1. Participants: Nine participants with PD and five healthy older adults (HOA)
Table 1. Subject demographics and clinical characteristics at baseline. Values are mean
(standard deviation) for continuous variables.
Protocol :
• All trials were block randomized
• CTRL: participants were asked to walk their normal gait.
• DUAL: participants were asked to walk and state as many different words as possible
starting with a different letter every trial.
Figure 1. Study protocol for a 12 week music accompanied walking intervention.
Music:
• Standardized 80 track music playlist played on random
Equipment:
• 4th generation iPod Touch® with Bluetooth® headphones
• GaitReminder® Application
• 6 Peak Vicon® Motion capture cameras
Measures of interest:
• Gait Velocity (m/s)
• Stride Length (m)
• Number of verbal responses
Statistical analysis:
• Gait Measures: Repeated-measures analyses of variance (RM-ANOVA) were completed
for each gait measure with time (4week/16week) and task (CTRL/DUAL) as within-
subject factors and group (HOA/PD) as the between-subject factor.
• Number of responses: Repeated-measures analysis of variance (RM-ANOVA) were
completed for each measure was with time (4week/16week) and task (SEATED/GAIT)
as within-subject factors and group (HOA/PD) as the between-subject factors
• Statistical significance was set at p≤0.05
The effect of a music accompanied walking program on gait and cognitive
performance during single and dual task.
• The aim of this study was to identify whether a music accompanied walking program would
affect dual-task gait and cognitive performance.
Background
Objective
Methods
Results
Discussion
Darina Mamadaliyeva, Hannah Allen, Matt Schneider, Teac Engen, Lesley Brown, Jon Doan, & Natalie de Bruin
Department of Kinesiology, University of Lethbridge, Lethbridge, AB, Canada
Figure 4. Average Number of Responses: The main effect was task (p=0.077). Both
groups increased in average responses from 4 to 16 weeks during seated trials. HOA
maintained the number of responses across time for gait tasks while PD showed an
increase.*
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Take Home Message
• This study provides evidence that a 12 week music accompanied walking program does
affect dual tasking and prioritization. Inappropriate prioritization of two concurrent tasks could
potentially have a negative affect on PD groups as it increases risks of falling.
• Gait impairments are a hallmark symptom of Parkinson’s disease (PD) resulting in a
decrease in stride length, cadence, and velocity.1,2 These gait impairments lead to higher
risks of falling and a debilitating quality of life. 3,4
• Parkinson's disease can lead to cognitive deficits in general and these can become evident
during dual tasking, such as talking while walking, resulting in exacerbated gait deficits1,3.
• Symptoms of Parkinson's Disease such as gait impairments become resistant to
medication however, music accompanied walking interventions have shown evidence in
improving and maintaining constant gait parameters such as cadence, stride length, and
velocity. 6
• The PD showed to be relatively consistent between CTRL and DUAL task in the 12 week
intervention in regards to stride length and velocity. The PD group had a consistently higher
stride velocity and stride length than the HOA group and this may be due to the
demographic variety between the group. Between the groups, the PD group is
predominately males where as the HOA is females, thus the PD group naturally would
have a larger stride length from having longer legs and a taller body.8,9 The PD groups
stride velocity is kept constantly faster than the HOA group, perhaps this is due too an
increase in stride length as they are both outcomes of one another.9
• Over a 12 week span biologically, with no intervention, it could be assumed that the PD
group would show deterioration in physical and cognitive function however this study does
not depict that.9 It can be speculated that the PD group may have maintained their constant
level of activity leading to patient safety and decrease risk of falling by maintaining dual
tasking.
• Task prioritization is another aspect to take into account when looking at the findings for
average number of responses and stride length. The PD group’s average number of
responses increased as stride length decreased suggesting that perhaps more attention is
being placed on the cognitive versus the physical task. With the division of the participants
attentional focus between 4 and 16 weeks, it can be speculated that the participants were
designating more attention to the cognitive task and less to the physical task than they
were previously. If there is inappropriate prioritization of one task, cognitive for example, at
the expense of the other, physical, there could be a possibility that postural stability will be
affected resulting in decreasing safety and increasing fall risk. 1,4,7
1.Kelly V. etal Parkinson Disease 2012. 6. Cho S. etal 2004;2:145-152
2. Stegomoller E.L. etal. PTJ 2014;6:757-766. 7. O’Shea S. etal PTJ 2002;88:888-897
3. Rochester L. etal PMR 2005;86:999-1006 8. McIntosh G.C. etal JourNeuro 1997;62:224.
Yogev-Seligmann G. etal 2008;3:329-342 9. Lewis G.N etal JourNeuro 2000;2077-2090.
5. Nocera J.R. etal JRRD 2013;50:699-708
Figure 3. Stride Velocity: The main interaction was seen in task x group x time (p= 0.057).
Stride velocity was not affected by time or group for the CTRL tasks. The HOA group increase
stride velocity from 4 to 16 weeks for DUAL while in contrast, the PD group maintains
consistent. The PD exhibits a higher stride velocity than HOA at 4 weeks for DUAL. *
Figure 2. Stride Length: The main interaction was task x group (p=0.141). Stride length in
the CTRL task remained relatively constant between both groups however, shorter strides are
seen in the DUAL task when compared to CTRL task (p=0.021). A task x group interaction is
approaching significance (p=0.141), indicating that the decrease in stride length from CTRL to
DUAL tasks was significant for the PD group. HOA experienced shorter stride length in DUAL
tasks than PD.
Characteristic HOA PD
Sex 4F, 1M 3F, 6M
Age (yrs) 62.6 (±6.8) 65.0 (±7.3)
Disease duration (yrs) 8.8 (±6.8)
UPDRS (III) score 30.8 (±16.8)
4 Weeks
Assessment
Intervention
16 Weeks
Assessment
• 3 CTRL
• 3 DUAL
• 12 weeks
• Walking a
minimum of
3x/week
with music
• 3 CTRL
• 3 DUAL
1
1.1
1.2
1.3
1.4
1.5
1.6
HOA PD
StrideLenght(m)
CTRL_4 weeks
CTRL_16 weeks
DUAL_4 weeks
DUAL_16 weeks
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
HOA PD
StrideVelocity(m/s)
CTRL_4 weeks
CTRL_16 weeks
DUAL_4 weeks
DUAL_16 weeks
*All values are mean and standard error.
0
1
2
3
4
5
6
7
HOA PD
AverageResponses
Seated_4 weeks
Seated_16 weeks
Gait_4 weeks
Gait_16 weeks