Fine motor skills in patients with Parkinsons disease: effect of auditory cueing

Background and purpose - Parkinson’s disease with cardinal feature of bradykinesia is a movement disorder. The effect of cueing in disorders like parkinsons patients ,stroke, spinal cord injury for improving motor skills and gait and lower limb functions have long been investigated by the Researchers, but there are dearth of studies evaluating the effect of cueing on fine motor skills in patients with parkinson’s disease. Hence this study tries to investigate the effect of auditory cueing on fine motor skills in Parkinson’s disease. Methodology - 25 diagnosed Parkinson’s patients having primary level of education, with mean age 72±5 yrs in Hoehn and Yahr stages 1 to 3 of disease and MMSE score above 24 were included in the study. Two groups were formed; one group performing activities with auditory cueing and other group performing activities without auditory cueing. Scores were calculated using Jebsen Taylor Hand Function Test. Results - Mean values of pre and post intervention timings on Jebsen Taylor Hand Function Test were calculated. Group with auditory cueing showed improvement in total sores of subtests of Jebsen Taylor Hand Function Test with mean and standard deviation (58.51±2.69) seconds in dominant hand and (54.59±2.43) seconds in non-dominant hand, whereas, Group without auditory cueing showed improvement in total sores of subtests of Jebsen Taylor Hand Function Test with mean and standard deviation of (13.39±2.07) seconds in dominant hand and (13.52±1.96) seconds in non-dominant hand. Conclusion- Auditory cueing is proved to be an effective method in improving fine motor skills in patients with Parkinsons disease.

Orienting Auditory Attention through Vision: the Impact of Monaural Listening

The understanding of linguistic messages can be made extremely complex by the simultaneous presence of interfering sounds, especially when they are also linguistic in nature. In two experiments, we tested if visual cues directing attention to spatial or temporal components of speech in noise can improve its identification. The hearing-in-noise task required identification of a five-digit sequence (target) embedded in a stream of time-reversed speech. Using a custom-built device located in front of the participant, we delivered visual cues to orient attention to the location of target sounds and/or their temporal window. In Exp. 1 (), we validated this visual-to-auditory cueing method in normal-hearing listeners, tested under typical binaural listening conditions. In Exp. 2 (), we assessed the efficacy of the same visual cues in normal-hearing listeners wearing a monaural ear plug, to study the effects of simulated monaural and conductive hearing loss on visual-to-auditory attention orienting. While Exp. 1 revealed a benefit of both spatial and temporal visual cues for hearing in noise, Exp. 2 showed that only the temporal visual cues remained effective during monaural listening. These findings indicate that when the acoustic experience is altered, visual-to-auditory attention orienting is more robust for temporal compared to spatial attributes of the auditory stimuli. These findings have implications for the relation between spatial and temporal attributes of sound objects, and when planning devices to orient audiovisual attention for subjects suffering from hearing loss.

The Role of Visual and Auditory Communication in the Performance of a Joint Team Task

Objective This study examines visual, auditory, and the combination of both (bimodal) coupling modes in the performance of a two-person perceptual-motor task, in which one person provides the perceptual inputs and the other the motor inputs. Background Parking a plane or landing a helicopter on a mountain top requires one person to provide motor inputs while another person provides perceptual inputs. Perceptual inputs are communicated either visually, auditorily, or through both cues. Methods One participant drove a remote-controlled car around an obstacle and through a target, while another participant provided auditory, visual, or bimodal cues for steering and acceleration. Difficulty was manipulated using target size. Performance (trial time, path variability), cue rate, and spatial ability were measured. Results Visual coupling outperformed auditory coupling. Bimodal performance was best in the most difficult task condition but also high in the easiest condition. Cue rate predicted performance in all coupling modes. Drivers with lower spatial ability required a faster auditory cue rate, whereas drivers with higher ability performed best with a lower rate. Conclusion Visual cues result in better performance when only one coupling mode is available. As predicted by multiple resource theory, when both cues are available, performance depends more on auditory cueing. In particular, drivers must be able to transform auditory cues into spatial actions. Application Spotters should be trained to provide an appropriate cue rate to match the spatial ability of the driver or pilot. Auditory cues can enhance visual communication when the interpersonal task is visual with spatial outputs.

Effects of Simultaneous Cognitive Task on Gait Event Accuracy with Auditory Stimuli: Comparison between Young Adults in Their 20s and the Elderly in their 70s

The purpose of this study was to compare the difference in the accuracy of gait events between young and older adults during metronomic walking by auditory cueing. Additionally, age-specific changes in the gait event accuracy according to additional simultaneous cognitive tasks were examined. The time interval (or temporal error) between the auditory cue (i.e., metronome) and the heel contact was used as the accuracy of the gait event. Fifteen young group (YG, 24.7 ± 0.8 years) and 14 elderly (EG, 78.4 ± 5.5 years) people participated in the experiment. The temporal errors under two gait conditions (MET: walking with metronome; MET + BC: walking with metronome while counting backward) were compared for each group. The results revealed that all the temporal errors of EG were significantly greater than those of YG. While the addition of simultaneous cognitive tasks resulted in a significant increase in temporal error in both age groups, the coefficient of variation (CV) of the temporal error significantly increased only in the EG group. In other words, although heel contact accuracy with auditory stimuli was affected by the simultaneous cognitive task in both groups, it was demonstrated that the variability of the error in the young adults remained constant. Therefore, the time error measurement used in this study has the potential to be used as a tool to judge the gait instability of the elderly compared with young adults.

Rhythm and Reaching: The Influence of Rhythmic Auditory Cueing in a Goal-Directed Reaching Task With Adults Diagnosed With Cerebral Palsy

Improvements in functional reaching directly support improvements in independence. The addition of auditory inputs (e.g., music, rhythmic counting) may improve goal-directed reaching for individuals with cerebral palsy (CP). To effectively integrate auditory stimuli into adapted teaching and rehabilitation protocols, it is necessary to understand how auditory stimuli may enhance limb control. This study considered the influence of auditory stimuli during the planning or execution phases of goal-directed reaches. Adults (with CP = 10, without CP = 10) reached from a home switch to two targets. Three conditions were presented—no sound, sound before, and sound during—and three-dimensional movement trajectories were recorded. Reaction times were shorter for both groups in the sound before condition, while the group with CP also reached peak velocity relatively earlier in the sound before condition. The group with CP executed more consistent movements in both sound conditions. Sound presented before movement initiation improved both the planning and execution of reaching movements for adults with CP.

Dissonance in Music Impairs Spatial Gait Parameters in Patients with Parkinson’s Disease

Background: It is known that music influences gait parameters in Parkinson’s disease (PD). However, it remains unclear whether this effect is merely due to temporal aspects of music (rhythm and tempo) or other musical parameters. Objective: To examine the influence of pleasant and unpleasant music on spatiotemporal gait parameters in PD, while controlling for rhythmic aspects of the musical signal. Methods: We measured spatiotemporal gait parameters of 18 patients suffering from mild PD (50%men, mean±SD age of 64±6 years; mean disease duration of 6±5 years; mean Unified PD Rating scale [UPDRS] motor score of 15±7) who listened to eight different pieces of music. Music pieces varied in harmonic consonance/dissonance to create the experience of pleasant/unpleasant feelings. To measure gait parameters, we used an established analysis of spatiotemporal gait, which consists of a walkway containing pressure-receptive sensors (GAITRite®). Repeated measures analyses of variance were used to evaluate effects of auditory stimuli. In addition, linear regression was used to evaluate effects of valence on gait. Results: Sensory dissonance modulated spatiotemporal and spatial gait parameters, namely velocity and stride length, while temporal gait parameters (cadence, swing duration) were not affected. In contrast, valence in music as perceived by patients was not associated with gait parameters. Motor and musical abilities did not relevantly influence the modulation of gait by auditory stimuli. Conclusion: Our observations suggest that dissonant music negatively affects particularly spatial gait parameters in PD by yet unknown mechanisms, but putatively through increased cognitive interference reducing attention in auditory cueing.