The effect of metronome and music on gait variability in people with Parkinson’s disease (P2.8-018)

Objective: This study compares the effect of metronome and music rhythms with variable inter-beat intervals on gait variability in people with Parkinson’s disease (PD).

Background: People with PD benefit from external auditory stimulation to stabilize gait. Stimuli with beat-to-beat variability mimicking the stride-to-stride variability present in healthy locomotion may provide greater benefits than traditional periodic stimuli. It is unknown if musical stimuli would provide greater benefits compared to metronome stimuli.

Design/Methods: Fourteen people with PD (67.79 ±9.54 y.o.) and fourteen controls (70.79 ±9.88 y.o.) walked for twelve minutes around an indoor track three different times. They first walked without stimuli at preferred speed; they were then instructed to step in time in random order with metronome or musical stimulus presenting beat-to-beat fluctuations, centered around the participant’s preferred tempo. The perceived difficulty and enjoyability of each trial was assessed using continuous Likert-like scales. Gait measures were recorded using force-sensitive insoles. Gait variability was assessed using the coefficient of variation (CV) and the scaling exponent α-DFA.

Results: Two-ways ANOVAs (2 groups × 3 trials) did not detect main nor interaction effects for α-DFA. There was no interaction nor main effect of group for CV, but there was a main effect of trials (p=.039). Paired sample t-test revealed that CV was higher during both metronome (p=.04) and music (p=.008) trials compared to baseline. The control group perceived the music significantly more difficult to sync with than the metronome (p=.033). The PD group presented a similar (non-significant) trend. Both groups considered both stimuli equally enjoyable.

Conclusions: Our results question previous studies suggesting that variable auditory cues improve gait in patients with PD. Both stimuli lead participants to walk with a (non-significant) healthier pattern of fluctuations, but with a less stable gait (i.e., greater CV). Future studies should test the efficacy of variable metronomes in patients with greater impairments.

Disclosure: Dr. Hellman has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Teva Pharmaceuticals. Dr. Marmelat has nothing to disclose. Dr. Duncan has nothing to disclose. Dr. Meltz has nothing to disclose. Dr. Meidinger has nothing to disclose.