Abstract
Objective
To determine whether rhythmic music and metronome cues alter spatiotemporal gait measures
and gait variability in people with Alzheimer disease (AD).
Design
A repeated-measures study requiring participants to walk under different cueing conditions.
Setting
University movement laboratory.
Participants
Of the people (N=46) who met study criteria (a diagnosis of probable AD and ability
to walk 100m) at routine medical review, 30 (16 men; mean age ± SD, 80±6y; revised
Addenbrooke's Cognitive Examination range, 26–79) volunteered to participate.
Interventions
Participants walked 4 times over an electronic walkway synchronizing to (1) rhythmic
music and (2) a metronome set at individual mean baseline comfortable speed cadence.
Main Outcome Measures
Gait spatiotemporal measures and gait variability (coefficient of variation [CV]).
Data from individual walks under each condition were combined. A 1-way repeated-measures
analysis of variance was used to compare uncued baseline, cued, and retest measures.
Results
Gait velocity decreased with both music and metronome cues compared with baseline
(baseline, 110.5cm/s; music, 103.4cm/s; metronome, 105.4cm/s), primarily because of
significant decreases in stride length (baseline, 120.9cm; music, 112.5cm; metronome,
114.8cm) with both cue types. This was coupled with increased stride length variability
compared with baseline (baseline CV, 3.4%; music CV, 4.3%; metronome CV, 4.5%) with
both cue types. These changes did not persist at (uncued) retest. Temporal variability
was unchanged.
Conclusions
Rhythmic auditory cueing at comfortable speed tempo produced deleterious effects on
gait in a single session in this group with AD. The deterioration in spatial gait
parameters may result from impaired executive function associated with AD. Further
research should investigate whether these instantaneous cue effects are altered with
more practice or with learning methods tailored to people with cognitive impairment.
Keywords
List of abbreviations:
ACE-R (revised Addenbrooke's Cognitive Examination), AD (Alzheimer disease), CV (coefficient of variation), GDS (Geriatric Depression Scale), MDC (minimum detectable change), PD (Parkinson's disease), RACs (rhythmic auditory cues)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 15, 2012
Footnotes
Presented in poster format to the Joint World Congress of the International Society of Posture and Gait Research and Gait & Mental Function, June 24–28, 2012, Trondheim, Norway.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
