College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA.
Department of Physical Therapy, University of New England, Portland, ME, USA.
J Parkinsons Dis. 2023;13(7):1253-1265. doi: 10.3233/JPD-230169.
Reduced motor automaticity in Parkinson's disease (PD) negatively impacts the quality, intensity, and amount of daily walking. Rhythmic auditory stimulation (RAS), a clinical intervention shown to improve walking outcomes, has been limited by barriers associated with the need for ongoing clinician input.
To assess the feasibility, proof-of-concept, and preliminary clinical outcomes associated with delivering an autonomous music-based digital walking intervention based on RAS principles to persons with PD in a naturalistic setting.
Twenty-three persons with PD used the digital intervention independently for four weeks to complete five weekly 30-minute sessions of unsupervised, overground walking with music-based cues. The intervention progressed autonomously according to real-time gait sensing. Feasibility of independent use was assessed by examining participant adherence, safety, and experience. Intervention proof-of-concept was assessed by examining spatiotemporal metrics of gait quality, daily minutes of moderate intensity walking, and daily steps. Preliminary clinical outcomes were assessed following intervention completion.
Participants completed 86.4% of sessions and 131.1% of the prescribed session duration. No adverse events were reported. Gait speed, stride length, and cadence increased within sessions, and gait variability decreased (p < 0.05). Compared to baseline, increased daily moderate intensity walking (mean Δ= +21.44 minutes) and steps (mean Δ= +3,484 steps) occurred on designated intervention days (p < 0.05). Quality of life, disease severity, walking endurance, and functional mobility were improved after four weeks (p < 0.05).
Study findings supported the feasibility and potential clinical utility of delivering an autonomous digital walking intervention to persons with PD in a naturalistic setting.
帕金森病（PD）患者的运动自主性降低会降低日常步行的质量、强度和数量。节律性听觉刺激（RAS）是一种已被证明可以改善步行效果的临床干预措施，但由于需要持续的临床医生投入，其应用受到限制。
评估基于 RAS 原理为 PD 患者提供自主音乐数字步行干预措施的可行性、概念验证和初步临床结果，该措施在自然环境中实施。
23 名 PD 患者独立使用该数字干预措施四周，每周完成五次 30 分钟的无监督地面步行，音乐提示。干预措施根据实时步态感应自动进行。通过检查参与者的依从性、安全性和体验来评估独立使用的可行性。通过评估步态质量的时空指标、日常中等强度步行分钟数和日常步数来评估干预措施的概念验证。干预完成后评估初步临床结果。
参与者完成了 86.4%的课程和 131.1%的规定课程时间。没有报告不良事件。在课程中，步行速度、步长和步频增加，步态变异性降低（p<0.05）。与基线相比，指定干预日的日常中等强度步行（平均Δ=+21.44 分钟）和步数（平均Δ=+3484 步）增加（p<0.05）。四周后，生活质量、疾病严重程度、步行耐力和功能性移动能力得到改善（p<0.05）。
研究结果支持在自然环境中为 PD 患者提供自主数字步行干预措施的可行性和潜在临床应用。
