Individuals With Parkinson’s Disease Retain Spatiotemporal Gait Control With Music and Metronome Cues

in Motor Control
View More View Less
  • 1 The University of North Carolina at Chapel Hill
Restricted access

Purchase article

USD  $24.95

Student 1 year online subscription

USD  $77.00

1 year online subscription

USD  $103.00

Student 2 year online subscription

USD  $147.00

2 year online subscription

USD  $195.00

The purpose of this study was to determine the difference in spatiotemporal gait measures induced by stepping to the beat of a metronome and to music cues of various frequencies in individuals with Parkinson’s disease. Twenty-one participants with Parkinson’s disease were instructed to time their steps to a metronome and music cues (at 85%, 100%, and 115% of overground cadence). The authors calculated cadence, cadence accuracy, and step length during each cue condition and an uncued control condition. The music and metronome cues produced comparable results in cadence manipulation, with reduced cadence accuracy noted at slower intended frequencies. Nevertheless, the induced cadence elicited a concomitant alteration in step length. The music and metronome cues produced comparable changes to gait, but suggest that temporal control is more limited at slower frequencies, presumably by the challenge of increasing the step length.

Chawla, Hoppe, and Lewek are with the Division of Physical Therapy, Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Browner is with the Department of Neurology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Lewek (mlewek@med.unc.edu) is corresponding author.
  • Ashoori, A., Eagleman, D.M., & Jankovic, J. (2015). Effects of auditory rhythm and music on gait disturbances in Parkinson’s disease. Frontiers in Neurology, 6, 234. PubMed ID: 26617566 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Baltadjieva, R., Giladi, N., Gruendlinger, L., Peretz, C., & Hausdorff, J.M. (2006). Marked alterations in the gait timing and rhythmicity of patients with de novo Parkinson’s disease. European Journal of Neuroscience, 24(6), 18151820. PubMed ID: 17004944 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bella, S.D., Benoit, C.E., Farrugia, N., Keller, P.E., Obrig, H., Mainka, S., & Kotz, S.A. (2017). Gait improvement via rhythmic stimulation in Parkinson’s disease is linked to rhythmic skills. Scientific Reports, 7(1), 42005. PubMed ID: 28233776 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bello, O., Marquez, G., Camblor, M., & Fernandez-Del-Olmo, M. (2010). Mechanisms involved in treadmill walking improvements in Parkinson’s disease. Gait & Posture, 32(1), 118123. PubMed ID: 20452773 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Braunlich, K., Seger, C.A., Jentink, K.G., Buard, I., Kluger, B.M., & Thaut, M.H. (2019). Rhythmic auditory cues shape neural network recruitment in Parkinson’s disease during repetitive motor behavior. European Journal of Neuroscience, 49(6), 849858. PubMed ID: 30375083 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175191.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ford, M.P., Malone, L.A., Nyikos, I., Yelisetty, R., & Bickel, C.S. (2010). Gait training with progressive external auditory cueing in persons with Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 91(8), 12551261. PubMed ID: 20684907 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Frazzitta, G., Maestri, R., Uccellini, D., Bertotti, G., & Abelli, P. (2009). Rehabilitation treatment of gait in patients with Parkinson’s disease with freezing: A comparison between two physical therapy protocols using visual and auditory cues with or without treadmill training. Movement Disorders, 24(8), 11391143. PubMed ID: 19370729 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Frenkel-Toledo, S., Giladi, N., Peretz, C., Herman, T., Gruendlinger, L., & Hausdorff, J.M. (2005). Treadmill walking as an external pacemaker to improve gait rhythm and stability in Parkinson’s disease. Movement Disorders, 20(9), 11091114. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hoppe, M., Chawla, G., Browner, N., & Lewek, M.D. (2020). The effects of metronome frequency differentially affects gait on a treadmill and overground in people with Parkinson disease. Gait & Posture, 79, 4145. PubMed ID: 32344358 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Howe, T.E., Lövgreen, B., Cody, F.W., Ashton, V.J., & Oldham, J.A. (2003). Auditory cues can modify the gait of persons with early-stage Parkinson’s disease: A method for enhancing parkinsonian walking performance? Clinical Rehabilitation, 17(4), 363367. PubMed ID: 12785243 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kesar, T.M., Binder-Macleod, S.A., Hicks, G.E., & Reisman, D.S. (2011). Minimal detectable change for gait variables collected during treadmill walking in individuals post-stroke. Gait & Posture, 33(2), 314317. PubMed ID: 21183350 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Keus, S.H., Munneke, M., Nijkrake, M.J., Kwakkel, G., & Bloem, B.R. (2009). Physical therapy in Parkinson’s disease: Evolution and future challenges. Movement Disorders, 24(1), 114. PubMed ID: 18946880 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leow, L.A., Parrott, T., & Grahn, J.A. (2014). Individual differences in beat perception affect gait responses to low- and high-groove music. Frontiers in Human Neuroscience, 8, 811. PubMed ID: 25374521 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leow, L.-A., Rinchon, C., & Grahn, J. (2015). Familiarity with music increases walking speed in rhythmic auditory cuing. Annals of the New York Academy of Sciences, 1337, 5361. PubMed ID: 25773617 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lewek, M.D. (2011). The influence of body weight support on ankle mechanics during treadmill walking. Journal of Biomechanics, 44(1), 128133. PubMed ID: 20855074 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lohnes, C.A., & Earhart, G.M. (2011). The impact of attentional, auditory, and combined cues on walking during single and cognitive dual tasks in Parkinson disease. Gait & Posture, 33(3), 478483. PubMed ID: 21273075 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mazzoni, P., Hristova, A., & Krakauer, J.W. (2007). Why don’t we move faster? Parkinson’s disease, movement vigor, and implicit motivation. Journal of Neuroscience, 27(27), 71057116. PubMed ID: 17611263 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McIntosh, G.C., Brown, S.H., Rice, R.R., & Thaut, M.H. (1997). Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 62(1), 2226. PubMed ID: 9010395 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mendonça, C., Oliveira, M., Fontes, L., & Santos, J. (2014). The effect of instruction to synchronize over step frequency while walking with auditory cues on a treadmill. Human Movement Science, 33, 3342. PubMed ID: 24576706 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morris, M.E., Huxham, F., McGinley, J., Dodd, K., & Iansek, R. (2001). The biomechanics and motor control of gait in Parkinson disease. Clinical Biomechanics, 16(6), 459470. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morris, M.E., Iansek, R., Matyas, T.A., & Summers, J.J. (1994). The pathogenesis of gait hypokinesia in Parkinson’s disease. Brain, 117(5), 11691181. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morris, M.E., Iansek, R., Matyas, T.A., & Summers, J.J. (1996). Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanisms. Brain, 119(2), 551568. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Morris, M.E., Martin, C.L., & Schenkman, M.L. (2010). Striding out with Parkinson disease: Evidence-based physical therapy for gait disorders. Physical Therapy, 90(2), 280288. PubMed ID: 20022998 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Picelli, A., Camin, M., Tinazzi, M., Vangelista, A., Cosentino, A., Fiaschi, A., & Smania, N. (2010). Three-dimensional motion analysis of the effects of auditory cueing on gait pattern in patients with Parkinson’s disease: A preliminary investigation. Neurological Sciences, 31(4), 423430. PubMed ID: 20182896 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Postuma, R.B., Berg, D., Stern, M., Poewe, W., Olanow, C.W., Oertel, W., … Deuschl, G. (2015). MDS clinical diagnostic criteria for Parkinson’s disease. Movement Disorders, 30(12), 15911601. PubMed ID: 26474316 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rodger, M.W., & Craig, C.M. (2016). Beyond the metronome: Auditory events and music may afford more than just interval durations as gait cues in Parkinson’s disease. Frontiers in Neuroscience, 10, 272. PubMed ID: 27378841 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rose, D., Delevoye-Turrell, Y., Ott, L., Annett, L.E., & Lovatt, P.J. (2019). Music and metronomes differentially impact motor timing in people with and without Parkinson’s disease: Effects of slow, medium, and fast tempi on entrainment and synchronization performances in finger tapping, toe tapping, and stepping on the spot tasks. Parkinsons Disease, 2019, 6530838. PubMed ID: 31531220 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sherron, M.A., Stevenson, S.A., Browner, N.M., & Lewek, M.D. (2020). Targeted rhythmic auditory cueing during treadmill and overground gait for individuals with Parkinson disease: A case series. Journal of Neurologic Physical Therapy, 44, 268274. Advance online publication. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Spaulding, S.J., Barber, B., Colby, M., Cormack, B., Mick, T., & Jenkins, M.E. (2013). Cueing and gait improvement among people with Parkinson’s disease: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 94(3), 562570. PubMed ID: 23127307 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Suteerawattananon, M., Morris, G.S., Etnyre, B.R., Jankovic, J., & Protas, E.J. (2004). Effects of visual and auditory cues on gait in individuals with Parkinson’s disease. Journal of the Neurological Sciences, 219(1–2), 6369. PubMed ID: 15050439 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thaut, M.H., McIntosh, G.C., Rice, R.R., Miller, R.A., Rathbun, J., & Brault, J.M. (1996). Rhythmic auditory stimulation in gait training for Parkinson’s disease patients. Movement Disorders, 11(2), 193200. PubMed ID: 8684391 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Willems, A.M., Nieuwboer, A., Chavret, F., Desloovere, K., Dom, R., Rochester, L., … Van Wegen, E. (2006). The use of rhythmic auditory cues to influence gait in patients with Parkinson’s disease, the differential effect for freezers and non-freezers, an explorative study. Disability and Rehabilitation, 28(11), 721728. PubMed ID: 16809215 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wittwer, J.E., Webster, K.E., & Hill, K. (2013). Music and metronome cues produce different effects on gait spatiotemporal measures but not gait variability in healthy older adults. Gait & Posture, 37(2), 219222. PubMed ID: 22871238 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Wu, T., Hallett, M., & Chan, P. (2015). Motor automaticity in Parkinson’s disease. Neurobiology of Disease, 82, 226234. PubMed ID: 26102020 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 96 96 35
Full Text Views 0 0 0
PDF Downloads 0 0 0