Gait Training Methods and ChangesiIn Gait Parameters in Parkinson`s Disease (Literature Review)

Parkinson’s disease is a chronic progressive neurological disorder that can impact function to a variable degree. Changes in gait parameters are the most common signs of Parkinson’s disease. Patients with Parkinson’s disease walk with a reduced step length, step time, walking velocity and walking cadence, increased stride cycle time, coefficient of variation of the step amplitude and step time and increased risk to fall. So, various gait training methods are applied. The effect of rhythmic auditory stimulation on gait in Parkinson’s disease patients is analysed. We can use various kinds of music, metronome, scansion and clapping as a rhythmic auditory stimulation.One of gait training methods in Parkinson’s disease patients is treadmill training. There are attempts to combine treadmill training with transcranial magnetic stimulation and virtual reality. We can use Nordic walking method and because walking technique requires straight posture, trunk rotation, bigger step and heel stride. More often robot–assisted gait training is used in patients with Parkinson’s disease gait training. The effect of dual–tasking and walking with music methods for gait and balance training in patients with Parkinson’s disease is also analysed. This method requires participants to perform primary and secondary tasks at the same time. The secondary task can be cognitive or motor. Dual–tasking is widely analysed because opinions about applying this method are very controversial. Walking with music method is more often analysed in scientific literature. This method could not be compared to rhythmic auditory stimulation method because the latter requires precise walking to rhythm and walking with music method is oriented to emotional component (music is chosen according patients’ music taste). As these methods are applied, we can see an increase in chosen walking and maximal walking velocities, step length and time, distance covered, and decrease in the coefficient of variation of the step time and turning time.Keywords: Gait impairments, walking velocity, rhythmic auditory stimulation.

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Rhythmic auditory stimulation for reduction of falls in Parkinson’s disease: a randomized controlled study

Clinical Rehabilitation ◽

10.1177/0269215518788615 ◽

2018 ◽

Vol 33 (1) ◽

pp. 34-43 ◽

Cited By ~ 14

Author(s):

Michael H Thaut ◽

Ruth R Rice ◽

Thenille Braun Janzen ◽

Corene P Hurt-Thaut ◽

Gerald C McIntosh

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Fear Of Falling ◽

Gait Training ◽

Auditory Stimulation ◽

Controlled Study ◽

Control Group ◽

Home Based ◽

Gait Parameters ◽

Rhythmic Auditory Stimulation

Objective: To test whether rhythmic auditory stimulation (RAS) training reduces the number of falls in Parkinson’s disease patients with a history of frequent falls. Design: Randomized withdrawal study design. Subjects: A total of 60 participants (aged 62–82 years) diagnosed with idiopathic Parkinson’s disease (Hoehn and Yahr stages III or IV) with at least two falls in the past 12 months. Intervention: Participants were randomly allocated to two groups and completed 30 minutes of daily home-based gait training with metronome click–embedded music. The experimental group completed 24 weeks of RAS training, whereas the control group discontinued RAS training between weeks 8 and 16. Main measures: Changes in clinical and kinematic parameters were assessed at baseline, weeks 8, 16, and 24. Results: Both groups improved significantly at week 8. At week 16—after the control group had discontinued training—significant differences between groups emerged including a rise in the fall index for the control group ( M = 10, SD = 6). Resumption of training reduced the number of falls so that group differences were no longer significant at week 24 ( Mexperimental = 3, SD = 2.6; Mcontrol = 5, SD = 4.4; P > 0.05). Bilateral ankle dorsiflexion was significantly correlated with changes in gait, fear of falling, and the fall index, indicating ankle flexion as a potential kinematic mechanism RAS addresses to reduce falls. Conclusion: RAS training significantly reduced the number of falls in Parkinson’s disease and modified key gait parameters, such as velocity and stride length.

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A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease

Parkinson s Disease ◽

10.1155/2012/508720 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Quincy J. Almeida ◽

Haseel Bhatt

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Optic Flow ◽

Visual Cues ◽

Step Length ◽

Gait Training ◽

Control Group ◽

Training Interventions ◽

Visual Cueing ◽

Walking Velocity

Visual cues are known to improve gait in Parkinson's disease (PD); however, the contribution of optic flow continues to be disputed. This study manipulated transverse line cues during two gait training interventions (6 weeks). PD subjects (N=42) were assigned to one of three groups: treadmill (TG), overground (OG), or control group (CG). Participants walked across lines placed on either treadmills or 16-meter carpets, respectively. The treadmill (TG) offered a reduced dynamic flow from the environment, while lines presented on the ground (OG) emphasized optic flow related to the participant's own displacement. Both interventions significantly improved (and maintained through retention period) step length, thus improving walking velocity. Only the OG improved in the TUG test, while only the TG showed hints of improving (and maintaining) motor symptoms. Since gait improvements were found in both training groups, we conclude that by reducing optic flow, gait benefits associated with visual cueing training can still be achieved.

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Rhythmic auditory stimulation in gait training for Parkinson's disease patients

Movement Disorders ◽

10.1002/mds.870110213 ◽

1996 ◽

Vol 11 (2) ◽

pp. 193-200 ◽

Cited By ~ 430

Author(s):

M. H. Thaut ◽

G. C. McIntosh ◽

R. R. Rice ◽

R. A. Miller ◽

J. Rathbun ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Training ◽

Auditory Stimulation ◽

Rhythmic Auditory Stimulation

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A Case-Controlled Pilot Study on Rhythmic Auditory Stimulation-Assisted Gait Training and Conventional Physiotherapy in Patients With Parkinson's Disease Submitted to Deep Brain Stimulation

Frontiers in Neurology ◽

10.3389/fneur.2020.00794 ◽

2020 ◽

Vol 11 ◽

Cited By ~ 1

Author(s):

Antonino Naro ◽

Loris Pignolo ◽

Chiara Sorbera ◽

Desiree Latella ◽

Luana Billeri ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Pilot Study ◽

Brain Stimulation ◽

Gait Training ◽

Auditory Stimulation ◽

Rhythmic Auditory Stimulation ◽

Conventional Physiotherapy ◽

Deep Brain

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Electromyographical Gait Characteristics in Parkinson’s Disease: Effects of Combined Physical Therapy and Rhythmic Auditory Stimulation

Frontiers in Neurology ◽

10.3389/fneur.2018.00211 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 12

Author(s):

Christopher A. Bailey ◽

Federica Corona ◽

Mauro Murgia ◽

Roberta Pili ◽

Massimiliano Pau ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Therapy ◽

Auditory Stimulation ◽

Gait Characteristics ◽

Rhythmic Auditory Stimulation

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Cognitive effects of rhythmic auditory stimulation in Parkinson’s disease: A P300 study

Brain Research ◽

10.1016/j.brainres.2018.05.016 ◽

2019 ◽

Vol 1716 ◽

pp. 70-79 ◽

Cited By ~ 3

Author(s):

Juan Lei ◽

Nadine Conradi ◽

Cornelius Abel ◽

Stefan Frisch ◽

Alla Brodski-Guerniero ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Auditory Stimulation ◽

Cognitive Effects ◽

Rhythmic Auditory Stimulation

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Rhythmic Auditory Stimulation and Gait Training in Traumatic Brain Injury: A Pilot Study

Journal of Music Therapy ◽

10.1093/jmt/thaa016 ◽

2020 ◽

Author(s):

Sarah Thompson ◽

Kaitlin Hays ◽

Alan Weintraub ◽

Jessica M Ketchum ◽

Robert G Kowalski

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Pilot Study ◽

High Risk ◽

Control Period ◽

Gait Training ◽

Auditory Stimulation ◽

Gait Parameters ◽

Rhythmic Auditory Stimulation ◽

Functional Gait

Abstract Rhythmic auditory stimulation (RAS) has been well researched with stroke survivors and individuals who have Parkinson’s disease, but little research exists on RAS with people who have experienced traumatic brain injury (TBI). This pilot study aimed to (1) assess the feasibility of the study design and (2) explore potential benefits. This single-arm clinical trial included 10 participants who had a 2-week control period between baseline and pretreatment. Participants had RAS daily for a 2-week treatment period and immediately completed post-treatment assessments. Participants then had a 1-week control period and completed follow-up assessment. The starting cadence was evaluated each day of the intervention period due to the variation in daily functioning in this population. All 10 participants were 1–20 years post-TBI with notable deviations in spatial-temporal aspects of gait including decreased velocity, step symmetry, and cadence. All participants had a high risk of falling as defined by achieving less than 22 on the Functional Gait Assessment (FGA). The outcome measures included the 10-m walk test, spatial and temporal gait parameters, FGA, and Physical Activity Enjoyment Scale. There were no adverse events during the study and gait parameters improved. After the intervention, half of the participants achieved a score of more than 22 on the FGA, indicating that they were no longer at high risk of experiencing falls.

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