Objective: To determine if different types of personalized music rhythmic auditory stimulation (RAS) training can improve gait control in Parkinson’s Disease (PD) patients with freezing of gait (FOG).

Background: FOG is a challenging symptom of PD that disrupts movement initiation and execution.¹ Current treatments remain inconclusive. PD affects the basal ganglia, impairing the brain’s ability to generate internal rhythmic patterns. RAS, particularly music, may enhance gait by activating motor areas during rhythm perception, leading to increased stride length and speed.² However, the optimal RAS paradigm remains uncertain. The study aims to improve FOG through personalized RAS.

Method: The study included 20 PD patients with FOG. An initial assessment was conducted using the Unified Parkinson’s Disease Rating Scale (UPDRS) and Berg Balance Scale (BBS). Natural cadence was tested over 3 days with 9 sessions. Personalized music was selected based on cadence tests. Participants then received music-based RAS training over 3 days with 9 sessions. Post-training tests were performed to measure time spent in walking and duration of FOG. Patients are assessed while on medication, with pre- and post-testing conducted in two walking scenarios: a 10-meter natural-pace walk and the Timed Up and Go (TUG) test. Gait parameters measured include walking speed, step frequency, step length, lower limb variability, and gait symmetry using the phase coordination index, while upper limb coordination is analyzed through arm swing asymmetry. Balance and fall risk are evaluated using the BBS and the Falls Efficacy Scale, while the New Freezing of Gait Questionnaire assesses freezing severity.

Results: Results showed significant improvements across several key measures. UPDRS Part III scores improved significantly (P=0.003), indicating enhanced motor function. Balance also improved, as reflected in the BBS (P=0.039). The TUG test showed a significant reduction in both completion time (P=0.033) and FOG duration (P=0.041). Additionally, participants self-reported noticeable improvements in FOG.

Conclusion: Personalized RAS intervention can significantly improve movement, balance, and TUG test results in PD patients with FOG. Coordinating leg movements with musical rhythm helps increase physical coordination, decrease FOG duration, and increase movement speed.

References: 1. Huang H-C, Chen C-M, Lu M-K, et al. Gait-Related Brain Activation During Motor Imagery of Complex and Simple Ambulation in Parkinson’s Disease With Freezing of Gait. Frontiers in aging neuroscience 2021;13:731332.
2. Ye X, Li L, He R, Jia Y, Poon W. Rhythmic auditory stimulation promotes gait recovery in Parkinson’s patients: A systematic review and meta-analysis. Frontiers in neurology 2022;13:940419.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/improvement-of-freezing-of-gait-with-personalized-rhythmic-auditory-stimulation-in-parkinsons-disease/