Gait Responses in People with Parkinson Disease During Autonomous Closed-loop Rhythmic Auditory Stimulation: An...

Area of Science:

• Neuroscience
• Biomedical Engineering
• Rehabilitation Science

Background:

• Closed-loop rhythmic auditory stimulation (RAS) offers potential for enhancing gait quality in Parkinson disease (PD).
• Understanding auditory-motor entrainment and gait responses to tempo changes is crucial for optimizing RAS interventions.
• Community-based walking interventions using RAS warrant investigation for their effects on gait parameters.

Purpose of the Study:

• To assess auditory-motor entrainment and spatiotemporal gait responses to controlled rhythm tempo increases.
• To evaluate these responses before and after a community-based RAS walking intervention in individuals with PD.
• To determine if the closed-loop RAS system promotes implicit motor learning and improves gait rhythmicity.

Main Methods:

• Thirteen individuals with PD participated in 30 sessions using an autonomous closed-loop RAS system.
• Gait responses to tempo increases were measured at baseline (BL) and post-intervention (POST) in a clinic hallway.
• Key metrics included rhythm tempo, entrainment, cadence, stride length, gait speed, and stride time variability (STV).

Main Results:

• Participants demonstrated entrainment to rhythmic cues and increased cadence and stride length with tempo increases during both BL and POST assessments.
• Significant increases in gait speed were observed only in the POST assessment.
• Nearly 70% of participants exhibited significantly lower STV post-intervention, indicating improved gait rhythmicity, which correlated with increased stride length.

Conclusions:

• Autonomous closed-loop RAS systems can effectively induce entrainment and elicit meaningful gait responses to tempo changes in people with PD.
• The RAS system appears to facilitate implicit motor learning, leading to potential improvements in gait rhythmicity and stride length.
• Post-intervention improvements suggest that RAS may offer benefits for fall prevention in individuals with Parkinson disease.