modulate cadence and thus velocity of gait of subjects with early-stage Parkinson's disease. The provision of auditory cues provides a potential strategy for enhancing walking performance in these patients.
authors.affiliation: Rehabilitation Research Unit, Postgraduate Institute, School of Health and Social Care, University of Teesside, Middlesbrough, Tees Valley TS1 3BA, UK. tracey.howe@tees.ac.uk
authors.forename: T E
authors.initials: TE
authors.lastname: Howe
authors.forename: B
authors.initials: B
authors.lastname: Lövgreen
authors.forename: F W J
authors.initials: FW
authors.lastname: Cody
authors.forename: V J
authors.initials: VJ
authors.lastname: Ashton
authors.forename: J A
authors.initials: JA
authors.lastname: Oldham
mesh_terms: D000328:Adult; D000368:Aged; D001307:Auditory Perception; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016138:Walking