Objective: To investigate the effects of a 12-week home-based musical gait feedback program on cognition in persons with Parkinson’s disease (PD).

Background: Individuals with PD can experience shortening of stride length. Previous research suggests automated feedback applications are an effective means of gait training and well-accepted by individuals with PD. In this study, we explored the effects of an iPod application (GaitReminder™) that provides users with real time step-size feedback through music play. To our knowledge, this is the first time a comprehensive neuropsychological battery has been completed by PD patients completing gait training with musical cueing technology.

Methods: Twenty persons with PD (mean age 66.4 ± 8.9, 12 males) were semi-randomized via sequential alternating enrollment into one of two training conditions. Group 1 participants (n=10, 5 males) received 12-weeks of gait training where music play was contingent on achieving a set step size. Group 2 participants received 6 weeks of passive music listening, where music played continuously regardless of step size, followed by 6 weeks of contingency-based training. Participants were instructed to use GaitReminder™ a minimum of three times a week for at least 15 minutes. Single-blinded assessments of global cognition (MoCA, MMSE), memory (HVLT), executive function (Stroop Color-Word Test, Trail Making Test Parts A & B), and attention and working memory (Attention Network Test, Digit Order Test) were completed at baseline, 6 weeks, and 12 weeks.

Results: At baseline, no significant differences were present in group demographics (age, gender, education, Modified Hoehn and Yahr Stage, UPDRS Part III).  Group 1 reported an average of 34 walks per participant (mean duration 26.35 minutes, mean distance 1.79 km). Group 2 participants completed 40 walks on average (20 per phase; mean duration 34.13 minutes, mean distance 2.35 km). Group 2 reported an improvement over time on the Beck Anxiety Inventory (p < 0.05). No significant changes were found in cognition, with no group differences. For walking results, see Table 1.

[table 1]

Table 1. Average results per walk by group and feedback phase.

Conclusions: Contingency-based musical gait enhancement is a feasible home exercise intervention for persons with PD. The optimal dose of exercise required for exercise-induced cognitive benefits in PD requires further investigation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effects-of-contingency-based-musical-gait-feedback-on-cognition-in-individuals-with-parkinsons-disease-an-interim-analysis/