title: Effects of external cues on gait parameters of Parkinson's disease patients: a systematic review.
abstract: OBJECTIVE
  A systematic review to evaluate the benefits of external cues on the gait of PD patients and their impact on the quality of life, freezing and psychomotor performance was performed. The types of cues that could lead to more significant gains were analyzed.
  
  
  METHODS
  We searched for randomized clinical trials (RCTs) and quasi-randomized clinical trial (QRCTs) that assessed the influence of different external cues on gait, freezing, quality of life and psychomotor performance.
  
  
  RESULTS
  Of 259 articles collected, seven (six RCTs and one QRCT) were included in the methodological quality criteria (two consider visual cues, two consider auditory cues, one considers verbal instructions, one considers combined cues and one considers sensory cues). All of the data regarding the methodology, interventions, population and bias were described. Cues generally led to a statistically significant improvement in the step and stride length, speed of gait, cadence and UPDRS. None of these studies assessed the quality of life, and one study analyzed freezing.
  
  
  CONCLUSIONS
  Our review could show that external cues are effective for improving the gait parameters and psychomotor performance of PD patients. We need more studies to verify if the impact of this type of treatment could improve the quality of life of patients with PD.
authors.affiliation: Universidade Federal de São Paulo/Escola Paulista de Medicina-UNIFESP/EPM, Urgency Medicine and Medicine based in Evidence, São Paulo, SP, Brazil. Electronic address: prialves_fisio@yahoo.com.br.
authors.forename: Priscila A
authors.initials: PA
authors.lastname: Rocha
authors.affiliation: Universidade Federal de São Paulo/Escola Paulista de Medicina-UNIFESP/EPM, Urgency Medicine and Medicine based in Evidence, São Paulo, SP, Brazil.
authors.forename: Gustavo M
authors.initials: GM
authors.lastname: Porfírio
authors.affiliation: Universidade Federal de São Paulo/Escola Paulista de Medicina-UNIFESP/EPM, Neurology, São Paulo, SP, Brazil.
authors.forename: Henrique B
authors.initials: HB
authors.lastname: Ferraz
authors.affiliation: Universidade Federal de São Paulo/Escola Paulista de Medicina-UNIFESP/EPM, Urgency Medicine and Medicine based in Evidence, São Paulo, SP, Brazil.
authors.forename: Virginia F M
authors.initials: VF
authors.lastname: Trevisani
mesh_terms: D003463:Cues; D005684:Gait / Q000502:physiology*; D006801:Humans; D010300:Parkinson Disease / Q000534:rehabilitation*; D011597:Psychomotor Performance / Q000502:physiology*
keywords: Cues; Gait; Parkinson's disease; Rehabilitation; Systematic review