Autocorrelated Rhythmic Auditory Stimulations as the best way to use a metronome for Parkinson’s Disease patients: a prospective cohort study
(2018) Belgian Society for NeuroRehabilitation (BSNR) — Location: Leuven (17.November.2018)
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- Background : Parkinson’s Disease (PD) patients suffer from gait impairments responsible for falls: reduced speed and stride length and deterioration of stride duration variability. Previous studies on isochronic Rhytmic Auditory Stimulation (RAS) showed good effects on speed and stride length but deleterious effects on stride duration variability. The aim of this study is to compare between 3 different RAS (isochronic, random and autocorrelated) on PD patients’ gait parameters and stride duration variability. Methods : Nine PD patients (Hoehn & Yahr stage 1-3) performed 4 x 10 min overground walking. Each session corresponded to a specific condition: Spontaneous Condition (SC), Isochronic RAS (IC), Random RAS (RC) and Autocorrelated RAS (AC). Unidimensional accelerometers were used to measure ankle movements on 512 consecutive gait cycles. Based on these data and using a software, gait parameters were assessed: gait speed, cadence, step length, temporal organization (i.e. Long-Range Autocorrelations; LRA) and magnitude (i.e. coefficient of variation; CV) of stride duration variability. LRA were assessed using the Rescaled Range Analysis (Hurst exponent) and the Power Spectral Density (α exponent). A one-way repeated measures ANOVA was applied to determine the effect of the various RAS on spatiotemporal gait parameters and on stride duration variability. Results : Spatiotemporal parameters and CV were not modified by the RAS. LRA were present in all patients during SC. On contrary, all RAS altered the LRA. Compared to the exponents assessed during SC, H and α exponents were significantly lower during IC and RC. H during AC was decreased and reached a slight significant difference with that of SC (p=0.036) but α didn’t. H and α during AC were the highest between all RAS conditions. Conclusions : LRA are broken during the IC. On the contrary, the use of autocorrelated RAS (AC) allows to maintain an acceptable level of LRA for PD patients’ gait stability. The autocorrelated RAS would therefore possibly be the best way to apply auditory cueing to PD patients compared to the other RAS conditions but this must be confirmed by future longitudinal studies.
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Lheureux, A., Warlop, T., Detrembleur, C., Jeanjean, A., & Lejeune, T. (2018). Autocorrelated Rhythmic Auditory Stimulations as the best way to use a metronome for Parkinson’s Disease patients: a prospective cohort study. Belgian Society for NeuroRehabilitation (BSNR), Leuven. https://hdl.handle.net/2078.5/52137