Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Neurology University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Gait Posture. 2020 Jun;79:41-45. doi: 10.1016/j.gaitpost.2020.04.003. Epub 2020 Apr 18.
Treadmills and rhythmic auditory cueing can influence stepping rhythm for individuals with Parkinson disease (PD). Of concern, however, is that auditory cueing directly addresses the temporal features of gait, whereas adjusting step length may be more important for people with PD. Stepping to a faster cadence when walking overground may increase gait speed, but without requiring an increased step length. Furthermore, given the potentially valuable role of walking on a treadmill for individuals with PD, we are concerned that increasing cadence with rhythmic auditory cueing while walking at a constant treadmill speed will induce even shorter steps.
What is the effect of different metronome cue frequencies on spatiotemporal gait parameters when walking overground compared to walking on a treadmill in people with PD?
Using a repeated-measures design, 21 people with PD (stage 1-3) walked overground and on a treadmill with and without metronome cues of 85 %, 100 %, and 115 % of their baseline cadence frequency for one minute each. We assessed step length, and cadence during all conditions. Gait speed was assessed during overground gait.
An interaction effect between cue frequency and walking environment revealed that participants took longer steps during the 85 % condition on the treadmill only. When walking overground, metronome cues of 85 % and 115 % of baseline cadence yielded decreases and increases, respectively, in both cadence and gait speed with no associated change in step length.
These data suggest that people with PD are able to alter spatiotemporal gait parameters immediately when provided the appropriate metronome cue and walking environment. We propose to target shortened step lengths by stepping to the beat of slow frequency auditory cues while walking on a treadmill, whereas the use of fast frequency cues during overground walking can facilitate faster walking speeds.
跑步机和节奏听觉提示可以影响帕金森病（PD）患者的步幅节奏。然而，令人担忧的是，听觉提示直接针对步态的时间特征，而调整步长对于 PD 患者可能更为重要。在地面上行走时以更快的步频行走可能会增加步行速度，但无需增加步长。此外，鉴于在跑步机上行走对 PD 患者可能具有潜在的有益作用，我们担心在恒定跑步机速度下行走时，通过节奏听觉提示增加步频会导致步幅更短。
与在跑步机上行走相比，当 PD 患者在地面上行走时，不同节拍器提示频率对时空步态参数有何影响？
使用重复测量设计，21 名 PD 患者（1-3 期）分别在地面和跑步机上以 85%、100%和 115%的基线步频进行 1 分钟的无节拍器和节拍器提示行走。我们评估了所有条件下的步长和步频。在地面行走时评估步行速度。
提示频率和行走环境之间的交互作用表明，参与者仅在跑步机上 85%的条件下迈出更长的步。当在地面上行走时，85%和 115%的基线步频的节拍器提示分别导致步频和步行速度降低和增加，而步长没有变化。
这些数据表明，当提供适当的节拍器提示和行走环境时，PD 患者能够立即改变时空步态参数。我们建议在跑步机上以慢频率听觉提示行走时，通过跟随节拍来纠正缩短的步长，而在地面行走时使用快频率提示可以促进更快的步行速度。
