Objective: To investigate the influence of auditory cue on gait asymmetry in an environment unobstructed and with obstacle in people with Parkinson’s disease (PD) and neurologically healthy individuals.

Background: Gait is impaired in people with PD, including an asymmetric behavior. Auditory cues are effective to improve gait in people with PD. However, the effect of auditory cues on gait asymmetry, especially during walking with obstacle crossing, in people with PD is little known.

Methods: Thirteen people with PD, and 13 matched-control participated in this study. Participants performed 5 trials of unobstructed gait and 10 trials of obstacle (15cm high) crossing during gait (5 crossing trials with each leg) with and without auditory cues. Trials were performed in two blocks: without (first) and with auditory cues. For auditory cues trials, the cue (controlled by a metronome) was personalized for each individual according the cadence determined by three trials performed previously to start the experiment. The gait asymmetry of kinematic parameters was analyzed by the steps with most and least affected limb for people with PD and dominant and non-dominant limb. Symmetric index of gait parameters were analyzed with MANOVAs (group x walking x auditory cues), with walking and auditory cues as repeated measures.

Results: The groups showed distinct behavior for gait asymmetry when auditory cues were provided (Table 1). Control group showed greater asymmetry for step length, duration, velocity and cadence than people with PD when auditory cues were offered. In addition, only control group showed greater asymmetry in the trials with auditory cues, especially during obstacle crossing. While control group showed greater asymmetry for stride velocity with auditory cues during obstacle crossing compared to unobstructed walking, people with PD presented greater asymmetry for step length and cadence during obstacle crossing compared to unobstructed walking without auditory cues. Finally, auditory cues in unobstructed walking decreased step velocity asymmetry in people with PD, without effects during obstacle crossing.

Conclusions: Auditory cues showed no effects on gait asymmetry for obstacle walking in individuals with PD. However, the combination of auditory cues with obstacle crossing increased gait asymmetry in neurologically health individuals.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/auditory-cues-during-obstacle-crossing-increase-gait-asymmetry-in-neurologically-health-individuals-but-not-in-people-with-parkinsons-disease/