Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA.
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
Gait Posture. 2021 Jun;87:101-109. doi: 10.1016/j.gaitpost.2021.04.028. Epub 2021 Apr 21.
Entrainment of walking with rhythmic auditory cues (e.g., metronome or music) induces gait improvements in people with Parkinson's disease (PD). However, evidence regarding acute impacts of music cues on parkinsonian gait is lacking. Findings in healthy adults imply that familiarity with music cues modulates stride amplitude and stride-to-stride variability; yet the role of familiarity with music on parkinsonian gait remains unknown.
To investigate 1) whether familiar and unfamiliar music cueing differentially influences stride and arm swing amplitude and stride-to-stride variability, 2) how stride and arm swing amplitude and stride-to-stride variability are altered by enhanced familiarity with music by repeated listening and walking during rhythmically-cued walking in persons with PD.
Twenty individuals with idiopathic PD (mean age = 68.9 years, 7 females, H&Y stage 1-3) walked in time with familiar and unfamiliar music cues (Session 1). Participants then repeatedly listened and walked to the same familiar and unfamiliar music cues (Session 2). Spatiotemporal gait parameters in each 2-min trial were recorded with motion capture wearable sensors.
In Session 1, gait velocity, stride length, arm swing peak velocity and range of motion, and stride-to-stride variability increased with both music cues compared with baseline; stride length, enjoyment and beat salience were greater in familiar than unfamiliar music cues. In Session 2, repeatedly listening and walking to unfamiliar music, but not familiar music, increased gait velocity, stride length, familiarity, enjoyment, and beat salience, and reduced stride-to-stride time variability.
Music cues in general induced acute improvements of stride and arm swing amplitude but not stride-to-stride variability, and enhanced familiarity with music improved stride amplitude and variability along with increased enjoyment and reduced cognitive demand in people with PD. Our findings aid in understanding the role of familiarity with music in alleviating gait disturbance and optimizing music-based interventions for PD.
通过有节奏的听觉提示（如节拍器或音乐）来诱导步行，可以改善帕金森病（PD）患者的步态。然而，关于音乐提示对帕金森步态的急性影响的证据尚缺乏。健康成年人的研究结果表明，对音乐提示的熟悉程度会调节步幅和步长变异性；然而，音乐对帕金森步态的熟悉程度的作用仍不清楚。
探究 1）熟悉和不熟悉的音乐提示是否会对步幅和手臂摆动幅度以及步长变异性产生不同的影响，2）在节奏提示步行中，通过反复听音乐和行走来增强对音乐的熟悉度，如何改变 PD 患者的步幅和手臂摆动幅度以及步长变异性。
20 名特发性 PD 患者（平均年龄=68.9 岁，女性 7 名，H&Y 分期 1-3）在熟悉和不熟悉的音乐提示下（第 1 次会话）与音乐同步行走。然后，参与者反复听并跟随相同的熟悉和不熟悉的音乐提示（第 2 次会话）。在每个 2 分钟的试验中，使用运动捕捉可穿戴传感器记录时空步态参数。
在第 1 次会话中，与基线相比，两种音乐提示都增加了步态速度、步长、手臂摆动峰值速度和运动范围以及步长变异性；与不熟悉的音乐提示相比，熟悉的音乐提示具有更大的步长、愉悦感和节拍显著性。在第 2 次会话中，反复听并跟随不熟悉的音乐，但不是熟悉的音乐，增加了步态速度、步长、熟悉度、愉悦感和节拍显著性，减少了步长变异性。
一般来说，音乐提示急性改善了步幅和手臂摆动幅度，但没有改善步长变异性，而增强对音乐的熟悉度则改善了 PD 患者的步幅幅度和变异性，同时增加了愉悦感，降低了认知需求。我们的发现有助于理解对音乐的熟悉程度在缓解步态障碍和优化基于音乐的 PD 干预中的作用。
