Bella Simone Dalla, Dotov Dobromir, Bardy Benoît, de Cock Valérie Cochen
International Laboratory for Brain, Music, and Sound Research (BRAMS), Department of Psychology, University of Montreal, Montreal, Canada.
EuroMov, Montpellier University, Montpellier, France.
Ann N Y Acad Sci. 2018 Jun 4. doi: 10.1111/nyas.13859.
Gait dysfunctions in Parkinson's disease can be partly relieved by rhythmic auditory cueing. This consists in asking patients to walk with a rhythmic auditory stimulus such as a metronome or music. The effect on gait is visible immediately in terms of increased speed and stride length. Moreover, training programs based on rhythmic cueing can have long-term benefits. The effect of rhythmic cueing, however, varies from one patient to the other. Patients' response to the stimulation may depend on rhythmic abilities, often deteriorating with the disease. Relatively spared abilities to track the beat favor a positive response to rhythmic cueing. On the other hand, most patients with poor rhythmic abilities either do not respond to the cues or experience gait worsening when walking with cues. An individualized approach to rhythmic auditory cueing with music is proposed to cope with this variability in patients' response. This approach calls for using assistive mobile technologies capable of delivering cues that adapt in real time to patients' gait kinematics, thus affording step synchronization to the beat. Individualized rhythmic cueing can provide a safe and cost-effective alternative to standard cueing that patients may want to use in their everyday lives.
帕金森病中的步态功能障碍可通过有节奏的听觉提示得到部分缓解。这包括要求患者在有节奏的听觉刺激（如节拍器或音乐）下行走。从速度和步长增加方面来看，对步态的影响立竿见影。此外，基于有节奏提示的训练计划可能具有长期益处。然而，有节奏提示的效果因人而异。患者对刺激的反应可能取决于节奏能力，而这种能力通常会随着疾病的发展而恶化。相对保留的跟上节拍的能力有利于对有节奏提示产生积极反应。另一方面，大多数节奏能力较差的患者要么对提示没有反应，要么在跟着提示行走时步态恶化。为应对患者反应的这种变异性，提出了一种针对音乐有节奏听觉提示的个性化方法。这种方法要求使用能够提供实时适应患者步态运动学的提示的辅助移动技术，从而实现与节拍的步伐同步。个性化有节奏提示可以为患者在日常生活中可能想要使用的标准提示提供一种安全且经济高效的替代方案。
