The possible price of auditory cueing: Influence on obstacle avoidance in Parkinson's disease§

Authors

  • Wandana Nanhoe-Mahabier MSc,

    1. Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Arnaud Delval MD, PhD,

    1. Department of Neurology and Movement Disorders, Salengro Hospital, Lille Regional University Hospital, Lille, France
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  • Anke H. Snijders MD,

    1. Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Vivian Weerdesteyn PT, PhD,

    1. Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Sebastiaan Overeem MD,

    1. Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Bastiaan R. Bloem MD, PhD

    Corresponding author
    1. Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    • Professor of Neurology, Department of Neurology, 935 Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands

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  • Funding agencies: Supported by France Parkinson (grant to A.D); Netherlands Organisation for Health Research and Development (NWO) (MD-Medical Research Trainee grant 92.003.490 to A.H.S.); Netherlands Organisation for Scientific Research (VIDI research grant 016.116.371 to S.O.); NWO (grant 016.076.352 to B.R.B.).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Background:

Under carefully controlled conditions, rhythmic auditory cueing can improve gait in patients with Parkinson's disease (PD). In complex environments, attention paid to cueing might adversely affect gait, for example when a simultaneous task—such as avoiding obstacles—has to be executed. We primarily examined whether concurrent auditory cueing interferes with an obstacle avoidance task in patients with PD. The secondary aim was to study differences between patients with and without freezing of gait.

Methods:

Nineteen patients with PD (8 with freezing) were examined on a treadmill in 4 conditions: normal walking; walking with auditory cueing; walking with an obstacle avoidance task; and walking with auditory cueing and obstacle avoidance. Outcome measures included kinematic gait parameters and obstacle crossing parameters.

Results:

Auditory cueing improved gait in PD, without negative effects on concurrent obstacle avoidance. Additionally, freezers avoided obstacles less efficiently than non-freezers.

Conclusions:

PD patients are able to successfully execute an obstacle avoidance task, when auditory cueing is administered simultaneously. The different obstacle avoidance behavior in freezers may contribute to their higher fall risk. © 2012 Movement Disorder Society

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