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Duppen CP, Sachdeva N, Wrona H, Dayan E, Browner N, Lewek MD. Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease. Exp Brain Res 2024:10.1007/s00221-024-06933-5. [PMID: 39361030 DOI: 10.1007/s00221-024-06933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024]
Abstract
Rhythmic auditory cueing (RAC) using an isochronous metronome is an effective approach to immediately enhance spatiotemporal aspects of gait for people with Parkinson disease (PwPD). Whereas entraining to RAC typically occurs subconsciously via cerebellar pathways, the use of metronome frequencies that deviate from one's typical cadence, such as those used in rehabilitation, may require conscious awareness. This heightened awareness may increase cognitive load and limit the persistence of gait training gains. Here, we explore the immediate effects of incorporating an implicit motor learning approach (i.e., error-based recalibration) to gait training with RAC. Twenty older adults (10 with PD and 10 controls) were asked to match their footfalls to both isochronous and subtly varying metronomes while walking on a treadmill and overground. Our findings revealed intriguing differences between treadmill and overground walking. During treadmill walking to a slower metronome frequency, both groups reduced their cadence and increased step lengths, but did not make the necessary adjustments to match the subtly varying metronome. During overground walking, both groups modified their cadence in response to a 3-4% change in metronome frequency (p < 0.05). Both metronomes yielded evidence of implicit and explicit retention during overground and treadmill walking. Furthermore, during overground walking the PD group showed greater implicit retention of cadence changes following the varying metronome, compared to the isochronous metronome. Our results suggest that incorporating implicit motor learning approaches to gait training during a single session of overground walking may enhance short term implicit retention of gait behaviors for PwPD.
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Affiliation(s)
- Chelsea Parker Duppen
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nikhil Sachdeva
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hailey Wrona
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- NC and North Carolina State University, Raleigh, NC, USA
| | - Eran Dayan
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nina Browner
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael D Lewek
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Division of Physical Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Gao X, Zhang H, Fu X, Yang Y, Dou J. The effect of home-based exercise on motor and non-motor symptoms with Parkinson's disease patients: A systematic review and network meta-analysis. J Clin Nurs 2024; 33:2755-2774. [PMID: 38661119 DOI: 10.1111/jocn.17136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/23/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To evaluate the effects of home-based exercise in Parkinson's disease (PD) patients. DESIGN A network meta-analysis of randomized controlled trials. METHODS This study systematically searched PubMed, MEDLINE, Embase, Cochrane library and Web of Science. The quality of the literature was assessed using the Cochrane Risk of Bias 2.0 criteria. The data were pooled using R software. Results are presented as pooled standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS Thirty studies involving 2264 PD patients were included. Meta-analysis results showed that home-based exercise had a small effect in relieving overall motor symptoms in PD patients (SMD: -.28, 95% Crl [-.43; -.14]), improving quality of life (SMD = .15 [.03, .26]), walking speed (SMD = .30 [.04, .56]), balance ability (SMD = .18 [.04, .33]; p < .0001) and finger dexterity (SMD = .28 [.10, .46]). Mixed exercise (Mix) had better effects on improving motor symptoms and quality of life. In addition, the results of dose analysis showed that only mixed exercise exceeding 850 METs-min per week and more than 18 weeks can significantly alleviate the overall motor symptoms of PD patients. CONCLUSION Home-based exercise was an effective form of therapy for alleviating motor symptoms. In addition, Mix appeared to be more suitable for PD patients engaging in home-based exercise. Existing evidence suggested that significant therapeutic effects were achieved with a Mix, with a weekly exercise volume exceeding 850 METs and a duration of more than 18 weeks. RELEVANCE TO CLINICAL PRACTICE Home-based exercise had a small effect in relieving overall motor symptoms in PD patients, improving quality of life, walking speed, balance ability and finger dexterity. In terms of exercise dosage, we recommend the exercise period is no less than 18 weeks and the dose per is no less than 850 METs-min. No Patient or Public Contribution.
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Affiliation(s)
- Xianqi Gao
- Department of Nursing Sciences, School of Medicine, Lishui University, Lishui, Zhejiang, China
| | - Haoyang Zhang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
| | - Xueying Fu
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, China
| | - Jiejie Dou
- Faculty of Teacher Education, Lishui University, Lishui, Zhejiang, China
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Igusa T, Uchida H, Tsuchiya K, Sema S, Kaneko S, Yoshita T, Nagai S, Kobayashi T, Akiba T, Tanaka Y, Kikuchi S, Hirao K. Effects of rhythmic auditory stimulation on gait speed in older adult inpatients in a convalescent rehabilitation ward: a pilot randomized controlled trial. Eur Geriatr Med 2024:10.1007/s41999-024-01010-0. [PMID: 38890234 DOI: 10.1007/s41999-024-01010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To assess the impact of gait training with rhythmic auditory stimulation (RAS) on enhancing gait speed in older people admitted to a convalescent rehabilitation ward (CRW), compared to conventional gait training methods. METHODS The study was designed as a single-center, open-label, pilot, randomized, parallel-group study. Thirty older people admitted to CRW were divided into two groups: the experimental group, which received gait training with RAS (n = 15, females = 53.3%, mean age = 83.9, SD = 6.5), and the control group, which underwent usual gait training (n = 15, females = 60.0%, mean age = 81.3, SD = 8.4). Regardless of their assigned group, all participants underwent 30 min training sessions, five times a week, for 3 weeks. The primary outcome was the 10 m walk test (10mWT), and the secondary outcomes included the Medical Outcome Study 8-Item Short-Form Health Survey and the Japanese version of the modified Gait Efficacy Scale. All measurements were taken at baseline and again at week 3. RESULTS Results indicated that older people in CRWs in the experimental group showed significant improvements in their 10mWT (effect size - 1.02) compared to the control group. None of the secondary outcomes were significant. CONCLUSIONS This study suggests the preliminary effectiveness and feasibility of a gait practice intervention using RAS in a CRW. TRIAL REGISTRATION The University Hospital Medical Information Network (UMIN) Registered 1 October 2022 (UMIN000049089).
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Affiliation(s)
- Takumi Igusa
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Hiroyuki Uchida
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Shota Sema
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Shunsuke Kaneko
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Taiki Yoshita
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Sakyo Nagai
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Takuya Kobayashi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Takanari Akiba
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Yukiko Tanaka
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan.
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Hutin E, Poirier T, Meimoun M, Mardale V, Ghédira M. Model-based cueing-as-needed for walking in Parkinson's disease: A randomized cross-over study. Rev Neurol (Paris) 2024:S0035-3787(24)00532-0. [PMID: 38834484 DOI: 10.1016/j.neurol.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/29/2024] [Accepted: 05/03/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Correcting of the lack of regularity in steps is a key component of gait rehabilitation in Parkinson's disease. We proposed to introduce adaptive spatial auditory cueing (ASAC) based on verbal instruction "lengthen the step" automatically delivered when the stride length decreased below a predetermined threshold. OBJECTIVES The present study compared the effect of usual rhythmic auditory cueing versus ASAC used during a walking training in Parkinson's disease. METHODS Fifteen patients with Parkinson's disease performed both interventions in randomized order, one week apart: a 20-minute walking training with rhythmic auditory cueing, in form of a metronome adjusted on 110% of the patient's own cadence, or ASAC delivered when the stride length is less than 110% of the patient's own stride length. Assessment criteria were walking distance covered during the intervention, speed, step length, cadence, coefficients of variation of step length and step duration, and indexes of spatial and temporal asymmetry during a walking test before and just after the intervention. RESULTS The walking distance is higher with ASAC compared with rhythmic auditory cueing (rhythmic auditory cueing, 905 (203) m, mean (standard deviation); ASAC, 1043 (212) m; P=0.002). Between-intervention comparison showed some similar effects on walking after the intervention including free speed and step length increases (P<0.05). CONCLUSION The distance covered during 20-minute walking with ASAC increases by 15% compared to the use of classical rhythmic auditory cueing, while the immediate therapeutic effects show similar spatial-temporal benefits on short-distance walking. Auditory biofeedback cueing promoting the increase in step length might improve gait relearning in Parkinson's disease.
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Affiliation(s)
- E Hutin
- Laboratoire Analyse et Restauration du Mouvement (ARM), Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1, rue Gustave-Eiffel, 94010 Créteil cedex, France.
| | - T Poirier
- Institut de Formation en Masso-Kinésithérapie Saint-Michel, 68, rue du Commerce, 75015 Paris, France
| | - M Meimoun
- Laboratoire Analyse et Restauration du Mouvement (ARM), Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1, rue Gustave-Eiffel, 94010 Créteil cedex, France
| | - V Mardale
- Laboratoire Analyse et Restauration du Mouvement (ARM), Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1, rue Gustave-Eiffel, 94010 Créteil cedex, France; Service de Médecine Physique et de Réadaptation, Hôpital Dupuytren, AP-HP, 1, avenue Eugène-Delacroix, 91210 Draveil, France
| | - M Ghédira
- Laboratoire Analyse et Restauration du Mouvement (ARM), Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1, rue Gustave-Eiffel, 94010 Créteil cedex, France
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Tamir-Ostrover H, Hassin-Baer S, Fay-Karmon T, Friedman J. Quantifying Changes in Dexterity as a Result of Piano Training in People with Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2024; 24:3318. [PMID: 38894110 PMCID: PMC11174779 DOI: 10.3390/s24113318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
People with Parkinson's disease often show deficits in dexterity, which, in turn, can lead to limitations in performing activities of daily life. Previous studies have suggested that training in playing the piano may improve or prevent a decline in dexterity in this population. In this pilot study, we tested three participants on a six-week, custom, piano-based training protocol, and quantified dexterity before and after the intervention using a sensor-enabled version of the nine-hole peg test, the box and block test, a test of finger synergies using unidimensional force sensors, and the Quantitative Digitography test using a digital piano, as well as selected relevant items from the motor parts of the MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39) quality of life questionnaire. The participants showed improved dexterity following the training program in several of the measures used. This pilot study proposes measures that can track changes in dexterity as a result of practice in people with Parkinson's disease and describes a potential protocol that needs to be tested in a larger cohort.
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Affiliation(s)
- Hila Tamir-Ostrover
- Department of Physical Therapy, Faculty of Medical & Health Sciences, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Sharon Hassin-Baer
- Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 5262000, Israel; (S.H.-B.); (T.F.-K.)
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tsvia Fay-Karmon
- Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan 5262000, Israel; (S.H.-B.); (T.F.-K.)
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Jason Friedman
- Department of Physical Therapy, Faculty of Medical & Health Sciences, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel;
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
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Samadi A, Rasti J, Emadi Andani M. Enhancing gait cadence through rhythm-modulated music: A study on healthy adults. Comput Biol Med 2024; 174:108465. [PMID: 38613895 DOI: 10.1016/j.compbiomed.2024.108465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND AND OBJECTIVE Gait disorders stemming from brain lesions or chemical imbalances, pose significant challenges for patients. Proposed treatments encompass medication, deep brain stimulation, physiotherapy, and visual stimulation. Music, with its harmonious structures, serves as a continuous reference, synchronizing muscle activities through neural connections between hearing and motor functions, can show promise in gait disorder management. This study explores the influence of heightened music rhythm on young healthy participants' gait cadence in three conditions: FeedForward (independent rhythm), FeedBack (cadence-synced rhythm), and Adaptive (cadence-controlled musical experience). The objective is to increase gait cadence through rhythm modulation during walking. METHOD The study involved 18 young healthy participants (13 males and 5 females) who did not have any gait or hearing disorders. Each participant completed the gait task in the three aforementioned conditions. Each condition was comprised of three sessions: 1) Baseline, where participants walked while listening to the original music; 2) Intervention, changing the music rhythm to affect the gait cadence; and 3) Realign, replaying the original music and measuring the durability of the effect of the Intervention session. The measurement tool was a pair of footwear equipped with push-button switches that transmited the foot-to-ground contact to the LabVIEW® software, all designed by the research team. Repeated measures of ANOVA was employed to evaluate the impact of the sessions and conditions. RESULTS In all three conditions, there was a significant effect of music on increasing gait cadence during Intervention and Realign sessions (p < 0.001). Additionally, the immediate impact of music on gait cadence in the Adaptive condition was superior to the other conditions. CONCLUSION The study findings indicate that increasing the rhythm of music during walking has a significant impact on gait cadence among young healthy participants. This effect remained significant even after realigning the music to normal. It could be harnessed to support the rehabilitation of individuals with movement disorders characterized by a decrease in movement speed, such as Parkinson's disease. Moreover, the results indicate that the Adaptive method showed promising outcomes, suggesting its potential for further exploration as an effective means to control gait cadence.
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Affiliation(s)
- Aboubakr Samadi
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran.
| | - Javad Rasti
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran.
| | - Mehran Emadi Andani
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Huang X, Dong K, Gan C, Xu Z, Lei D, Dong X, Liu H, Chen X. Effect of Rhythmically Cued Exercise Interventions on Functions in Patients With Parkinson Disease: A Meta-Analysis. Phys Ther 2024; 104:pzad158. [PMID: 37962936 DOI: 10.1093/ptj/pzad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/06/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with Parkinson disease. METHODS PubMed, Cochrane Database, Web of Science, Embase, and CINAHL were searched June 15, 2023. Original studies investigating the efficacy of rhythmically cued exercise interventions on the functions of patients with Parkinson disease were included. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. The protocol was registered in PROSPERO (CRD42022371203). RESULTS A total of 38 original studies involving 1486 participants were included. Rhythmically cued exercise interventions demonstrated superior effects on motor function compared to exercise therapy without rhythm (standardized mean difference [SMD] = -0.31). However, no significant improvements were observed in cognition and mental state. Overall, significant improvements were observed in motor examination (SMD = -0.61), Timed "Up & Go" Test (mean difference [MD] = -0.91), activities of daily living (SMD = -0.49), balance (SMD = 0.59), walking velocity (MD = 0.06), step length (MD = 2.65), and stride length (MD = 0.04) following rhythmically cued exercise interventions. No significant improvements were observed in freezing of gait and cadence. Assessment of publication bias showed no significant evidence of publication bias. Meta-regression analyses revealed a significant association between treatment duration and improvement in motor function. Furthermore, adverse events and dropout rates did not significantly differ between the 2 groups. CONCLUSION Rhythmically cued exercise interventions are effective in improving motor function in the early to middle stages of Parkinson disease. More than 10 weeks of intervention yielded better results. However, these interventions do not have a significant impact on cognition and mental states. Importantly, rhythmically cued exercise interventions are safe and well tolerated. Large-scale trials are needed for further confirmation. IMPACT This study contributes to the development of safe and reliable home rehabilitation programs, aiming to enhance the quality of life for patients with Parkinson disease.
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Affiliation(s)
- Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ke Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chu Gan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiqin Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xinghua Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Burrai F, Apuzzo L, Zanotti R. Effectiveness of Rhythmic Auditory Stimulation on Gait in Parkinson Disease: A Systematic Review and Meta-analysis. Holist Nurs Pract 2024; 38:109-119. [PMID: 34121062 DOI: 10.1097/hnp.0000000000000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parkinson disease is a neurodegenerative disease present in approximately 2% of the population older than 65 years. Rhythmic auditory stimulation in the early 1990s aimed to improve individual mobility in terms of gait speed, stride length, and cadence. Our systematic review and meta-analysis aimed to summarize and evaluate the evidence of the effects of rhythmic auditory stimulation on gait speed, stride length, and cadence in patients with Parkinson disease. A systematic review and meta-analysis of randomized controlled trials was conducted to determine the efficacy of rhythmic auditory stimulation in patients with Parkinson disease. Five studies were included in the review (209 patients). Rhythmic auditory stimulation resulted, on average, a gait speed improvement of 0.53 standard deviation (SD) units (95% CI, 0.23 to 0.83; P = .0005), a stride length improvement of 0.51 SD units (95% CI, 0.18 to 0.84; P = .003) greater than that in the control group. All trials contained a risk of bias due to a lack of blinding. The quality of evidence was low. No adverse events were identified. Rhythmic auditory stimulation may have a beneficial effect on gait speed and stride length in patients with Parkinson disease. Future studies should consider a power analysis to recruit an adequate number of subjects and minimize the risk of sample bias. Further research should provide the additional results required for an acceptable estimate of the effects of rhythmic auditory stimulation on gait in patients with Parkinson disease.
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Affiliation(s)
- Francesco Burrai
- SC Educational, Research and Organization, ATS Sardegna, Sassari, Italy (Dr Burrai); Carlo Chenis Hospice, Local Health Authority, ASL Roma 4, Civitavecchia, Italy (Mr Apuzzo); and Department of Medicine, University of Padova, Padova, Italy (Dr Zanotti)
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Colverson A, Barsoum S, Cohen R, Williamson J. Rhythmic musical activities may strengthen connectivity between brain networks associated with aging-related deficits in timing and executive functions. Exp Gerontol 2024; 186:112354. [PMID: 38176601 DOI: 10.1016/j.exger.2023.112354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/14/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
Brain aging and common conditions of aging (e.g., hypertension) affect networks important in organizing information, processing speed and action programming (i.e., executive functions). Declines in these networks may affect timing and could have an impact on the ability to perceive and perform musical rhythms. There is evidence that participation in rhythmic musical activities may help to maintain and even improve executive functioning (near transfer), perhaps due to similarities in brain regions underlying timing, musical rhythm perception and production, and executive functioning. Rhythmic musical activities may present as a novel and fun activity for older adults to stimulate interacting brain regions that deteriorate with aging. However, relatively little is known about neurobehavioral interactions between aging, timing, rhythm perception and production, and executive functioning. In this review, we account for these brain-behavior interactions to suggest that deeper knowledge of overlapping brain regions associated with timing, rhythm, and cognition may assist in designing more targeted preventive and rehabilitative interventions to reduce age-related cognitive decline and improve quality of life in populations with neurodegenerative disease. Further research is needed to elucidate the functional relationships between brain regions associated with aging, timing, rhythm perception and production, and executive functioning to direct design of targeted interventions.
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Affiliation(s)
- Aaron Colverson
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, 1651 4th street, San Francisco, CA, United States of America.
| | - Stephanie Barsoum
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, PO Box 100277, Gainesville, FL 32610-0277, United States of America
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, PO Box 100277, Gainesville, FL 32610-0277, United States of America
| | - John Williamson
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, PO Box 100277, Gainesville, FL 32610-0277, United States of America
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Gros P, Spee BTM, Bloem BR, Kalia LV. If Art Were a Drug: Implications for Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S159-S172. [PMID: 38788090 PMCID: PMC11380257 DOI: 10.3233/jpd-240031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Parkinson's disease (PD) is a chronic and complex neurodegenerative disorder. Conventional pharmacological or surgical therapies alone are often insufficient at adequately alleviating disability. Moreover, there is an increasing shift toward person-centered care, emphasizing the concept of "living well". In this context, arts-based interventions offer great promise, functioning as platforms for creative expression that could provide novel mechanisms to promote quality of life. Here we present a qualitative review of arts-based interventions for PD, including music, dance, drama, visual arts, and creative writing. For each, we discuss their applications to PD, proposed mechanisms, evidence from prior studies, and upcoming research. We also provide examples of community-based projects. Studies to date have had relatively small sample sizes, but their findings suggest that arts-based interventions have the potential to reduce motor and non-motor symptoms. They may also empower people with PD and thereby address issues of self-esteem, foster personal problem-solving, and augment holistic well-being. However, there is a paucity of research determining optimal dosage and symptom-specific benefits of these therapies. If art were a drug, we would have to perform appropriately powered studies to provide these data before incorporating it into routine patient care. We therefore call for further research with properly designed studies to offer more rigorous and evidence-based support for what we intuitively think is a highly promising approach to support individuals living with PD. Given the possible positive impact on people's lives, arts-based approaches merit further development and, if proven to be effective, systematic inclusion within integrated management plans.
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Affiliation(s)
- Priti Gros
- Edmond J. Safra Program in Parkinson Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Blanca T M Spee
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, The Netherlands
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lorraine V Kalia
- Edmond J. Safra Program in Parkinson Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Iriarte E, Araya AX. Walking to Prevent Fear of Falling Among Community-Dwelling Older Adults: A Scoping Review. J Gerontol Nurs 2024; 50:15-21. [PMID: 38170459 DOI: 10.3928/00989134-20231211-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The current review sought to identify and synthesize the evidence on available interventions that include walking and their impact on fear of falling (FOF) among community-dwelling older adults without cognitive impairment. A 10-year search was conducted (January 2012 to January 2022) in two peer-reviewed databases. A total of 116 articles were identified, and 22 articles were reviewed. Most studies included multicomponent walking interventions, such as walking and another type of intervention or exercise. Among the different questionnaires to assess FOF, the Falls Efficacy Scale-International was the most used in 77.3% (n = 17) of studies. In addition to walking, interventions to reduce FOF mainly included balance training, lower extremity strengthening, cardio or aerobic exercises, or a combination of these exercises. Further research is needed to evaluate the impact of unidimensional walking interventions, as well as those that incorporate psychological and technological elements targeted to FOF prevention and management. [Journal of Gerontological Nursing, 50(1), 15-21.].
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12
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Kola S, Subramanian I. Updates in Parkinson's Disease Integrative Therapies: an Evidence-Based Review. Curr Neurol Neurosci Rep 2023; 23:717-726. [PMID: 37921943 DOI: 10.1007/s11910-023-01312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE OF REVIEW This review summarizes recent evidence-based integrative therapies for Parkinson's disease (PD) that may improve motor and non-motor symptoms, enhance quality of life, and alter disease progression. RECENT FINDINGS Imaging studies have demonstrated that aerobic exercise changes brain structure and function, while strength training improves posture and balance. Loneliness is associated with worsening PD severity, but social prescribing and cognitive behavioral therapy may effectively foster connections. Ayurvedic and traditional Chinese medicine practices including yoga, meditation, tai chi, and acupuncture may help improve mobility, mood, sleep, and quality of life. Art therapy enhances visuospatial skills, whereas music and dance therapy can alleviate freezing of gait. Several studies demonstrate successful use of these integrative strategies virtually, thereby improving patient accessibility and participation. PD management has broadened to include integrative approaches combining conventional and complementary therapies. Potential benefits of movement, nutrition, sleep, socialization, and mind-body practices have been confirmed with several recent randomized controlled trials.
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Affiliation(s)
- Sushma Kola
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Indu Subramanian
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- SW PADRECC, Veterans Affairs, Los Angeles, CA, USA
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13
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Dery H, Buaron B, Mazinter R, Lavi S, Mukamel R. Playing with your ears: Audio-motor skill learning is sensitive to the lateral relationship between trained hand and ear. iScience 2023; 26:107720. [PMID: 37674982 PMCID: PMC10477063 DOI: 10.1016/j.isci.2023.107720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/06/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023] Open
Abstract
A salient feature of motor and sensory circuits in the brain is their contralateral hemispheric bias-a feature that might play a role in integration and learning of sensorimotor skills. In the current behavioral study, we examined whether the lateral configuration between sound-producing hand and feedback-receiving ear affects performance and learning of an audio-motor skill. Right-handed participants (n = 117) trained to play a piano sequence using their right or left hand while auditory feedback was presented monaurally, either to the right or left ear. Participants receiving auditory feedback to the contralateral ear during training performed better than participants receiving ipsilateral feedback (with respect to the training hand). Furthermore, in the Left-Hand training groups, the contralateral training advantage persisted in a generalization task. Our results demonstrate that audio-motor learning is sensitive to the lateral configuration between motor and sensory circuits and suggest that integration of neural activity across hemispheres facilitates such learning.
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Affiliation(s)
- Hadar Dery
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Batel Buaron
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Roni Mazinter
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shalev Lavi
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Roy Mukamel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
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14
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Gigonzac M, Terrier P. Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial. BMC Geriatr 2023; 23:542. [PMID: 37674129 PMCID: PMC10481504 DOI: 10.1186/s12877-023-04255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
CONTEXT Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls. RATIONALE Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls. OBJECTIVE The aim is to assess the efficacy of an arm-in-arm gait-training program in older people. DESIGN The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial. PARTICIPANTS We will enroll 66 dyads of older people and their younger "gait instructors". The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry. INTERVENTION Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks. OUTCOMES The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 - week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training. EXPECTED RESULTS Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors. TRIAL REGISTRATION ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
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Affiliation(s)
- Mathilde Gigonzac
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland
| | - Philippe Terrier
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland.
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15
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Moreno-Ligero M, Lucena-Anton D, Salazar A, Failde I, Moral-Munoz JA. mHealth Impact on Gait and Dynamic Balance Outcomes in Neurorehabilitation: Systematic Review and Meta-analysis. J Med Syst 2023; 47:75. [PMID: 37462759 PMCID: PMC10354142 DOI: 10.1007/s10916-023-01963-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 06/22/2023] [Indexed: 07/21/2023]
Abstract
Gait and dynamic balance are two main goals in neurorehabilitation that mHealth systems could address. To analyze the impact of using mHealth systems on gait and dynamic balance outcomes in subjects with neurological disorders. Randomized controlled trials (RCT) published in PubMed, Web of Science, Scopus, and PEDro databases were searched up to April 2023. Studies including adults with neurological disorders, analyzing the effectiveness of mHealth systems on gait and dynamic balance compared with conventional therapy and/or not intervention, were included. The PEDro scale and the Cochrane Collaboration's 2.0 tool were used for the methodological quality and risk of bias assessment. The Review Manager 5.4 software was used to obtain meta-analyses. 13 RCT were included in the systematic review and 11 in the meta-analyses, involving 528 subjects. A total of 21 mobile applications were identified for gait and balance training, and to enhance physical activity behaviors. There were significant differences in gait parameters, speed by 0.10 s/m (95% confidence interval (CI)=0.07,0.13;p<0.001), cadence by 8.01 steps/min (95%CI=3.30,12.72;p<0.001), affected step length by 8.89 cm (95%CI=4.88,12.90;p<0.001), non-affected step length by 8.08 cm (5%CI=2.64,13.51;p=0.004), and in dynamic balance, Timed Up and Go by -7.15 s (95%CI=-9.30,-4.99;p<0.001), and mobility subscale of Posture Assessment Scale for Stroke by 1.71 points (95%CI=1.38,2.04;p<0.001). Our findings suggested the use of mHealth systems for improving gait in subjects with neurological disorders, but controversial results on dynamics balance recovery were obtained. However, the quality of evidence is insufficient to strongly recommend them, so further research is needed.
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Affiliation(s)
- Marta Moreno-Ligero
- Department of Biomedicine, Biotechnology and Public Health, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009, Cadiz, Spain
| | - David Lucena-Anton
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009, Cadiz, Spain.
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), University of Cadiz, 11009, Cadiz, Spain.
| | - Alejandro Salazar
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), University of Cadiz, 11009, Cadiz, Spain
- Department of Statistics and Operational Research, School of Engineering, University of Cadiz, 11510, Puerto Real, Cadiz, Spain
| | - Inmaculada Failde
- Department of Biomedicine, Biotechnology and Public Health, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), University of Cadiz, 11009, Cadiz, Spain
| | - Jose A Moral-Munoz
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), University of Cadiz, 11009, Cadiz, Spain
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16
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Duppen CP, Wrona H, Dayan E, Lewek MD. Evidence of Implicit and Explicit Motor Learning during Gait Training with Distorted Rhythmic Auditory Cues. J Mot Behav 2023; 56:42-51. [PMID: 37394515 DOI: 10.1080/00222895.2023.2231874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/04/2023]
Abstract
Gait training with rhythmic auditory cues contains motor learning mechanisms that are weighted more explicitly than implicitly. However, various clinical populations may benefit from a shift to gait training with greater implicit motor learning mechanisms. To investigate the ability to incorporate more implicit-weighted motor learning processes during rhythmic auditory cueing, we attempted to induce error-based recalibration using a subtly varying metronome cue for naïve unimpaired young adults. We assessed the extent of implicit and explicit retention after both an isochronous metronome and subtly varying metronome frequency during treadmill and overground walking. Despite 90% of participants remaining unaware of the changing metronome frequency, participants adjusted their cadence and step length to the subtly changing metronome, both on a treadmill and overground (p < 0.05). However, despite evidence of both implicit and explicit processes involved with each metronome (i.e., isochronous and varying), there were no between-condition differences in implicit or explicit retention for cadence, step length, or gait speed, and thus no increased implicit learning advantage with the addition of error-based recalibration for young, unimpaired adults.
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Affiliation(s)
- Chelsea Parker Duppen
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hailey Wrona
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC and North Carolina State University, Raleigh, NC, USA
| | - Eran Dayan
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael D Lewek
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Physical Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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17
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Bonilla Yanez M, Kettlety SA, Finley JM, Schweighofer N, Leech KA. Gait speed and individual characteristics are related to specific gait metrics in neurotypical adults. Sci Rep 2023; 13:8069. [PMID: 37202435 PMCID: PMC10195830 DOI: 10.1038/s41598-023-35317-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/16/2023] [Indexed: 05/20/2023] Open
Abstract
Gait biofeedback is a well-studied strategy to reduce gait impairments such as propulsion deficits or asymmetric step lengths. With biofeedback, participants alter their walking to reach the desired magnitude of a specific parameter (the biofeedback target) with each step. Biofeedback of anterior ground reaction force and step length is commonly used in post-stroke gait training as these variables are associated with self-selected gait speed, fall risk, and the energy cost of walking. However, biofeedback targets are often set as a function of an individual's baseline walking pattern, which may not reflect the ideal magnitude of that gait parameter. Here we developed prediction models based on speed, leg length, mass, sex, and age to predict anterior ground reaction force and step length of neurotypical adults as a possible method for personalized biofeedback. Prediction of these values on an independent dataset demonstrated strong agreement with actual values, indicating that neurotypical anterior ground reaction forces can be estimated from an individual's leg length, mass, and gait speed, and step lengths can be estimated from individual's leg length, mass, age, sex, and gait speed. Unlike approaches that rely on an individual's baseline gait, this approach provides a standardized method to personalize gait biofeedback targets based on the walking patterns exhibited by neurotypical individuals with similar characteristics walking at similar speeds without the risk of over- or underestimating the ideal values that could limit feedback-mediated reductions in gait impairments.
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Affiliation(s)
- Maryana Bonilla Yanez
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Sarah A Kettlety
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - James M Finley
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
| | - Nicolas Schweighofer
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
| | - Kristan A Leech
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA.
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18
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Mainka S, Lauermann M, Ebersbach G. Arm swing deviations in patients with Parkinson's disease at different gait velocities. J Neural Transm (Vienna) 2023; 130:655-661. [PMID: 36917345 PMCID: PMC10121495 DOI: 10.1007/s00702-023-02619-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
Asymmetry of arm swing (AS) has been described as a characteristic of normal physiological gait. In patients with Parkinson's disease (PWPD), a one-sided reduction of AS can occur already as a prodromal symptom. There is limited evidence regarding AS in PWPD, but a growing interest in AS as a focus of exercise therapy. The differences of AS between 32 healthy subjects (HS) and 36 mildly-to-moderately impaired PWPD were assessed in overground walking at various gait speeds. Assessments were carried out with a sensor-based gait measurement system over a 40 m walk in very slow, slow, preferred, fast, and very fast gait speed. Longitudinal and AS kinematics were compared with ANOVA function and regression analysis. PWPD exhibited a one-sided reduction of AS compared to HS at normal, fast, and very fast walking. AS coordination, representing the timing of reciprocity of right and left AS, was reduced in PWPD in very slow and normal walking. With respect to leg movements, PWPD exhibited an increase in stride time variability in very slow gait. There were no group differences for cadence, stride length, and gait velocity. This study informs about the kinematics of AS at various gait velocities ranging from very slow to very fast in mildly-to-moderately impaired PWPD. Reduced one-sided AS can be considered as a very early sign of parkinsonian gait disturbance that precedes alterations of locomotive leg movements and improves at faster gait speeds.
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Affiliation(s)
- Stefan Mainka
- Movement Disorder Clinic, Parkinsonklinik, Str. n. Fichtenwalde 16, 14547, Beelitz-Heilstätten, Germany.
| | | | - Georg Ebersbach
- Movement Disorder Clinic, Parkinsonklinik, Str. n. Fichtenwalde 16, 14547, Beelitz-Heilstätten, Germany
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19
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Identification and Illustration of Means to a Critical Assessment of Music and Health Research Literature. Healthcare (Basel) 2023; 11:healthcare11060807. [PMID: 36981464 PMCID: PMC10048624 DOI: 10.3390/healthcare11060807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
In 2019, the WHO released a scoping review investigating art therapies in evidence-based healthcare practices to identify and understand the gaps in the literature. However, the studies curated were not evaluated for their quality. To address this limitation, several assessment tools to critically appraise music-based research studies that investigate therapies pertaining to preventative healthcare were investigated. Two critical appraisal tools were selected for their robustness and appropriateness for the studies in question: the Joanna Briggs Institute checklists and the Music-Based Intervention Guidelines. These tools were tested by two assessors on a total of 23 music studies from the Preventative and Prevention Health section of the WHO report. Based on the requirements for each critical appraisal tool, seven studies received a full assessment utilizing both checklists. Of these seven, two studies scored on the higher index, indicating that the studies followed a detailed methodology to provide concrete and accurate results. The findings of the study highlighted the limitations of study designs and music-based interventions. With this information, beneficial recommendations for future research in this domain are provided to improve the quality of research, ensuring its place in evidence-based healthcare practices.
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20
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Lee H, Ko B. Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1046. [PMID: 36673802 PMCID: PMC9859027 DOI: 10.3390/ijerph20021046] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
This systematic review and meta-analysis examined previous studies on music-based interventions for individuals with Parkinson’s disease (PD). The effectiveness of the interventions on various motor and non-motor outcomes was evaluated. This review was conducted by searching PubMed, CINAHL, PsycINFO, and Cochrane Library CENTRAL prior to June 2022 for randomized controlled trial (RCT) and controlled clinical trial (CCT) studies published in English. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was used for heterogeneity. The initial search identified 745 studies, and 13 studies involving 417 participants with PD which met the inclusion criteria included in this review. The results of the meta-analysis revealed that music-based interventions can significantly improve walking velocity (MD = 0.12, 95% CI = 0.07~0.16, p < 0.00001), stride length (MD = 0.04, 95% CI = 0.02~0.07, p = 0.002), and mobility (MD = −1.05, 95% CI = −1.53~−0.57, p < 0.0001). However, the results did not support significant effects for music-based interventions on cadence (MD = 3.21, 95% CI = −4.15~10.57, p = 0.39), cognitive flexibility (MD = 20.91, 95% CI = −10.62~52.44, p = 0.19), inhibition (SMD = 0.07, 95% CI = −0.40~0.55, p = 0.76), and quality of life (SMD = −0.68, 95% CI= −1.68~0.32, p = 0.18). The findings suggest that music-based interventions are effective for the improvement of some motor symptoms, but evidence for non-motor symptoms is limited. Further high-quality studies with a larger sample size are required to obtain the robust effects of music-based interventions on various outcomes among patients with PD.
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Affiliation(s)
- Hyunjung Lee
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Bumsuk Ko
- Department of Music, Graduate School, Hansei University, Gunpo 15852, Republic of Korea
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21
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Spinosa V, Vitulli A, Logroscino G, Brattico E. A Review on Music Interventions for Frontotemporal Aphasia and a Proposal for Alternative Treatments. Biomedicines 2022; 11:biomedicines11010084. [PMID: 36672592 PMCID: PMC9855720 DOI: 10.3390/biomedicines11010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/08/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
Frontotemporal dementia (FTD) is a rare neurodegenerative disease, characterized by behavioral and language impairments. Primary progressive aphasia (PPA) is the linguistic variant of this heterogeneous disorder. To date, there is a lack of consensus about which interventions are effective in these patients. However, several studies show that music-based interventions are beneficial in neurological diseases. This study aims, primarily, to establish the state of the art of music-based interventions designed for PPA due to FTD and, secondarily, to inform the planning of PPA-dedicated future interventions for Italian neurological institutions. The first aim is fulfilled by a review which critically screens the neurological studies examining the effects of music- and/or rhythm-based interventions, especially, on language rehabilitation in aphasic FTD. We found that only two papers fulfilled our criteria and concerned specifically aphasic patients due to FTD. Of those, one paper reported a study conducted in an Italian institution. Most of the reviewed studies focused, instead, on aphasia in post-stroke patients. The results of our review invite further studies to investigate the role of music as a valuable support in the therapy for neurodegenerative patients with language problems and in particular to PPA due to FTD. Moreover, based on this initial work, we can delineate new music-based interventions dedicated to PPA for Italian institutions.
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Affiliation(s)
- Vittoria Spinosa
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari “Aldo Moro”, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Alessandra Vitulli
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari “Aldo Moro”, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari “Aldo Moro”, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Elvira Brattico
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- Department of Education, Psychology, Communication, University of Bari “Aldo Moro”, 70121 Bari, Italy
- Correspondence:
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22
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Jola C, Sundström M, McLeod J. Benefits of dance for Parkinson's: The music, the moves, and the company. PLoS One 2022; 17:e0265921. [PMID: 36409733 PMCID: PMC9678293 DOI: 10.1371/journal.pone.0265921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Dance classes designed for people with Parkinson's are very popular and associated not only with increasing individuals' motor control abilities but also their mood; not least by providing a social network and the enjoyment of the music. However, quantitative evidence of the benefits is inconsistent and often lacks in power. For a better understanding of the contradictory findings between participants' felt experiences and existing quantitative findings in response to dance classes, we employed a mixed method approach that focussed on the effects of music. Participant experience of the dance class was explored by means of semi-structured interviews and gait changes were measured in a within-subjects design through the Timed Up and Go (TUG) test before and after class, with and without music. We chose the TUG test for its ecological validity, as it is a simple test that resembles movements done in class. We hypothesised that the music and the dance class would have a facilitating effect on the TUG performance. In line with existing research, we found that before class, the gait of 26 participants was significantly improved when accompanied by a soundtrack. However, after class, music did not have a significantly facilitating effect, yet gait without music significantly improved after class compared to before. We suggest that whilst the music acts as an external stimulator for movement before the dance class, after the dance class, participants have an internalised music or rhythm that supports their motor control. Thus, externally played music is of less relevance. The importance of music was further emphasised in the qualitative data alongside social themes. A better understanding of how music and dance affects Parkinson's symptoms and what aspects make individuals 'feel better' will help in the design of future interventions.
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Affiliation(s)
- Corinne Jola
- Division of Psychology and Forensic Science, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Moa Sundström
- Division of Psychology and Forensic Science, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Julia McLeod
- Division of Nursing and Mental Health, School of Applied Sciences, Abertay University, Dundee, United Kingdom
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23
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Rusowicz J, Szczepańska-Gieracha J, Kiper P. Neurologic Music Therapy in Geriatric Rehabilitation: A Systematic Review. Healthcare (Basel) 2022; 10:2187. [PMID: 36360527 PMCID: PMC9690210 DOI: 10.3390/healthcare10112187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 09/08/2024] Open
Abstract
(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson's disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients.
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Affiliation(s)
- Jagoda Rusowicz
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
| | | | - Paweł Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
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Pantelyat A, Dayanim G, Kang K, Turk B, Pagkatipunan R, Huenergard SK, Mears A, Bang J. Rhythmic auditory cueing in atypical parkinsonism: A pilot study. Front Neurol 2022; 13:1018206. [PMID: 36388209 PMCID: PMC9650086 DOI: 10.3389/fneur.2022.1018206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
Rhythmic auditory cueing (RAC) can improve gait parameters in neurological disorders such as Parkinson's disease and stroke. However, there is a lack of research on the effects of RAC in patients with atypical parkinsonian disorders (APD). Using a smartphone metronome application, we aimed to investigate the immediate effects of RAC in patients with clinically diagnosed APD, namely Progressive Supranuclear Palsy (PSP-Richardson Syndrome and other variants, PSP-nonRS), Corticobasal Syndrome (CBS), Multiple System Atrophy (MSA), and Dementia with Lewy Bodies (DLB). A total of 46 APD participants (25 PSP, 9 CBS, 8 MSA and 4 DLB; age: mean = 70.17, standard deviation = 7.15) walked at their preferred pace for 2 min without any rhythmic auditory cueing (RAC). Participants then walked the same path for another 2 min with RAC set at a tempo 10% faster than the baseline cadence of each participant. After a 10–15-min break, participants walked the same path for another 2 min without RAC to observe for carryover effects. Gait parameters [cadence (steps/minute), gait velocity (meters/minute), and stride length (centimeters)] were collected at baseline, during RAC, and post-RAC. There was a significant improvement in cadence in all participants from baseline to during RAC and post-RAC (corrected p-values = 0.009 for both). Gait velocity also improved from baseline to during RAC and post-RAC in all participants, although this improvement was not significant after correcting for multiple comparisons. The changes in cadence and gait velocity were most pronounced in PSP. In addition, our exploratory analysis showed that the cadence in the suspected TAU group (PSP+CBS) showed a significant improvement from baseline to during RAC and post-RAC (corr. p-value = 0.004 for both). This pilot study using short-term RAC in APD patients demonstrated improvements in cadence and velocity. There is an urgent need for effective gait rehabilitation modalities for patients with APD, and rhythmic cueing can be a practical and useful intervention to improve their gait pattern.
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Affiliation(s)
- Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Music and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Alexander Pantelyat
| | - Gabriel Dayanim
- College of Computer, Mathematical, and Natural Sciences, University of Maryland, College Park, MD, United States
| | - Kyurim Kang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Center for Music and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Bela Turk
- Departments of Neurology and Pediatrics, Moser Center for Leukodystrophies, Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Ruben Pagkatipunan
- Department of Rehabilitation, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States
| | - Sera-Kim Huenergard
- Department of Rehabilitation, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States
| | - Albert Mears
- Department of Rehabilitation, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States
| | - Jee Bang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Karpodini CC, Dinas PC, Angelopoulou E, Wyon MA, Haas AN, Bougiesi M, Papageorgiou SG, Koutedakis Y. Rhythmic cueing, dance, resistance training, and Parkinson's disease: A systematic review and meta-analysis. Front Neurol 2022; 13:875178. [PMID: 36034281 PMCID: PMC9413961 DOI: 10.3389/fneur.2022.875178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim of the present systematic review and meta-analysis was to synthesize evidence associated with the functional and clinical effectiveness of rhythmic cueing, dance, or resistance training (RT) on motor and non-motor parameters in Parkinson's Disease patients, and to provide a comparative perspective not offered by existing systematic reviews. Methodology Eligibility criteria for selecting studies retained no restrictions in methodological design and included interventions of rhythmic cueing, dance, RT, and measurements of motor and non-motor parameters. Animal studies, reviews, editorials, conferences, magazines, and gray literature articles were excluded. Two independent investigators searched Cochrane Library, Medline, PubMed, and SPORTDiscus from the date of their inception until 1 June 2021. The ROBINS-I tool was employed for the non-randomized controlled trials, and the updated for Risk of Bias 2 tool of Cochrane Library used for randomized controlled trials. For meta-analyses, the RevMan 5.4.13 software was used. For incompatible meta-analysis studies, a narrative data synthesis was conducted. Results A total of 49 studies included in the systematic review involving 3767 PD participants. Meta-analyses revealed that rhythmic cueing training assists gait velocity (p = 0.01), stride length (p = 0.01), and motor symptoms (p = 0.03). Similarly, dance training benefits stride length (p = 0.05), lower extremity function-TUG (p = 0.01), and motor symptoms (p = 0.01), whilst RT improves lower extremity function-TUG (p = 0.01), quality of life (p = 0.01), knee flexion (p = 0.02), and leg press (p = 0.01). Subgroup analyses have shown non-significant differences in gait velocity (p = 0.26), stride length (p = 0.80), functional mobility-TUG (p = 0.74), motor symptoms-UPDRS-III (p = 0.46), and quality of life-PDQ39 (p = 0.44). Conclusion Rhythmic cueing, dance, or RT positively affect the examined outcomes, with rhythmic cueing to be associated with three outcomes (Gait, Stride, and UPDRS-III), dance with three outcomes (TUG, Stride, and UPDRS-III), and RT with two outcomes (TUG and PDQ-39). Subgroup analyses confirmed the beneficial effects of these forms of exercise. Clinicians should entertain the idea of more holistic exercise protocols aiming at improving PD manifestations.International Prospective Register of systematic reviews (PROSPERO) (registration number: CRD42020212380).
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Affiliation(s)
- Claire Chrysanthi Karpodini
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Petros C. Dinas
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Efthalia Angelopoulou
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition University Hospital, Athens, Greece
| | - Matthew A. Wyon
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Aline Nogueira Haas
- School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Maria Bougiesi
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Sokratis G. Papageorgiou
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition University Hospital, Athens, Greece
| | - Yiannis Koutedakis
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
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Wu Z, Kong L, Zhang Q. Research Progress of Music Therapy on Gait Intervention in Patients with Parkinson’s Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159568. [PMID: 35954925 PMCID: PMC9368619 DOI: 10.3390/ijerph19159568] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
Music therapy is an effective way to treat the gait disorders caused by Parkinson’s disease. Rhythm music stimulation, therapeutic singing, and therapeutic instrument performance are often used in clinical practice. The mechanisms of music therapy on the gait of patients with Parkinson’s disease include the compensation mechanism of cerebellum recruitment, rhythm entrainment, acceleration of motor learning, stimulation of neural coherence, and increase of cortical activity. All mechanisms work together to complete the intervention of music therapy on patients’ gait and help patients to recover better. In this paper, the effect of music therapy on gait disorders in Parkinson’s disease patients was reviewed, and some suggestions were put forward.
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Ye X, Li L, He R, Jia Y, Poon W. Rhythmic auditory stimulation promotes gait recovery in Parkinson's patients: A systematic review and meta-analysis. Front Neurol 2022; 13:940419. [PMID: 35968291 PMCID: PMC9366143 DOI: 10.3389/fneur.2022.940419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveUsing rhythmic auditory stimulation (RAS) to improve gait disturbance in Parkinson's disease (PD) is an available treatment option, yet a consensus on its effectiveness remains controversial. We summarized the effects of RAS on gait, functional activity and quality of life in PD patients through a systematic review and meta-analysis.MethodsPubMed, Embase, Web of Science, Medline, and Cochrane Library databases were initially searched to identify relevant literature up to August 2021. Next, the methodological quality of eligible comparative studies was assessed by the Physiotherapy Evidence Database Scale. The treatment effects to clinical outcome in relation to gait, motor activities, and quality of life were analyzed.ResultsA total of 18 studies consisted of 774 subjects were included in this meta-analysis. Comparing with the control group, RAS had significantly increased stride length (p < 0.001), accelerated gait speed (p < 0.001), reduced the occurrence of freezing events during walking (P = 0.009), achieved an improvement in Unified Parkinson's Disease Rating Scale (UPDRS) II (P = 0.030), UPDRS-III (P < 0.001) and Parkinson's Disease Quality of Life Questionnaire (PDQL) (p = 0.009) scores over an interval of 1–26 months.ConclusionIn this meta-analysis of 18 randomized controlled trials, we have demonstrated that RAS improves the general motor functions (UPDRS-III), particularly in gait, mobility and quality of life, in patients with Parkinson's disease.
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Affiliation(s)
- Xiaofan Ye
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Ling Li
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Rong He
- Physiotherapy Department, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yizhen Jia
- Core Laboratory, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Waisang Poon
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
- *Correspondence: Waisang Poon
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Reh J, Schmitz G, Hwang TH, Effenberg AO. Loudness affects motion: asymmetric volume of auditory feedback results in asymmetric gait in healthy young adults. BMC Musculoskelet Disord 2022; 23:586. [PMID: 35715757 PMCID: PMC9206330 DOI: 10.1186/s12891-022-05503-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background The potential of auditory feedback for motor learning in the rehabilitation of various diseases has become apparent in recent years. However, since the volume of auditory feedback has played a minor role so far and its influence has hardly been considered, we investigate the volume effect of auditory feedback on gait pattern and gait direction and its interaction with pitch. Methods Thirty-two healthy young participants were randomly divided into two groups: Group 1 (n = 16) received a high pitch (150-250 Hz) auditory feedback; group 2 (n = 16) received a lower pitch (95-112 Hz) auditory feedback. The feedback consisted of a real-time sonification of the right and left foot ground contact. After an initial condition (no auditory feedback and full vision), both groups realized a 30-minute habituation period followed by a 30-minute asymmetry period. At any condition, the participants were asked to walk blindfolded and with auditory feedback towards a target at 15 m distance and were stopped 5 m before the target. Three different volume conditions were applied in random order during the habituation period: loud, normal, and quiet. In the subsequent asymmetry period, the three volume conditions baseline, right quiet and left quiet were applied in random order. Results In the habituation phase, the step width from the loud to the quiet condition showed a significant interaction of volume*pitch with a decrease at high pitch (group 1) and an increase at lower pitch (group 2) (group 1: loud 1.02 ± 0.310, quiet 0.98 ± 0.301; group 2: loud 0.95 ± 0.229, quiet 1.11 ± 0.298). In the asymmetry period, a significantly increased ground contact time on the side with reduced volume could be found (right quiet: left foot 0.988 ± 0.033, right foot 1.003 ± 0.040, left quiet: left foot 1.004 ± 0.036, right foot 1.002 ± 0.033). Conclusions Our results suggest that modifying the volume of auditory feedback can be an effective way to improve gait symmetry. This could facilitate gait therapy and rehabilitation of hemiparetic and arthroplasty patients, in particular if gait improvement based on verbal corrections and conscious motor control is limited.
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Affiliation(s)
- Julia Reh
- Institute of Sports Science, Leibniz University Hannover, Am Moritzwinkel 6, 30167, Hannover, Germany.
| | - Gerd Schmitz
- Institute of Sports Science, Leibniz University Hannover, Am Moritzwinkel 6, 30167, Hannover, Germany
| | - Tong-Hun Hwang
- Institute of Sports Science, Leibniz University Hannover, Am Moritzwinkel 6, 30167, Hannover, Germany
| | - Alfred O Effenberg
- Institute of Sports Science, Leibniz University Hannover, Am Moritzwinkel 6, 30167, Hannover, Germany.
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Allen NE, Canning CG, Almeida LRS, Bloem BR, Keus SH, Löfgren N, Nieuwboer A, Verheyden GS, Yamato TP, Sherrington C. Interventions for preventing falls in Parkinson's disease. Cochrane Database Syst Rev 2022; 6:CD011574. [PMID: 35665915 PMCID: PMC9169540 DOI: 10.1002/14651858.cd011574.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Most people with Parkinson's disease (PD) experience at least one fall during the course of their disease. Several interventions designed to reduce falls have been studied. An up-to-date synthesis of evidence for interventions to reduce falls in people with PD will assist with informed decisions regarding fall-prevention interventions for people with PD. OBJECTIVES To assess the effects of interventions designed to reduce falls in people with PD. SEARCH METHODS CENTRAL, MEDLINE, Embase, four other databases and two trials registers were searched on 16 July 2020, together with reference checking, citation searching and contact with study authors to identify additional studies. We also conducted a top-up search on 13 October 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) of interventions that aimed to reduce falls in people with PD and reported the effect on falls. We excluded interventions that aimed to reduce falls due to syncope. DATA COLLECTION AND ANALYSIS We used standard Cochrane Review procedures. Primary outcomes were rate of falls and number of people who fell at least once. Secondary outcomes were the number of people sustaining one or more fall-related fractures, quality of life, adverse events and economic outcomes. The certainty of the evidence was assessed using GRADE. MAIN RESULTS This review includes 32 studies with 3370 participants randomised. We included 25 studies of exercise interventions (2700 participants), three studies of medication interventions (242 participants), one study of fall-prevention education (53 participants) and three studies of exercise plus education (375 participants). Overall, participants in the exercise trials and the exercise plus education trials had mild to moderate PD, while participants in the medication trials included those with more advanced disease. All studies had a high or unclear risk of bias in one or more items. Illustrative risks demonstrating the absolute impact of each intervention are presented in the summary of findings tables. Twelve studies compared exercise (all types) with a control intervention (an intervention not thought to reduce falls, such as usual care or sham exercise) in people with mild to moderate PD. Exercise probably reduces the rate of falls by 26% (rate ratio (RaR) 0.74, 95% confidence interval (CI) 0.63 to 0.87; 1456 participants, 12 studies; moderate-certainty evidence). Exercise probably slightly reduces the number of people experiencing one or more falls by 10% (risk ratio (RR) 0.90, 95% CI 0.80 to 1.00; 932 participants, 9 studies; moderate-certainty evidence). We are uncertain whether exercise makes little or no difference to the number of people experiencing one or more fall-related fractures (RR 0.57, 95% CI 0.28 to 1.17; 989 participants, 5 studies; very low-certainty evidence). Exercise may slightly improve health-related quality of life immediately following the intervention (standardised mean difference (SMD) -0.17, 95% CI -0.36 to 0.01; 951 participants, 5 studies; low-certainty evidence). We are uncertain whether exercise has an effect on adverse events or whether exercise is a cost-effective intervention for fall prevention. Three studies trialled a cholinesterase inhibitor (rivastigmine or donepezil). Cholinesterase inhibitors may reduce the rate of falls by 50% (RaR 0.50, 95% CI 0.44 to 0.58; 229 participants, 3 studies; low-certainty evidence). However, we are uncertain if this medication makes little or no difference to the number of people experiencing one or more falls (RR 1.01, 95% CI 0.90 to 1.14230 participants, 3 studies) and to health-related quality of life (EQ5D Thermometer mean difference (MD) 3.00, 95% CI -3.06 to 9.06; very low-certainty evidence). Cholinesterase inhibitors may increase the rate of non fall-related adverse events by 60% (RaR 1.60, 95% CI 1.28 to 2.01; 175 participants, 2 studies; low-certainty evidence). Most adverse events were mild and transient in nature. No data was available regarding the cost-effectiveness of medication for fall prevention. We are uncertain of the effect of education compared to a control intervention on the number of people who fell at least once (RR 10.89, 95% CI 1.26 to 94.03; 53 participants, 1 study; very low-certainty evidence), and no data were available for the other outcomes of interest for this comparisonWe are also uncertain (very low-certainty evidence) whether exercise combined with education makes little or no difference to the number of falls (RaR 0.46, 95% CI 0.12 to 1.85; 320 participants, 2 studies), the number of people sustaining fall-related fractures (RR 1.45, 95% CI 0.40 to 5.32,320 participants, 2 studies), or health-related quality of life (PDQ39 MD 0.05, 95% CI -3.12 to 3.23, 305 participants, 2 studies). Exercise plus education may make little or no difference to the number of people experiencing one or more falls (RR 0.89, 95% CI 0.75 to 1.07; 352 participants, 3 studies; low-certainty evidence). We are uncertain whether exercise combined with education has an effect on adverse events or is a cost-effective intervention for fall prevention. AUTHORS' CONCLUSIONS: Exercise interventions probably reduce the rate of falls, and probably slightly reduce the number of people falling in people with mild to moderate PD. Cholinesterase inhibitors may reduce the rate of falls, but we are uncertain if they have an effect on the number of people falling. The decision to use these medications needs to be balanced against the risk of non fall-related adverse events, though these adverse events were predominantly mild or transient in nature. Further research in the form of large, high-quality RCTs are required to determine the relative impact of different types of exercise and different levels of supervision on falls, and how this could be influenced by disease severity. Further work is also needed to increase the certainty of the effects of medication and further explore falls prevention education interventions both delivered alone and in combination with exercise.
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Affiliation(s)
- Natalie E Allen
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Colleen G Canning
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Lorena Rosa S Almeida
- Movement Disorders and Parkinson's Disease Clinic, Roberto Santos General Hospital, Salvador, Brazil
- Motor Behavior and Neurorehabilitation Research Group, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Bastiaan R Bloem
- Raboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, Netherlands
| | - Samyra Hj Keus
- Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
- Quality and Improvement, OLVG, Amsterdam, Netherlands
| | - Niklas Löfgren
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Women's and Children's Health, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Tiê P Yamato
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Vinciguerra C, Federico A. Neurological music therapy during the COVID-19 outbreak: updates and future challenges. Neurol Sci 2022; 43:3473-3478. [PMID: 35230597 PMCID: PMC8885382 DOI: 10.1007/s10072-022-05957-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/11/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND In the last few years, several studies confirmed the effectiveness of music therapy (MT) for the rehabilitative management of patients with neurological disorders. AIM Here we discuss the feasibility and disadvantages of tele-neurological MT (tele-NMT) compared to the traditional MT programmes. METHODS We selected all the articles registered in the Web of Knowledge, PubMed, Google Scholar and ScienceDirect from March 2020 to November 2021 concerning tele-NMT during the COVID-19 outbreak, collecting same examples and experiences. RESULTS With the advent of the COVID-19, several music-based interventions (MBIs) have been adapted from "in person" to a "remote and virtual" mode (through the telemedicine). DISCUSSION Tele-NMT could represent a promising option to provide constant care and support to people with neurological diseases during the pandemic.
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Affiliation(s)
- Claudia Vinciguerra
- Neurology Unit, EMG Lab, University Hospital "San Giovanni Di Dio E Ruggi d'Aragona", Largo Città Di Ippocrate, 84100, Salerno, Italy.
| | - Antonio Federico
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
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Szewczyk AK, Mitosek-Szewczyk K, Dworzańska E. Where words are powerless to express: Use of music in paediatric neurology. J Pediatr Rehabil Med 2022; 16:179-194. [PMID: 35599509 DOI: 10.3233/prm-200802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Music is an art form that strongly affects people and can elicit many different emotions at the same time, including happiness, anxiety, sadness, and even ecstasy. What is it about music that causes such a strong reaction from each of us? Music engages many senses, which in turn can produce a multiplicity of responses and help create more extensive neuronal connections, as well as influence behaviour through structural and functional changes in the brain. Music-based interventions as a therapeutic tool in rehabilitation are becoming more common. It is said that the impact of music on the human body is positive. However, what impact does music have on the young nervous system, especially the affected one? This review presents the advantages and disadvantages of the use of music in paediatric neurology to treat dyslexia, cerebral palsy, and stroke, among others. Potential negative impacts such as musicogenic epilepsy and hallucinations will be discussed.
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Affiliation(s)
- Anna K Szewczyk
- Department of Neurology, Medical University of Lublin, Lublin, Poland.,Doctoral School, Medical University of Lublin, Lublin, Poland
| | | | - Ewa Dworzańska
- Department of Child Neurology, Medical University of Lublin, Lublin, Poland
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32
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Wang L, Peng JL, Ou-Yang JB, Gan L, Zeng S, Wang HY, Zuo GC, Qiu L. Effects of Rhythmic Auditory Stimulation on Gait and Motor Function in Parkinson's Disease: A Systematic Review and Meta-Analysis of Clinical Randomized Controlled Studies. Front Neurol 2022; 13:818559. [PMID: 35493833 PMCID: PMC9053573 DOI: 10.3389/fneur.2022.818559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study aimed to summarize the effectiveness of rhythmic auditory stimulation (RAS) for the treatment of gait and motor function in Parkinson's disease (PD) through a systematic review and meta-analysis. Methods All studies were retrieved from eight databases. The effects of RAS on PD were determined using the following indicators: gait parameters including step length, stride width, step cadence, velocity, stride length; motor function including 6 min walk test (6MWT) and timed up-and-go test (TUGT); the Unified Parkinson's Disease Rating Scale (UPDRS); and the Berg Balance Scale (BBS). The risk map of bias of the quality of the studies and the meta-analysis results of the indicators was prepared with RevMan 5.2 software. Results Twenty-one studies were included in the systematic review, and 14 studies were included in the meta-analysis. In the meta-analysis, the results of gait parameters, namely, velocity, step length, and stride length, were statistically significant (P < 0.05), whereas the results of cadence and stride width were not statistically significant (P ≧ 0.05). The results of 6MWT and TUGT for motor function as well as UPDRS-II, UPDRS-III, and BBS were statistically significant (P < 0.05). Conclusions RAS could improve gait parameters, walking function, balance function, and daily living activities of individuals with PD. The application of RAS in conventional rehabilitation approaches can enhance motor performance in PD. Future studies should use a large sample size and a rigorous design to obtain strong conclusions about the advantages of RAS for the treatment of gait and motor function in PD.
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Affiliation(s)
- Lei Wang
- Department of Rehabilitation Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- *Correspondence: Lei Wang
| | - Jin-lin Peng
- Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-bin Ou-Yang
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Li Gan
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuai Zeng
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Hong-Yan Wang
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guan-Chao Zuo
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ling Qiu
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
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Braun Janzen T, Koshimori Y, Richard NM, Thaut MH. Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives. Front Hum Neurosci 2022; 15:789467. [PMID: 35111007 PMCID: PMC8801707 DOI: 10.3389/fnhum.2021.789467] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022] Open
Abstract
Research in basic and clinical neuroscience of music conducted over the past decades has begun to uncover music’s high potential as a tool for rehabilitation. Advances in our understanding of how music engages parallel brain networks underpinning sensory and motor processes, arousal, reward, and affective regulation, have laid a sound neuroscientific foundation for the development of theory-driven music interventions that have been systematically tested in clinical settings. Of particular significance in the context of motor rehabilitation is the notion that musical rhythms can entrain movement patterns in patients with movement-related disorders, serving as a continuous time reference that can help regulate movement timing and pace. To date, a significant number of clinical and experimental studies have tested the application of rhythm- and music-based interventions to improve motor functions following central nervous injury and/or degeneration. The goal of this review is to appraise the current state of knowledge on the effectiveness of music and rhythm to modulate movement spatiotemporal patterns and restore motor function. By organizing and providing a critical appraisal of a large body of research, we hope to provide a revised framework for future research on the effectiveness of rhythm- and music-based interventions to restore and (re)train motor function.
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Affiliation(s)
- Thenille Braun Janzen
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil
| | - Yuko Koshimori
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, CAMH, Toronto, ON, Canada
| | - Nicole M. Richard
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Faculty of Music, Belmont University, Nashville, TN, United States
| | - Michael H. Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- *Correspondence: Michael H. Thaut,
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Yang T, Liu Y, Li J, Xu H, Li S, Xiong L, Wang T. Advances in clinical basic research: Performance, treatments, and mechanisms of Parkinson disease. IBRAIN 2021; 7:362-378. [PMID: 37786563 PMCID: PMC10529016 DOI: 10.1002/ibra.12011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/05/2021] [Accepted: 12/05/2021] [Indexed: 02/05/2023]
Abstract
The loss of neuronal in the substantia nigra of the elderly contributes to striatal damage and plays a critical part in the common forms of neurodegenerative diseases such as Parkinson disease (PD). The deficit of dopamine is one of the most familiar neuropathological features of PD as well as α-Synuclein aggregation. The peripheral autonomic nervous system is also affected negatively during the course of the disease, although the subsistent of dyskinesias and else major motor characteristic deficits take significant role in the diagnostic methods during clinical practice, which is related to a number of non-motor symptoms that might increase aggregate risks. Multiple pathways and mechanisms are involved in the molecular pathogenesis: α-Synuclein, neuronal homeostasis, mitochondrial function, oxidative stress, as well as neuroinflammation. Investigations in the last few years for diagnostic biomarkers used neuroimaging, including single photon emission computed tomography as well as cutting-edge magnetic resonance imaging techniques, which has been presented to facilitate discrepant diagnosis. Pharmacological treatment is also important and efficient in equal measure. In addition to reliance on striatal dopamine replacement therapy, many solutions that are used for motor or nonmotor symptoms in these patients are available.
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Affiliation(s)
- Ting‐Ting Yang
- Department of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Yu‐Cong Liu
- Department of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Jing Li
- Department of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Hui‐Chan Xu
- Department of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Shun‐Lian Li
- Department of AnesthesiologyZunyi Medical UniversityZunyiGuizhouChina
| | - Liu‐Lin Xiong
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Ting‐Hua Wang
- Department of Anesthesiology, Translational Neuroscience Center, Institute of Neurological Disease, West China HospitalSichuan UniversityChengduChina
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Forman CR, Nielsen JB, Lorentzen J. Neuroplasticity at Home: Improving Home-Based Motor Learning Through Technological Solutions. A Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:789165. [PMID: 36188793 PMCID: PMC9397835 DOI: 10.3389/fresc.2021.789165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022]
Abstract
Background: Effective science-based motor rehabilitation requires high volume of individualized, intense physical training, which can be difficult to achieve exclusively through physical 1-on-1 sessions with a therapist. Home-based training, enhanced by technological solutions, could be a tool to help facilitate the important factors for neuroplastic motor improvements. Objectives: This review aimed to discover how the inclusion of modern information and communications technology in home-based training programs can promote key neuroplastic factors associated with motor learning in neurological disabilities and identify which challenges are still needed to overcome. Methods: We conducted a thorough literature search on technological home-based training solutions and categorized the different fundamental approaches that were used. We then analyzed how these approaches can be used to promote certain key factors of neuroplasticity and which challenges still need to be solved or require external personalized input from a therapist. Conclusions: The technological approaches to home-based training were divided into three categories: sensory stimuli training, digital exchange of information training, and telerehabilitation. Generally, some technologies could be characterized as easily applicable, which gave the opportunity to promote flexible scheduling and a larger overall training volume, but limited options for individualized variation and progression. Other technologies included individualization options through personalized feedback that might increase the training effect, but also increases the workload of the therapist. Further development of easily applicable and intelligent solutions, which can return precise feedback and individualized training suggestions, is needed to fully realize the potential of home-based training in motor learning activities.
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Affiliation(s)
- Christian Riis Forman
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
- Elsass Foundation, Charlottenlund, Denmark
| | - Jens Bo Nielsen
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
- Elsass Foundation, Charlottenlund, Denmark
| | - Jakob Lorentzen
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
- Department of Pediatric Neurology, University Hospital Rigshospitalet, Copenhagen, Denmark
- *Correspondence: Jakob Lorentzen
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Abril-Jiménez P, Merino-Barbancho B, Vera-Muñoz C, Arredondo Waldmeyer MT. Co-designing a remote rehabilitation tool for Parkinson's disease: exploratory values and challenges. BMC Neurol 2021; 21:491. [PMID: 34915855 PMCID: PMC8675517 DOI: 10.1186/s12883-021-02519-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Impaired motor function is one of the early symptoms shown in patients with Parkinson Disease (PD). For this reason, rehabilitative interventions have been used for many years to improve motor and non-motor symptoms. Among them, the use of music therapy has shown benefits in helping to overcome some of the most common motor dysfunction. Addressing the challenge of providing access to this type of therapy, this document presents the collaborative design process to develop a remote training support tool for PD based on music therapy. METHODS A qualitative study with creative co-design methods was used in which different groups of healthcare professionals, patients, and relatives participated in six iterative sessions. Workshops were designed and structured to incrementally discover requirements and needs and validate the proposed prototype ideas. RESULTS The study provided key aspects that were used for the development and validation of the proposed prototypes for the remote music-based training support tool for PD. Up to 20 factors that had a positive and/or negative influence on patient access to training were detected. These factors were classified into three common themes: daily activities and independence, participation in treatment and barriers to daily treatment, and self-management and personalization of information and telecommunication technologies (ICT). CONCLUSIONS This paper shows the results of a collaborative design process aimed at identifying the different factors, relevant to patients with PD, to improve their access to remote ICT-based training therapy and their expectations regarding alternative therapies, such as music. The participatory design methods and the iterative model used helped overcome many of the traditionally barriers that this type of technological support solutions usually have, facilitating the future participation.
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Affiliation(s)
- Patricia Abril-Jiménez
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Avda Complutense 30, D108, 28040 Madrid, Spain
| | - Beatriz Merino-Barbancho
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Avda Complutense 30, D108, 28040 Madrid, Spain
| | - Cecilia Vera-Muñoz
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Avda Complutense 30, D108, 28040 Madrid, Spain
| | - María Teresa Arredondo Waldmeyer
- Universidad Politécnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Avda Complutense 30, D108, 28040 Madrid, Spain
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Machado Sotomayor MJ, Arufe-Giráldez V, Ruíz-Rico G, Navarro-Patón R. Music Therapy and Parkinson's Disease: A Systematic Review from 2015-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11618. [PMID: 34770129 PMCID: PMC8582661 DOI: 10.3390/ijerph182111618] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 12/05/2022]
Abstract
Parkinson's disease can be approached from various points of view, one of which is music therapy-a complementary therapy to a pharmacological one. This work aims to compile the scientific evidence published in the last five years (2015-2020) on the effects of music therapy in patients with Parkinson's disease. A systematic review has been performed using the Web of Science and Scopus databases with the descriptors "music therapy" and "Parkinson's disease". A total of 281 eligible articles were identified, which, after applying the inclusion and exclusion criteria, were reduced to 58 papers. The results display a great diversity of evidence, confirming positive effects on various spheres. All mentioned patients with Parkinson's disease had experienced different music therapy programs. Some studies focused on the motor component, which can be addressed through listening, body rhythm, and rhythmic auditory stimulation. Other studies confirm effects on communication, swallowing, breathing, and the emotional aspect through programs that focus on singing, either individually or in groups, in order to improve the quality of life of people with PD. It was concluded that music therapy programs can achieve improvements in various areas of patients with Parkinson's.
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Affiliation(s)
| | - Víctor Arufe-Giráldez
- Department of Specific Teaching Training and Research and Diagnosis Methods in Education, University of A Coruña, 15001 A Coruña, Spain
| | - Gerardo Ruíz-Rico
- Department of Education, Educational Sciences Faculty, University of Almería, 04120 Almería, Spain;
| | - Rubén Navarro-Patón
- Department of Applied Learning, Faculty of Teacher Training, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain;
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Assessment of Risk Factors for Falls among Patients with Parkinson's Disease. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5531331. [PMID: 34621895 PMCID: PMC8492255 DOI: 10.1155/2021/5531331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 08/23/2021] [Accepted: 09/03/2021] [Indexed: 12/22/2022]
Abstract
Introduction The aim of this study was to assess the risk factors for falls in patients with Parkinson's disease. Materials and Methods The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson's disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility (χ2 = 31.86, p < 0.001), number of falls (χ2 = 37.92, p < 0.001), independence of the subjects (χ2 = 19.28, p < 0.001), type of injury suffered during the fall (χ2 = 36.93, p < 0.001), external factors (χ2 = 33.36, p < 0.001), and the level of fear of falling (χ2 = 8.88, p < 0.001). A significant relationship also occurred between the number of falls and the fear of falling (χ2 = 33.49, p < 0.001) and between the number of falls and disease severity (χ2 = 45.34, p < 0.001). The applied physiotherapy did not reduce the risk of falls (χ2 = 3.18, p = 0.17). Conclusions Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one's path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.
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Suárez-Iglesias D, Santos L, Sanchez-Lastra MA, Ayán C. Systematic review and meta-analysis of randomised controlled trials on the effects of yoga in people with Parkinson's disease. Disabil Rehabil 2021; 44:6210-6229. [PMID: 34533097 DOI: 10.1080/09638288.2021.1966522] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Yoga may be a beneficial treatment for people with Parkinson's disease (PD). However, no studies have critically reviewed and meta-analyzed the scientific evidence for yoga's benefits regarding motor and non-motor symptoms. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of yoga as a rehabilitation strategy for PD. MATERIALS AND METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was performed using MEDLINE/PubMed, PEDro, SPORTDiscus, and Scopus. Studies addressing any concepts on the impact of yoga intervention on physical and psychological outcomes in people with PD were included. RESULTS Fourteen RCTs were selected, with heterogeneous protocols and outcomes measures. Yoga interventions were safe and well-accepted for patients with mild to moderate PD. The descriptive analysis indicated that its practice might provide both physical and psychological benefits. Preliminary evidence showed that yoga has comparable or superior efficacy to exercise. A subsequent meta-analysis on five RCTs detected that yoga was more effective than passive control in ameliorating motor symptoms. CONCLUSIONS Yoga appears to be a promising rehabilitative therapy for individuals with PD. Recommendations are proposed for future studies.IMPLICATIONS FOR REHABILITATIONYoga is a safe and feasible therapy for people with mild to moderate PD.Yoga practice positively impacts physical and mental health in this population.When compared to exercise, yoga showed to have similar or even greater effects.
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Affiliation(s)
- David Suárez-Iglesias
- VALFIS Research Group, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Luis Santos
- Department of Physical Education and Sports, University of León, León, Spain.,Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Miguel A Sanchez-Lastra
- Universidade de Vigo, Departamento de Didácticas Especiais, Facultade de Ciencias da Educación e do Deporte, University of Vigo, Pontevedra, Spain
| | - Carlos Ayán
- Universidade de Vigo, Departamento de Didácticas Especiais, Facultade de Ciencias da Educación e do Deporte, University of Vigo, Pontevedra, Spain.,WellMove Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO
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40
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Pang MY. Physiotherapy management of Parkinson's disease. J Physiother 2021; 67:163-176. [PMID: 34154949 DOI: 10.1016/j.jphys.2021.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 05/03/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023] Open
Affiliation(s)
- Marco Yc Pang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong.
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Chen W, Zheng J, Shen G, Ji X, Sun L, Li X, Xu F, Gu JH. Music Therapy Alleviates Motor Dysfunction in Rats With Focal Cerebral Ischemia-Reperfusion Injury by Regulating BDNF Expression. Front Neurol 2021; 12:666311. [PMID: 34262520 PMCID: PMC8273236 DOI: 10.3389/fneur.2021.666311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Aim: Music-based therapy plays a role in central nervous system diseases. We aimed to explore the effect of different doses and durations of music therapy on motor function recovery after stroke and the underlying molecular mechanisms. Methods: Adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 1 h, which was followed by reperfusion. In experiment 1, the rats that survived 1 week after MCAO surgery were randomly allocated into four groups (n = 10 per group): MCAO group, 1 h music group (Mozart K.448 music therapy 1 h per day for 2 weeks), 12 h music group (Mozart K.448 music therapy 12 h/day for 2 weeks), and accelerated music group (reversely accelerated music therapy 12 h for 2 weeks, AM group). In experiment 2, the survived rats were randomly divied into three groups: MCAO group, 12 h music group (music therapy 12 h/day for 3 weeks), and 12 h music-R group (music therapy 12 h/day for 2 weeks and rest for 1 week). Three neuroscores were evaluated daily, starting on the first day after surgery until the end of the experiment. The rats were killed 3 weeks after MCAO surgery in experiment 1 or 4 weeks after surgery in experiment 2. Nissl staining of infart core, peri-infarct zone, and motor cortex was performed to assess neuronal survival and regeneration. Western blot and immunofluorescence were used to detect the expression and distribution of brain-derived neurotrophic factor (BDNF) and glial fibrillary acidic protein (GFAP) in ipsilateral hemispheres. Results: In the experiment of different music therapy doses, the motor function in the 12-h music group but not in the 1-h music group and AM group was significantly improved compared with that of the MCAO group. The BDNF protein level of the ipsilateral hemisphere motor cortex in the 12-h music group and the 1-h music group was higher than that of the MCAO group. The neurons and Nissl bodies were more in the 12-h music group than in the MCAO group. Immunofluorescence assay showed that a 12 h music therapy induces BDNF and GFAP accumulation at the damage boundary. In the experiment of different music therapy durations, 3 weeks music therapy (12 h music group) induced more longer cell synapses and more clearer cell-to-cell connections than 2 weeks music intervention (12 h music-R group). Moreover, the GFAP morphology in the 12-h music group was more similar to mature activated astrocytes than that in the 12-h music-R group. Conclusions: Music therapy may improve poststroke motor function and promote neuronal repair in the long term. The mechanism may be through stimulating BDNF and GFAP secretion in the injured motor cortex.
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Affiliation(s)
- Weiguan Chen
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Jiaxuan Zheng
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, China.,Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guangyu Shen
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Xin Ji
- Department of Clinical Pharmacy, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Linlin Sun
- Department of Clinical Pharmacy, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
| | - Xia Li
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Feng Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jin-Hua Gu
- Department of Clinical Pharmacy, Affiliated Maternity & Child Healthcare Hospital of Nantong University, Nantong, China
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Krotinger A, Loui P. Rhythm and groove as cognitive mechanisms of dance intervention in Parkinson's disease. PLoS One 2021; 16:e0249933. [PMID: 33956853 PMCID: PMC8101757 DOI: 10.1371/journal.pone.0249933] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/26/2021] [Indexed: 11/18/2022] Open
Abstract
Parkinson's disease (PD) is associated with a loss of internal cueing systems, affecting rhythmic motor tasks such as walking and speech production. Music and dance encourage spontaneous rhythmic coupling between sensory and motor systems; this has inspired the development of dance programs for PD. Here we assessed the therapeutic outcome and some underlying cognitive mechanisms of dance classes for PD, as measured by neuropsychological assessments of disease severity as well as quantitative assessments of rhythmic ability and sensorimotor experience. We assessed prior music and dance experience, beat perception (Beat Alignment Test), sensorimotor coupling (tapping to high- and low-groove songs), and disease severity (Unified Parkinson's Disease Rating Scale in PD individuals) before and after four months of weekly dance classes. PD individuals performed better on UPDRS after four months of weekly dance classes, suggesting efficacy of dance intervention. Greater post-intervention improvements in UPDRS were associated with the presence of prior dance experience and with more accurate sensorimotor coupling. Prior dance experience was additionally associated with enhanced sensorimotor coupling during tapping to both high-groove and low-groove songs. These results show that dance classes for PD improve both qualitative and quantitative assessments of disease symptoms. The association between these improvements and dance experience suggests that rhythmic motor training, a mechanism underlying dance training, impacts improvements in parkinsonian symptoms following a dance intervention.
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Affiliation(s)
- Anna Krotinger
- Department of Biology, Wesleyan University, Middletown, Connecticut, United States of America
- Center for Bioethics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Psyche Loui
- Department of Biology, Wesleyan University, Middletown, Connecticut, United States of America
- Department of Music, Northeastern University, Boston, Massachusetts, United States of America
- Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Middletown, Connecticut, United States of America
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Wan Z, Liu X, Yang H, Li F, Yu L, Li L, Wang Y, Jiang H, Zou J, Du J. Effects of Health Qigong Exercises on Physical Function on Patients with Parkinson's Disease. J Multidiscip Healthc 2021; 14:941-950. [PMID: 33953563 PMCID: PMC8091455 DOI: 10.2147/jmdh.s303945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/25/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To measure motor function improvements in patients with Parkinson's disease (PD) using Health Qigong exercises. Patients and Methods Fifty-two PD patients (Hoehn and Yahr stages I to IV) were randomly divided into experimental and control groups. Twenty-six PD patients in the experimental group were intervened with routine medicine and fitness Qigong exercise. The other 26 PD patients as the control group were treated only with regular medication. Twelve-week intervention had been conducted for the study, and participants completed the scheduled exercises 4 times per week for 60 minutes each time. Data which included the one-legged blind balance, physical coordination, and gait was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the repeated measures analysis of variance. Results A total of 40 participants (77% response rate) completed the study. There was no significant difference in baseline data. After 12 weeks of Health Qigong therapy, the length of time the one-legged blind balance test had increased (P < 0.01), and the time it took to TUG test was reduced (P < 0.01). Joint range of motion and gait significantly improved. The control group's there were no significant differences in the above variables, except for joint range of motion, which decreased. Conclusion Health Qigong exercises can significantly improve physical functions in patients with PD, especially for the balance ability, gait, joint range of motion in patients with PD. It can reduce their activity risk factor and improve their quality of life.
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Affiliation(s)
- Zhirong Wan
- Department of Neurology, Aerospace Central Hospital, Beijing, 100049, People's Republic of China
| | - Xiaolei Liu
- Chinese Traditional Regimen Exercise Intervention Research Center, Beijing Sport University, Beijing, 100084, People's Republic of China
| | - Hui Yang
- China Wushu Academy, Beijing Sport University, Beijing, 100084, People's Republic of China
| | - Fang Li
- Chinese Traditional Regimen Exercise Intervention Research Center, Beijing Sport University, Beijing, 100084, People's Republic of China
| | - Lingling Yu
- Physical Education School of Inner Mongolia Normal University, Hohhot, Inner Mongolia, People's Republic of China
| | - Lei Li
- School of Physical Education, Lu Dong University, Shandong, 264011, People's Republic of China
| | - Yulin Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Hao Jiang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, People's Republic of China
| | - Junjie Zou
- Neurology Department, Yantai Penglai People's Hospital, Yantai, 265600, People's Republic of China
| | - Jichen Du
- Department of Neurology, Aerospace Central Hospital, Beijing, 100049, People's Republic of China
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Cole LP, Henechowicz TL, Kang K, Pranjić M, Richard NM, Tian GLJ, Hurt-Thaut C. Neurologic Music Therapy via Telehealth: A Survey of Clinician Experiences, Trends, and Recommendations During the COVID-19 Pandemic. Front Neurosci 2021; 15:648489. [PMID: 33897362 PMCID: PMC8060694 DOI: 10.3389/fnins.2021.648489] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/09/2021] [Indexed: 11/28/2022] Open
Abstract
This cross-sectional survey investigated the transition of Neurologic Music Therapy (NMT) services from in-person (pre-COVID-19) to telehealth (since COVID-19) to (1) determine whether the use of an NMT paradigm contributes to the successful transition of therapy services to telehealth, (2) identify which NMT domains and techniques are transferable from in-person to telehealth, (3) identify whether there are differences in the transition of NMT services across different employment settings, and (4) evaluate the potential benefits and challenges of telehealth NMT. An online survey comprised of 49 closed and open-ended questions was distributed by the Academy of Neurologic Music Therapy to 2,778 NMT affiliates worldwide. The survey sought information on demographics, telehealth perceptions, technology, assessment, clinical practice, safety, and caregiver involvement. Quantitative and qualitative analyses were applied. Eighty-one participants answered the survey and the 69 who completed the survey in its entirety were included in the analysis. Results indicated that the frequency of NMT technique usage had no impact on the overall number of clinical hours retained over telehealth. Correlation analysis revealed an association between more frequent NMT usage and perceived likelihood of using telehealth in the future (i.e., once COVID-19 is no longer a major threat), as well as with fewer group sessions lost over telehealth. All NMT domains transferred to telehealth, although within the sensorimotor domain, fewer therapists implemented rhythmic auditory stimulation for telehealth sessions compared to in-person. Overall, NMTs had fewer hours for telehealth compared to in-person regardless of employment setting. Technological challenges were notable drawbacks, while major benefits included the ability to continue providing NMT when in-person sessions were not possible, increased accessibility for remote clients, and positive outcomes related to increased caregiver involvement. Based on the results, our recommendations for implementing telehealth in Neurologic Music Therapy include integrating telehealth into routine care, mitigating safety concerns, identifying those who could benefit most from remote delivery, involving caregivers, and developing/sharing resources for telehealth NMT.
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Affiliation(s)
- Lauren Patricia Cole
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Tara Lynn Henechowicz
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Kyurim Kang
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Marija Pranjić
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Nicole Marie Richard
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Gloria L J Tian
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Corene Hurt-Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
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Effect of Short-Term Metro-Rhythmic Stimulations on Gait Variability. Healthcare (Basel) 2021; 9:healthcare9020174. [PMID: 33561987 PMCID: PMC7915596 DOI: 10.3390/healthcare9020174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to define the effect of different short-term metro-rhythmic stimulations on the time and spatial parameters of gait. The secondary goal was to test whether prior instructions on how to respond to stimulations played a significant role in the stimulation by sound stimuli. Experimental tests of gait were conducted on a group of 36 healthy participants: group 1—subjects who were not informed how to react after hearing sound stimuli, group 2—subjects who received a clear instruction before the test to adjust the frequency of taking steps to the rhythm of the music. The gait research was carried out on a Zebris FDM-S (zebris Medical Gmbh, Isny, Germany) treadmill for various sound stimuli (arrhythmic stimulus, rhythmic stimuli at different rate). It was shown that a short-term influence of metro-rhythmic stimulations changes the time and spatial parameters of gait, i.e., gait frequency, length and duration of the gait cycle. The greatest impact on the modification of the time–space parameters of walking is exerted by rhythmic stimuli at a pace different from the frequency of gait at a preferred velocity. Providing information on how to respond to sounds heard may be important in gait therapy with RAS (rhythmic auditory stimulation).
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Alatawi SF. A scoping review of the nature of physiotherapists' role to avoid fall in people with Parkinsonism. Neurol Sci 2021; 42:3733-3748. [PMID: 33443671 PMCID: PMC8413181 DOI: 10.1007/s10072-020-05015-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 12/18/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is considered a neurological disease with a high prevalence rate among population. One of its main problems is recurrent fall which has numerous contributing factors such as history of fall, fear of falling, gait deficits, impaired balance, poor functional mobility, and muscle weakness. OBJECTIVE To review and explore the focus/nature of interventions which target the role of physiotherapy preventing fall in patients with PD. METHOD A scoping review was led dependent on Arksey and O'Malley as discussed by Wood et al. (2002). This paper based on this structure to perceive intervention studies have been embraced in physiotherapy to prevent fall after Parkinson's disease. The search included various databases. The referencing arrangements of every pertinent paper were additionally filtered for more studies. FINDINGS A total of 173 articles were included, 39 of which met the eligibility criteria. Fifteen studies reported on the direct impact of physiotherapy on fall, while the rest examined the impacts of physiotherapy on factors that are associated with fall. Different outcomes, interventions types, and duration were used in these studies. Findings showed a favorable result of physiotherapy on fall and near fall incidence, balance, gait, functional mobility, muscle strength, and fear of falling. CONCLUSION Physiotherapy has the possibility to decrease fall incidence and fall risk in people with PD. However, the heterogeneity in the patients' selection, intervention studies, outcome measures chosen, time since the onset of disease, variation in intensity, and duration of treatment between included studies make the comparisons difficult. Consequently, more studies are needed on best intervention.
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Affiliation(s)
- Salem F. Alatawi
- grid.440760.10000 0004 0419 5685Associate professor of neurorehabilitation Department of Physical Therapy Faculty of Applied Medical Sciences, University of Tabuk, Tabuk City, Saudi Arabia
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People with Parkinson disease with and without freezing of gait respond similarly to external and self-generated cues. Gait Posture 2020; 82:161-166. [PMID: 32932076 PMCID: PMC7718283 DOI: 10.1016/j.gaitpost.2020.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait deficits in Parkinson disease (PD), including freezing of gait (FOG), can be among the most debilitating symptoms. Rhythmic auditory cueing has been used to alleviate some gait symptoms. However, different cue types, such as externally-generated and self-generated cues, affect gait variability differently. The differential effects of these cue types on people with PD with FOG (PD + FOG), who often have higher gait variability, and those with PD without FOG (PD-FOG) is unknown. Given the relationship of gait variability to fall risk, this is an important area to address. RESEARCH QUESTION This study aims to 1) confirm the association between falls and gait variability measures in PD-FOG, PD + FOG and age-matched Controls; 2) investigate the effects of different cue types on gait variability in PD-FOG and PD + FOG; and 3) determine whether baseline gait characteristics are associated with response to cues. METHODS This cross-sectional study investigated PD-FOG (n = 24), PD + FOG (n = 20), and Controls (n = 24). Gait trials were collected during use of externally-generated and self-generated cues for all participants. Gait variability measures were the primary outcomes to assess the effects of rhythmic auditory cues. RESULTS Logistic regression models showed increased gait variability was associated with falls across groups. Repeated measures ANOVAs showed externally-generated cues increased gait variability, whereas self-generated cues did not, for all groups. Pearson's correlations showed participants with higher baseline gait variability had greater reduction in gait variability with rhythmic auditory cueing. SIGNIFICANCE Higher gait variability is associated with falls. This study demonstrates that PD + FOG are capable of using self-generated cues without increasing gait variability measures, thereby stabilizing gait. People with higher baseline gait variability are likely to experience the largest reductions in variability with the addition of external cues.
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Currey J, Sheng D, Neph Speciale A, Cinquini C, Cuza J, Waite BL. Performing Arts Medicine. Phys Med Rehabil Clin N Am 2020; 31:609-632. [PMID: 32981582 DOI: 10.1016/j.pmr.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Performing artists are a unique subset of athletes. With the highly repetitive nature of performance training, emphasis on proper technique, ergonomics, and preventive cross-training is vital, as many injuries are due to overuse or poor technique. There are novel medical concerns in performers, including ENT problems, mental health concerns and substance use risks. While music is central to performances, it is also a treatment modality to address cognitive, sensory, and motor dysfunctions in certain neurological conditions. Due to this wide array of issues, it is imperative to understand the specific needs and risks of performers to provide optimal medical care.
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Affiliation(s)
- Jovauna Currey
- Department of Sports and Physical Medicine, Kaiser Permanente, The Permanente Medical Group, 3975 Old Redwood Highway, MOB 5, Suite 152, Santa Rosa, CA 95403, USA. https://twitter.com/jcurreymd
| | - Dana Sheng
- Department of Physical Medicine and Rehabilitation, UC Davis, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
| | - Alyssa Neph Speciale
- Department of Physical Medicine and Rehabilitation, UC Davis, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
| | - Camilla Cinquini
- Kaiser Permanente Rehabilitation, The Permanente Medical Group, 3975 Old Redwood Highway, MOB 5, Suite 154, Santa Rosa, CA 95403, USA
| | - Jorge Cuza
- Department of Physical Medicine and Rehabilitation, UC Davis, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
| | - Brandee L Waite
- Department of Physical Medicine and Rehabilitation, UC Davis School of Medicine, UC Davis Sports Medicine, 3301 C Street, Suite 1600, Sacramento, CA 95816, USA.
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Katlen da Silva L, Silva Brito TS, Pascucci Sande de Souza LA, Luvizutto GJ. Music-based physical therapy in Parkinson's disease: An approach based on international Classification of Functioning, Disability and Health. J Bodyw Mov Ther 2020; 26:524-529. [PMID: 33992292 DOI: 10.1016/j.jbmt.2020.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/31/2020] [Accepted: 08/30/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Several studies suggests that the provision of auditory cues with music could be beneficial for people with Parkinson's Disease (PD). The aim of the study was to evaluate the effects of music-based physical therapy on the international Classification of Functioning, Disability and Health (ICF) components: disability, cognition, muscle strength, balance, and functional mobility. METHODS This was a controlled, non-randomized clinical trial involving 13 individuals with PD assessed at three times: baseline, period 1 (treatment), and period 2 (no treatment). The variables analyzed were: disability by Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn & Yahr (H&Y), cognitive function by Trail Making Test, muscle strength by Medical Research Council (MRC) and sitting-rising (SR) test, balance and functional mobility by Berg Balance Scale (BBS) and Timed up and Go (TUG). ANOVA with post-hoc multiple comparison was used to determine statistical differences between the baseline, period 1 and 2. RESULTS there was statistically significant difference among the period 1 and 2 for the cognitive function; there was a statistically significant difference between the period 1 and 2 in SR test; in the balance evaluation by BBS, an increase was observed between the baseline and the period 1, followed by a decrease in period 2; in the TUG, there was an increase between the period 1 and 2. CONCLUSION the music-based physical therapy, according to the ICF construct, was able to improve balance and functional mobility in individuals with PD. The functional gains were not maintained when the therapy was discontinued.
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Affiliation(s)
- Luana Katlen da Silva
- Undergraduate of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | | | - Gustavo José Luvizutto
- Professor of Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
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Lachance B, Fortin S, Bier N, Swaine B. Exploring the impact of a clinical dance therapy program on the mobility of adults with a neurological condition using a single-case experimental design. Arts Health 2020; 13:278-295. [PMID: 32809914 DOI: 10.1080/17533015.2020.1802606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study built upon previous quasi-experimental design research studying the effectiveness of a 12-week dance therapy program for persons with a physical disability (DTPD) aiming to improve mobility. METHODS We conducted a single-case experimental design (SCED), including pre- and post-interventions measures, with seven participants with repeated measures during pre-dance (A1), dance program (B) and post-dance phases (A2). RESULTS Five participants completed the study and significantly (p < 0.05) improved their scores on the MiniBESTest; 2/5 and 4/5 improved scores for the 4 Square Step Test and the Multidirectional Reach Test-Behind, respectively, with very large effect size (ES). Aggregated ES (A1-A2) went from moderate to very large. CONCLUSIONS Results support the effectiveness of the DTPD program for adults with neurological conditions, and for the use of SCED to explore effectiveness of dance interventions for heterogeneous cohorts.
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Affiliation(s)
- Brigitte Lachance
- School of Rehabilitation, Faculty of Medicine, Université De Montréal (Udem), Montréal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada.,Institut universitaire en réadaptation déficience physique de Montréal, Montréal, Canada.,Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'Île-de-Montréalal, Montréal, Canada
| | - Sylvie Fortin
- Department of Dance, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - Nathalie Bier
- School of Rehabilitation, Faculty of Medicine, Université De Montréal (Udem), Montréal, Canada.,Centre de recherche, Institut universitaire de gériatrie, Montréal, Canada
| | - Bonnie Swaine
- School of Rehabilitation, Faculty of Medicine, Université De Montréal (Udem), Montréal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada.,Institut universitaire en réadaptation déficience physique de Montréal, Montréal, Canada
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