TY - JOUR
T1 - The feasibility of singing to improve gait in Parkinson disease
AU - Harrison, Elinor C.
AU - McNeely, Marie E.
AU - Earhart, Gammon M.
N1 - Funding Information:
The authors thank Ryan Duncan, Martha Hessler, and Rich Nagel for assistance with data collection. This work was supported by NIHR01NS077959, the Program in Physical Therapy at Washington University, the Greater St. Louis Chapter of the American Parkinson Disease Association (APDA) and the APDA Center for Advanced Parkinson Disease Research at Washington University.
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single-session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD.
AB - Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single-session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD.
KW - Cueing
KW - Gait
KW - Music
KW - Parkinson disease
KW - Singing
UR - http://www.scopus.com/inward/record.url?scp=85013051082&partnerID=8YFLogxK
U2 - 10.1016/j.gaitpost.2017.02.008
DO - 10.1016/j.gaitpost.2017.02.008
M3 - Article
C2 - 28226309
AN - SCOPUS:85013051082
SN - 0966-6362
VL - 53
SP - 224
EP - 229
JO - Gait and Posture
JF - Gait and Posture
ER -