Effects of Cueing Training on Gait Variability

Self-generated cueing is considered a promising approach to improve gait stability. This study examines whether rhythm training enhances cueing performance by influencing rhythm perception and gait variability in young healthy participants as a preliminary step before applying it to patients with Parkinson's disease (PD). Fifteen healthy participants (7 males, 8 females; age 22.0 ± 2.6 years, height 163.1 ± 9.6 cm, weight 55.9 ± 8.3 kg) completed the 10-minute rhythm training, synchronizing button taps with a metronome at their individual cadence-based beats per minute (BPM) while receiving visual feedback. Rhythm and gait were assessed pre- and post-training to evaluate changes in each parameter and variability. No significant changes were observed in BPM or rhythm variability. However, the cadence-BPM difference significantly decreased (p = 0.006) with a moderate effect size (g = 0.592). In gait evaluation, cadence significantly decreased, and right step time significantly increased, both with small effect sizes. No significant changes were found in gait variability. A significant negative correlation was observed between the cadence-BPM difference and variability in right step time (p = 0.001, r = -0.749) and left stance time (p = 0.006, r = -0.676). Rhythm training improved synchronization between internal rhythm and walking cadence but did not reduce gait variability. The negative correlation between cadence-BPM difference and gait variability suggests enhanced rhythm synchronization may increase cognitive load, potentially worsening certain gait variability factors. Future research should explore these effects in patients with PD and determine optimal timing for self-generated cueing to maintain stable gait.