Objective: To investigate the effects of personalized visual and auditory cueing combined with task-specific sit-to-stand training on movement kinematics, functional mobility, and psychosocial outcomes in individuals with Parkinson’s disease (PD) and healthy adults.

Background: External cueing is commonly used to improve motor performance in PD by compensating for impaired internal movement initiation. However, the differential effects of personalized visual and auditory cues on sit-to-stand (STS) performance and related outcomes remain unclear. Understanding modality-specific responses may inform patient-centered rehabilitation strategies, particularly in home-based settings.

Method: Fourteen individuals with PD (Hoehn and Yahr stage 2.32 ± 0.42) and 14 age-matched healthy adults participated. Subgroup analyses were conducted based on personalized cue preference (visual: n=10; auditory: n=4 in each group). STS kinematics were assessed using a markerless motion capture system, including movement time, peak angular velocity, and onset of angular displacement. Additional outcomes included Five Times Sit-to-Stand (FTSTS), Timed Up and Go (TUG), Falls Efficacy Scale International (FES-I), and Parkinson’s Disease Questionnaire-8 (PDQ-8). Within-group comparisons were analyzed using Wilcoxon signed-rank tests.

Results: In the PD group, visual cueing resulted in significant improvements in peak trunk angular velocity during FTSTS (p=0.047) and reduced fall-related concern measured by FES-I (p=0.033). No significant changes were observed in overall TUG performance or spatiotemporal gait parameters. Auditory cueing showed trends toward improvement in STS kinematics but did not reach statistical significance. In healthy adults, visual cueing significantly improved STS subtask time during TUG (p=0.037), whereas other variables showed no significant changes, likely reflecting ceiling effects.

Conclusion: Preliminary findings suggest that personalized visual cueing combined with task-specific STS training may improve trunk kinematics and reduce fear of falling in individuals with PD. Auditory cueing may support temporal aspects of movement but demonstrated limited measurable effects in this short-term analysis. Tailoring cue modalities to individual preference may enhance feasibility and engagement in home-based rehabilitation programs.

References: 1. Martinez-Ramirez D, Rodriguez-Violante M, Ramirez-Zamora A. Gait in Parkinson’s disease. Parkinsons Dis. 2019;2019:1962123.
2. Beitz JM. Parkinson’s disease: a review. Front Biosci (Schol Ed). 2014;6(1):65-74.
3. Slaughter SE, Wagg AS, Jones CA, Schopflocher D, Ickert C, Bampton E, et al. Mobility of vulnerable elders study: effect of the sit-to-stand activity on mobility, function, and quality of life. J Am Med Dir Assoc. 2015;16(2):138-43.
4. Bhatt T, Yang F, Mak MK, Hui-Chan CW, Pai YC. Effect of externally cued training on dynamic stability control during the sit-to-stand task in people with Parkinson disease. Phys Ther. 2013;93(4):492-503.
5. Wade L, Needham L, McGuigan P, Bilzon J. Applications and limitations of current markerless motion capture methods for clinical gait biomechanics. PeerJ. 2022;10:e12995.
6. Mak MK, Hui-Chan CW. Cued task-specific training is better than exercise in improving sit-to-stand in patients with Parkinson’s disease: A randomized controlled trial. Mov Disord. 2008;23(4):501-9.
7. Rochester L, Hetherington V, Jones D, Nieuwboer A, Willems AM, Kwakkel G, et al. The effect of external rhythmic cues (auditory and visual) on walking during a functional task in homes of people with Parkinson’s disease. Arch Phys Med Rehabil. 2005;86(5):999-1006.
8. Ashoori A, Eagleman DM, Jankovic J. Effects of Auditory Rhythm and Music on Gait Disturbances in Parkinson’s Disease. Front Neurol. 2015;6:234.
9. Azulay JP, Mesure S, Blin O. Influence of visual cues on gait in Parkinson’s disease: contribution to attention or sensory dependence? J Neurol Sci. 2006;248(1-2):192-5.
10. Lewis GN, Byblow WD, Walt SE. Stride length regulation in Parkinson’s disease: the use of extrinsic, visual cues. Brain. 2000;123 ( Pt 10):2077-90.
11. Gavin C, Tuite F, Hesnan A, McMahon S, Sestak K, O’Malley J, et al. Understanding “Fear Of Falling” And How It Impacts Older Persons Motivation To Engage In Fall Prevention Exercise Interventions. Age and Ageing. 2024;53(Supplement_4).
12. Lindholm B, Hagell P, Hansson O, Nilsson MH. Factors associated with fear of falling in people with Parkinson’s disease. BMC Neurol. 2014;14:19.
13. Onder H, Iscan D, Tunc H, Yavuz Z, Comoglu S. High fear-of-falling in Parkinson’s disease: Distinct clinical phenotypes with motor and non-motor dominance. Parkinsonism Relat Disord. 2025;142:108138.
14. Chen K, Tan Y, Lu Y, Wu J, Liu X, Zhao Y. Effect of Exercise on Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Parkinsons Dis. 2020;2020:3257623.
15. Horváth K, Aschermann Z, Kovács M, Makkos A, Harmat M, Janszky J, et al. Changes in Quality of Life in Parkinson’s Disease: How Large Must They Be to Be Relevant? Neuroepidemiology. 2017;48(1-2):1-8.
16. Bartolo M, Serrao M, Tassorelli C, Don R, Ranavolo A, Draicchio F, et al. Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson’s disease. Mov Disord. 2010;25(3):325-31.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-personalized-visual-and-auditory-cueing-on-sit-to-stand-biomechanics-in-individuals-with-parkinsons-disease-a-subgroup-analysis/