A Training Approach to Improve Stepping Automaticity While Dual-tasking in Parkinson's Disease: A Prospective Pilot Study

Journal

Medicine (Baltimore)

Year

2017

Abstract

BACKGROUND: Deficits in motor movement automaticity in Parkinson's disease (PD), especially during multitasking, are early and consistent hallmarks of cognitive function decline, which increases fall risk and reduces quality of life. This study aimed to test the feasibility and potential efficacy of a wearable sensor-enabled technological platform designed for an in-home music-contingent stepping-in-place (SIP) training program to improve step automaticity during dual-tasking (DT). METHODS: This was a 4-week prospective intervention pilot study. The intervention uses a sensor system and algorithm that runs off the iPod Touch which calculates step height (SH) in real-time. These measurements were then used to trigger auditory (treatment group, music; control group, radio podcast) playback in real-time through wireless headphones upon maintenance of repeated large amplitude stepping. With small steps or shuffling, auditory playback stops, thus allowing participants to use anticipatory motor control to regain positive feedback. Eleven participants were recruited from an ongoing trial (Trial Number: ISRCTN06023392). Fear of falling (FES-I), general cognitive functioning (MoCA), self-reported freezing of gait (FOG-Q), and DT step automaticity were evaluated. RESULTS: While we found no significant effect of training on FES-I, MoCA, or FOG-Q, we did observe a significant group (music vs podcast) by training interaction in DT step automaticity (P<0.01). CONCLUSION: Wearable device technology can be used to enable musically-contingent SIP training to increase motor automaticity for people living with PD. The training approach described here can be implemented at home to meet the growing demand for self-management of symptoms by patients.

Music and Health Institute Terms

Cognitive Abilities; Gait; Mobility; Music Medicine; Neurodegenerative Disorders; Parkinson's Disease; Subjective Measures; Positive Verbalizations

Indexed Terms

Attention; Walking; Elderly; Prospective Studies; Pilot Projects; Physical Therapy Modalities; Psychomotor Performance; Algorithms; Parkinson Disease; Smartphone

Study Type

Quasi-Experimental Study; Quantitative Methods

Document Type

Article

More Info

Share

COinS