TY - JOUR
T1 - Fractal auditory stimulation has greater benefit for people with Parkinson's disease showing more random gait pattern
AU - Marmelat, Vivien
AU - Duncan, Austin
AU - Meltz, Shane
AU - Meidinger, Ryan L.
AU - Hellman, Amy M.
N1 - Funding Information:
The authors thank Connor Wicks for his help during data collection. This work was supported by the UNMC Skate-a-thon for Parkinson’s fund, the NASA Nebraska Space Grant Fellowship , and the Center for Research in Human Movement Variability of the University of Nebraska at Omaha, NIH ( P20GM109090 ). The study sponsors were not involved in the collection, analysis and interpretation of data, in the writing of the manuscript, nor in the decision to submit the manuscript for publication. The views expressed are those of the authors and not necessarily those of the NIH.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/7
Y1 - 2020/7
N2 - Background: Healthy gait dynamics are characterized by the presence of fractal, persistent stride-to-stride variations, which become more random with Parkinson's disease (PD). Rhythmic auditory stimulation with fractal beat-to-beat variations can change gait dynamics in people with PD toward more persistence. Research question: How does gait in people with PD change when synchronizing steps with fractal melodic metronomes with different step-to-beat ratios, and which stimulus do they prefer? Methods: In this cross-sectional study, 15 people with PD and 15 healthy older adults walked over-ground in three conditions: self-paced, paced by a fractal auditory stimulus with a 1:1 step-to-beat ratio (‘metronome’), and fractal auditory stimulus with a 1:2 step-to-beat ratio (‘music’). Gait dynamics were recorded with instrumented insoles, and detrended fluctuation analysis (DFA) was applied to the series of stride time intervals. Stimuli preference was assessed using Likert-like scales and open-ended questions. ANOVAs were used to compare mean, coefficient of variation, α-DFA, and the responses from the continuous Likert scales. Pearson correlations were used to assess the relationship between ‘music’ and ‘metronome’ enjoyment or difficulty with gait outcomes, and to determine the association between baseline α-DFA and changes due to the stimuli. Results: Our major findings are that (i) stride-to-stride variations were more persistent with the ‘metronome’ compared to baseline for both groups, (ii) the effect was greater for people with lower α-DFA at baseline (i.e., more random stride-to-stride variations), and (iii) both groups found the ‘metronome’ less difficult to synchronize with. Significance: This study showed that people with PD and healthy older adults walk with higher statistical persistence in their stride-to-stride variations when instructed to synchronize their steps with a fractal stimulus. Participants with lower persistence at baseline benefited the most from the fractal ‘metronome’, highlighting the importance to develop patient-centered tests and interventions.
AB - Background: Healthy gait dynamics are characterized by the presence of fractal, persistent stride-to-stride variations, which become more random with Parkinson's disease (PD). Rhythmic auditory stimulation with fractal beat-to-beat variations can change gait dynamics in people with PD toward more persistence. Research question: How does gait in people with PD change when synchronizing steps with fractal melodic metronomes with different step-to-beat ratios, and which stimulus do they prefer? Methods: In this cross-sectional study, 15 people with PD and 15 healthy older adults walked over-ground in three conditions: self-paced, paced by a fractal auditory stimulus with a 1:1 step-to-beat ratio (‘metronome’), and fractal auditory stimulus with a 1:2 step-to-beat ratio (‘music’). Gait dynamics were recorded with instrumented insoles, and detrended fluctuation analysis (DFA) was applied to the series of stride time intervals. Stimuli preference was assessed using Likert-like scales and open-ended questions. ANOVAs were used to compare mean, coefficient of variation, α-DFA, and the responses from the continuous Likert scales. Pearson correlations were used to assess the relationship between ‘music’ and ‘metronome’ enjoyment or difficulty with gait outcomes, and to determine the association between baseline α-DFA and changes due to the stimuli. Results: Our major findings are that (i) stride-to-stride variations were more persistent with the ‘metronome’ compared to baseline for both groups, (ii) the effect was greater for people with lower α-DFA at baseline (i.e., more random stride-to-stride variations), and (iii) both groups found the ‘metronome’ less difficult to synchronize with. Significance: This study showed that people with PD and healthy older adults walk with higher statistical persistence in their stride-to-stride variations when instructed to synchronize their steps with a fractal stimulus. Participants with lower persistence at baseline benefited the most from the fractal ‘metronome’, highlighting the importance to develop patient-centered tests and interventions.
KW - Fractal fluctuations
KW - Gait variability
KW - Parkinson's disease
KW - Rhythmic auditory stimulation
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U2 - 10.1016/j.gaitpost.2020.05.021
DO - 10.1016/j.gaitpost.2020.05.021
M3 - Article
C2 - 32554147
AN - SCOPUS:85086359662
VL - 80
SP - 234
EP - 239
JO - Gait and Posture
JF - Gait and Posture
SN - 0966-6362
ER -