title: The effect of external rhythmic cues (auditory and visual) on walking during a functional task in homes of people with Parkinson's disease.
abstract: OBJECTIVE
  To evaluate (1) the influence of rhythmic cues on gait interference during a functional activity and (2) the relationship of clinical symptoms to gait interference.
  
  
  METHODS
  Repeated-measures study.
  
  
  METHODS
  Participants' homes.
  
  
  METHODS
  Twenty subjects with idiopathic Parkinson's disease (PD) and a control group of 10 age-, sex-, and education-matched subjects.
  
  
  METHODS
  Subjects performed a simple functional task that included a walking component and a dual-motor task. The functional task was performed with and without external rhythmic (auditory and visual) cues.
  
  
  METHODS
  Walking speed, mean step length, and step frequency were compared during trials of the tasks. In addition, tests of cognitive executive function (Hayling and Brixton tests), anxiety and depression (Hospital Anxiety and Depression Scale), and fatigue (Multidimensional Fatigue Inventory) were undertaken.
  
  
  RESULTS
  The use of auditory cues during a dual task involving gait reduced the interference effect on the task; significant increases in step length were observed in PD subjects ( P =.018), representing an increase of 19%.
  
  
  CONCLUSIONS
  External auditory cues may be useful in reducing interference and maintaining gait performance during more complicated functional activities. Clinical symptoms, such as depression and fatigue, could influence the ability to focus attention and may increase gait interference during the performance of complex tasks, with subsequent implications for functional walking and safety.
authors.affiliation: Northumbria University, Newcastle, UK. Lynn.Rochester@northumbria.ac.uk
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
authors.forename: Victoria
authors.initials: V
authors.lastname: Hetherington
authors.forename: Diana
authors.initials: D
authors.lastname: Jones
authors.forename: Alice
authors.initials: A
authors.lastname: Nieuwboer
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Willems
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
authors.forename: Erwin
authors.initials: E
authors.lastname: Van Wegen
mesh_terms: D000368:Aged; D001007:Anxiety / Q000503:physiopathology; D001307:Auditory Perception; D003463:Cues; D003863:Depression / Q000503:physiopathology; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology* / Q000534:rehabilitation; D014796:Visual Perception; D016138:Walking / Q000502:physiology*