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The Immediate Effect of Attentional, Auditory, and a Combined Cue Strategy on Gait During Single and Dual Tasks in Parkinson’s Disease
Open accessAbstract
Objective To compare the effect of rhythmic auditory and attentional cues, and a combination of both cues on gait, in people with Parkinson's disease (PD) during single and dual tasks. Design A repeated-measures study requiring participants to perform single and dual-motor tasks under different cueing conditions. Setting Human movement analysis laboratory. Participants Fifteen participants with idiopathic PD and a comparison group of 12 healthy participants. Interventions Three cueing strategies were compared: a rhythmic auditory cue (walking in time to a metronome beat), an attentional strategy (asked to focus on taking big step), and a combination cue (asked to walk in time to a metronome beat while taking big steps). Main outcome measures Walking speed, step amplitude, and step frequency. Results Walking speed of PD participants improved significantly compared with noncued walking in the single- and dual-task condition with the attentional (P Conclusions The attentional strategy and the combination of a rhythmic auditory cue with an attentional strategy were equally effective, and improved walking speed and step amplitude significantly during both single and dual tasks. The combination cue, however, may still be a useful alternative in situations of increased attentional demand, or where problems exist with executive function.
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“whereas the use of an internal cue such as “think about taking larger steps” significantly reduced step frequency in persons with PD (Baker et al., 2007).”
From Respiratory Responses to Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Baker et al., 2007
In the citing paper
“whereas an internal cue such as “think about taking larger steps” significantly reduced step frequency in persons with PD (Baker et al., 2007).”
From Perception of Physical Demand, Mental Demand, and Performance: A Comparison of Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Baker et al., 2007
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“Interestingly, in 4 out of the 8 studies summarized in table 3, the cues were applied in both single- and dual-task paradigms [46,49,51,52].”
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“With careful concentration on critical aspects of movement, those with PD can achieve movement amplitudes of nearly normal size (Baker et al., 2007, Morris et al., 2001, 1996).”
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“the cue effect [2, 3] can make patients consciously improve their time, resulting in numerous false-positive cases.”
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“who also found that attentional strategies induced larger effects than auditory cues on gait parameters (14).”
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“[32] and thus change the cost/benefit ratio toward faster movements.”
InfluentialChanges in gait patterns with rhythmic auditory stimulation in adults with cerebral palsy
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“Some authors have shown an immediate change with RAS [2,26,39], while other studies did not fi nd a signi fi cant effect of RAS alone in patients with Parkinson’s disease [3] or Huntington’s disease [8].”
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“The improvements in stride length and gait velocity were not significantly different from the values obtained under single-task conditions (walking only) at baseline (Canning, 2005), nor those from matched healthy controls under a dual-task condition at baseline (Baker et al., 2007).”
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“PD patients can improve both their motor speed and accuracy of their movements with increased attention [35,36], and we propose that in our study, the hypodopaminergic state in PD leads to decreased attending to appetitive stimuli compared with aversive stimuli, leading to improved motor performance at the cost of an…”
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“Previous research employing dual task paradigms have involved secondary tasks which required a motor component [12-14,24-26], thus making it difficult to know if the results of these previous studies are truly due to a central overload problem, or a motor overload specifically.”
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Does Nordic Walking restore the temporal organization of gait variability in Parkinson’s disease?
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“Although the reduction of gait cadence could be perceived as dramatic, it should be noted that such decrease is usually observed with attentional strategies that specifically focus on step length criterion [28, 35].”
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“This suggests that testing dynamic balance abilities during curved trajectories could be useful for assessing gait in conditions more relevant to cognitive-motor dual tasks, and thus, closer to daily living activities [64,65].”
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“This theory is supported within this study as both groups improved on the secondary cognitive task (dual-task) when using a cue with greater response in PD, which is similar to previous cueing research (van Wegen et al., 2006; Baker et al., 2007; Rochester et al., 2007; Mak et al., 2013).”
ResultSelf-citationA fuzzy logic system for the home assessment of freezing of gait in subjects with Parkinsons disease
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How groove in music affects gait
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Brodie, M. A. D., Dean, R. T., Beijer, T. R., Canning, C. G., Smith, S., Menant, J. C., & Lord, S. R. (2015) · Journal of Parkinson s Disease · doi:10.3233/jpd-140430 · Cited by 26
“Many questions remain including: How do people follow auditory cues? Are effects specific to people with PD? Do people who experience freezing of gait respond differently to those who do not? It is unclear: If all people respond equally to auditory cues? And, whether symmetric cues make all people walk in an optimal m…”
Lirani‐Silva, E., Lord, S., Moat, D., Rochester, L., & Morris, R. (2018) · Neurology Report · doi:10.1097/npt.0000000000000250 · Cited by 26
Self-citation(2012) · Journal of Physical Therapy Science · doi:10.1589/jpts.24.1307 · Cited by 26
Effect of robot-assisted gait training on gait automaticity in Parkinson disease
Yun, S. J., Lee, H. H., Lee, W. H., Lee, S. H., Oh, B., & Seo, H. G. (2021) · Medicine · doi:10.1097/md.0000000000024348 · Cited by 25
Treadmill training with music cueing: a new approach for Parkinson’s gait facilitation
Chaiwanichsiri, D., Wangno, W., Kitisomprayoonkul, W., & Bhidayasiri, R. (2011) · Asian Biomedicine · doi:10.5372/1905-7415.0505.086 · Cited by 25
“[23] reported equal effectiveness of attentional strategy alone and the combination of rhythmic auditory cue and attentional strategy.”
BackgroundMelo-Thomas, L., & Thomas, U. (2014) · Behavioural Brain Research · doi:10.1016/j.bbr.2014.10.035 · Cited by 24
Strain recovery model for concrete after compressive creep
Chen, P., Zheng, W., Wang, Y., Du, K., & Chang, W. (2018) · Construction and Building Materials · doi:10.1016/j.conbuildmat.2018.12.085 · Cited by 24
Doença de Parkinson e Exercício Físico: Uma Revisão da Literatura
Soares, G. S., & Peyré‐Tartaruga, L. A. (2010) · Ciência em Movimento · doi:10.15602/1983-9480/cmbs.v12n24p69-85 · Cited by 23
Murgia, M., Corona, F., Pili, R., Sors, F., Agostini, T., Casula, C., Pau, M., & Guicciardi, M. (2015) · The Open Psychology Journal · doi:10.2174/1874350101508010220 · Cited by 23
“Some of these studies investigated the immediate effects of RAS on motor performance by assessing motor parameters after a single session of RAS [30-48].”
Analogy learning in Parkinson's disease: A proof-of-concept study
Jie, L.-J., Goodwin, V. A., Kleynen, M., Braun, S. M., Nunns, M., & Wilson, M. (2016) · International Journal of Therapy and Rehabilitation · doi:10.12968/ijtr.2016.23.3.123 · Cited by 23
Janssen, S., Heijs, J. J. A., van der Meijs, W., Nonnekes, J. H., Bittner, M., Dorresteijn, L. D. A., Bloem, B. R., Wezel, R. J. A. V., & Heida, T. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220735 · Cited by 25
An investigation on the impact of auditory and haptic feedback on rhythmic walking interactions
Maculewicz, J., Erkut, C., & Serafin, S. (2015) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2015.07.003 · Cited by 22
Fok, P., Farrell, M. J., McMeeken, J. M., & Kuo, Y. (2010) · Clinical Rehabilitation · doi:10.1177/0269215510387648 · Cited by 20
An architecture to manage motor disorders in Parkinson's disease
Pepa, L., Capecci, M., Verdini, F., Ceravolo, M. G., & Spalazzi, L. (2015) · IEEE World Forum on Internet of Things (WF-IoT) · doi:10.1109/wf-iot.2015.7389124 · Cited by 19
“Unluckily FoG is resistant to standard pharmacological treatments, but clinicians suggest the use of external rhythmic stimuli (cues) to alleviate this gait block [9].”
BackgroundNeurorééducation des syndromes parkinsoniens
Graciès, J. (2010) · Revue Neurologique · doi:10.1016/j.neurol.2009.10.026 · Cited by 22
Effect of type of secondary task on cued gait on people with idiopathic Parkinson′s disease
Chawla, H., Walia, S., Behari, M., & Noohu, M. M. (2014) · Journal of Neurosciences in Rural Practice · doi:10.4103/0976-3147.127865 · Cited by 19
“The combination of a rhythmic auditory cue and an attentional strategy has reported to improve gait speed and step amplitude during single as well as in dual task.[2,4] It’s also being reported that people with PD do not gain additional benefit combination of attentional and auditory cues.”
BackgroundMethodInfluentialLin, Y., Lin, I.-I., Chiou, W.-D., Chang, H.-C., Chen, R., Lu, C., & Chang, Y. (2023) · Healthcare · doi:10.3390/healthcare11040567 · Cited by 18
“Previous studies reported that a gait prioritization strategy could ameliorate gait deficits immediately [63,64] and after short-term training [65].”
BackgroundDupla-tarefa na doença de Parkinson: uma revisão sistemática de ensaios clínicos aleatorizados
Marinho, M. S., Chaves, P. D. M., & Tarabal, T. D. O. (2014) · Revista Brasileira de Geriatria e Gerontologia · doi:10.1590/s1809-98232014000100018 · Cited by 18
Effects of dance on gait and dual-task gait in Parkinson’s disease
Haputhanthirige, N. K. H., Sullivan, K. A., Moyle, G., Brauer, S., Jeffrey, E. R., & Kerr, G. (2023) · PLoS ONE · doi:10.1371/journal.pone.0280635 · Cited by 17
“Rhythmic auditory cues and attentional strategies are equally effective in improving walking speed and step amplitude [21].”
BackgroundImproving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease
Huang, C., Chen, Y., Hwang, I., & Wu, R. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.02.013 · Cited by 17
Hoppe, M., Chawla, G., Browner, N., & Lewek, M. D. (2020) · Gait & Posture · doi:10.1016/j.gaitpost.2020.04.003 · Cited by 16
Cavallieri, F., Sireci, F., Fioravanti, V., Toschi, G., Rispoli, V., Antonelli, F., Costantini, M., Ghirotto, L., & Valzania, F. (2021) · European Journal of Neurology · doi:10.1111/ene.14745 · Cited by 16
Impact of External Cue Validity on Driving Performance in Parkinson's Disease
Scally, K. A., Charlton, J., Iansek, R., Bradshaw, J. L., Moss, S. A., & Georgiou‐Karistianis, N. (2011) · Parkinson s Disease · doi:10.4061/2011/159621 · Cited by 16
“This pattern of findings reinforces the purported benefits of valid external cues on motor and cognitive performance in PD [19, 20, 24–29, 31–35, 63].”
ResultLi, Y., Wang, Z., Li, J., Yang, H., & Fang, Z. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1496692 · Cited by 15
“For instance, patients with PD often exhibit slowed movements, but with the aid of external cues, they can achieve near-normal speed and amplitude of movements (77, 81).”
Medijainen, K., Pääsuke, M., Lukmann, A., & Taba, P. (2019) · Neurorehabilitation · doi:10.3233/nre-192723 · Cited by 15
An Interactive Multimedia System for Parkinson’s Patient Rehabilitation
Yu, W., Vuong, C., & Ingalls, T. (2011) · Lecture notes in computer science · doi:10.1007/978-3-642-22024-1_15 · Cited by 15
“Our team has designed and developed a Parkinson’s Multimedia Rehabilitation System that combines physical therapy techniques, sensory cueing [2][3][9][12][21][20][21] and the BIG protocol [3][7][8], with visual and auditory feedback to create an engaging mediated environment.”
BackgroundMethodRaffegeau, T. E., Brinkerhoff, S. A., Clark, M., McBride, A. D., Williams, A. M., Fino, P. C., & Fawver, B. J. (2024) · Experimental Brain Research · doi:10.1007/s00221-024-06807-w · Cited by 14
“…Beurskens and Bock 2013; Beurskens et al. 2014), in people with deficits in cognitive-motor function (Montero-Odasso et al. 2017; Holtzer and Izzetoglu 2020; Li and Harmer 2020), and patients with movement disorders like Parkinson’s (Camicioli et al. 1998; Baker et al. 2007; Beck et al. 2018).”
BackgroundAttention and reach-to-grasp movements in Parkinson’s disease
Lu, C., Bharmal, A., Kiss, Z. H. T., Suchowersky, O., & Haffenden, A. M. (2010) · Experimental Brain Research · doi:10.1007/s00221-010-2341-0 · Cited by 14
“Movement performance has been found to be improved in the absence of external cues by using strategies to direct attention during walking ( Baker et al. 2007 ), reaction-time tasks (Cunnington et al. 1999), or writing (Oliveira et al. 1997).”
Metadata
- Authors
- Baker, K., Rochester, L., & Nieuwboer, A.
- Affiliations
- Northumbria University (GB)
- KU Leuven (BE)
- Corresponding author
- Baker, Katherine
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 88
- Issue
- 12
- Pages
- 1593-1600
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2073354809
- Cited by
- 191
- References
- 46
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 10 · 2023: 8 · 2022: 11 · 2021: 4 · 2020: 6 · 2019: 12 · 2018: 13 · 2017: 16 · 2016: 6 · 2015: 13 · 2014: 13 · 2013: 11 · 2012: 9
- FWCI
- 33.92
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Northumbria Research Link (Northumbria University) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Keywords
- Parkinson's disease, gait, dual-task walking, rhythmic auditory cueing, metronome, attentional cueing, walking speed, cadence, executive function
- MeSH terms
- Aged, Attention, Auditory Perception, Cues, Female, Humans, Male, Parkinson Disease, Psychomotor Performance, Reaction Time, Walking, Gait Ataxia
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