title: Turning in Parkinson's disease patients and controls: the effect of auditory cues.
abstract: Turning is an impaired activity in persons with Parkinson's disease (PwPD). The current study examines the turning characteristics in PwPD (9 freezers and 10 nonfreezers) and 9 controls, and explores the effect of rhythmic auditory cues while turning. Turning parameters were collected from a 180 degrees left U-turn during a noncued and a cued condition, using a 3D measuring system. Auditory cues were supplied with a metronome at a rhythm equaling the subject's comfortable step frequency during straight line walking. Results showed that in contrast to controls, PwPD used a wider turning-arc and took smaller, narrower steps. In addition, they demonstrated a higher Coefficient of Variation (CV) of step duration (6.92%) compared to controls (4.88%, P < 0.05). The "wide-arc" turning strategy of PwPD was more prominent in freezers than in nonfreezers. Auditory cues reduced the CV of step duration in PwPD (both freezers and nonfreezers) during turning (from 6.92 to 6.00%, P < 0.05). In summary: Cueing reduced the gait-timing variability during turning, but PwPD maintained a wider arc to turn compared with controls.
authors.affiliation: Department of Rehabilitation Sciences of the Faculty of Rehabilitation Sciences and Physiotherapy, Katholieke Universiteit Leuven, Belgium. annemarie.willems@gmail.com
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Willems
authors.forename: Alice
authors.initials: A
authors.lastname: Nieuwboer
authors.forename: Fabienne
authors.initials: F
authors.lastname: Chavret
authors.forename: Kaat
authors.initials: K
authors.lastname: Desloovere
authors.forename: René
authors.initials: R
authors.lastname: Dom
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
authors.forename: Erwin
authors.initials: E
authors.lastname: van Wegen
authors.forename: Diana
authors.initials: D
authors.lastname: Jones
mesh_terms: D000161:Acoustic Stimulation; D000368:Aged; D003463:Cues; D020820:Dyskinesias / Q000175:diagnosis / Q000534:rehabilitation; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009949:Orientation; D010300:Parkinson Disease / Q000175:diagnosis / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011214:Practice, Psychological; D013998:Time Perception; D016138:Walking