Objective: The goal of this study was to explore real life data collected during a gait rehabilitation program with music on Persons with Parkinson Disease.

Background: Physical activity, particularly walking, is a significant lever to slow the progression of motor symptoms in  Parkinson’s disease. However, adherence among Persons with Parkinson’s Disease remains a challenge. Laboratory studies have shown the efficacy  of cueing to improve gait parameters, with adapted cueing being especially useful for persons with impaired rhythmic abilities. The value of motivating adapted music applications in real-world settings still needs confirmation. Moreover, real-life data of rehabilitation programs are scarce. We developed BeatWalk, an application with an individualized approach synchronizing the beat of the music to the persons’ steps and recording the performances in real time.

Method: 25 PwPDs underwent a one-month outdoor gait rehabilitation program while listening to music (30 min/day, 5 days/week). Each session began with a minute of silence to measure patients’ spontaneous cadence. The application then played music adapted to the patient’s cadence; the tempo was gradually increased to accelerate speed during the session. We measured gait parameters evolution in real-life outdoor sessions and in laboratory conditions with the six-minute walk test.

Results: The real-life results showed that gait parameters improved within sessions, particularly when the music cueing began (speed (m/s) : 0.97 ± 0.53 vs 1.30 ± 0.50, p = 0.0004) and when comparing the beginning and the end of the rehabilitation program (speed (m/s) : 1.41 ± 0.23 vs 1.47 ± 0.25, p = 0.03). These improvements were similar to the results of the 6MWT performed in the laboratory in silence before and after the program (speed (m/s) : 1.22 ± 0.21 vs 1.29 ± 0.18, p = 0.002).

Conclusion: A gait rehabilitation program in real-life settings, incorporating adapted music, holds promise as a strategy to enhance walk. The utilization of digital mobile devices, as demonstrated in this study, enables precise monitoring of improvement progression. Such tools play a crucial role in shaping future recommendations for tailored physical activity interventions.

References: Awad, L.N., Jayaraman, A., Nolan, K.J. et al. Efficacy and safety of using auditory-motor entrainment to improve walking after stroke: a multi-site randomized controlled trial of InTandemTM. Nat Commun 15, 1081 (2024).
Cochen De Cock, V. et al. BeatWalk: Personalized Music-Based Gait Rehabilitation in Parkinson’s Disease. Front. Psychol. 0, (2021).
Ghai, S., Ghai, I., Schmitz, G. & Effenberg, A. O. Effect of rhythmic auditory cueing on parkinsonian gait: A systematic review and meta-analysis. Sci. Rep. 8, 506 (2018).
Cochen De Cock, V. et al. Rhythmic abilities and musical training in Parkinson’s disease: do they help? Npj Park. Dis. 4, 1–8 (2018)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/enhancing-real-life-gait-performance-in-persons-with-parkinson-disease-through-the-music-based-beatwalk-application/