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Barta K1, Da Silva C2, Tseng S-C2, Roddey T2
1University of St. Augustine for Health Sciences, Physical Therapy, Austin, United States, 2Texas Woman's University, Physical Therapy, Houston, United States
Background: Parkinson disease (PD) leads to neurological impairments yet the auditory system remains intact and receives information from the environment. Auditory cueing can elicit improved motor responses during walking in people with PD as it helps to bypass the dysfunctional basal ganglia not facilitating appropriate movements. Rhythmic Auditory Stimulation (RAS) is a form of auditory cueing that utilizes a fixed beat to which people synchronize their movements and is effective in improving gait parameters in individuals with PD. Patterned Sensory Enhancement (PSE) is an enhanced auditory technique which incorporates a musical component to impact gait and force patterns. Currently, only a music therapist (MT) can individualize auditory protocols. For a physical therapist (PT) to incorporate PSE into treatment, a new tool is needed. The Synchronized Optimization Auditory Rehabilitation (SOAR) tool is a novel approach created to simulate PSE techniques. This technology allows the melody to be customized to a person in real-time depending on the impairments presented and reaction to the auditory cue.
Purpose: The purposes of this study were to evaluate the concurrent validity of a new PSE tool with RAS and to assess the interrater reliability between MT's and PT's application of the new PSE tool.
Methods: Twenty people with PD participated and participants completed two separate days of testing within two hours of taking their PD medication. Spatiotemporal gait parameters were recorded using a computerized walkway. Day 1 consisted of the participant's gait measured during no auditory cue, RAS and the SOAR tool, as set up by the MT. Day 2 consisted of the PT using the SOAR tool to influence the participant's gait and measuring the same spatiotemporal parameters.
Results: The spatiotemporal parameters collected were velocity, cadence, left and right step length, step width, percentage time in stance phase for left and right leg, percentage time in swing phase for left and right leg, and percentage time in single leg stance for left and right leg. Pearson's correlation indicated a significant correlation (p 0.001) between RAS and the SOAR tool administered by the MT for all gait variables. Interrater reliability ICC values for the 2 disciplines were significant (p 0.001) and moderate to high for all the gait variables.
Conclusion(s): These findings indicate the possibility of the SOAR tool being an effective method of auditory cue delivery. Since the PT and the MT demonstrated similar abilities to use the SOAR system to develop a musical piece that affected the gait pattern of the participants, the findings suggest the usability of this system by PTs for treatment of individuals with PD.
Implications: The potential exists to positively influence an individual with PD's gait pattern with the more customized PSE approach of the SOAR tool. The findings of this study support the use of the SOAR tool for gait intervention by a PT when RAS and PSE are deemed appropriate.
Keywords: Parkinson's disease, RAS, gait
Funding acknowledgements: Study possible through a grant from University of St. Augustine for Health Sciences
Purpose: The purposes of this study were to evaluate the concurrent validity of a new PSE tool with RAS and to assess the interrater reliability between MT's and PT's application of the new PSE tool.
Methods: Twenty people with PD participated and participants completed two separate days of testing within two hours of taking their PD medication. Spatiotemporal gait parameters were recorded using a computerized walkway. Day 1 consisted of the participant's gait measured during no auditory cue, RAS and the SOAR tool, as set up by the MT. Day 2 consisted of the PT using the SOAR tool to influence the participant's gait and measuring the same spatiotemporal parameters.
Results: The spatiotemporal parameters collected were velocity, cadence, left and right step length, step width, percentage time in stance phase for left and right leg, percentage time in swing phase for left and right leg, and percentage time in single leg stance for left and right leg. Pearson's correlation indicated a significant correlation (p 0.001) between RAS and the SOAR tool administered by the MT for all gait variables. Interrater reliability ICC values for the 2 disciplines were significant (p 0.001) and moderate to high for all the gait variables.
Conclusion(s): These findings indicate the possibility of the SOAR tool being an effective method of auditory cue delivery. Since the PT and the MT demonstrated similar abilities to use the SOAR system to develop a musical piece that affected the gait pattern of the participants, the findings suggest the usability of this system by PTs for treatment of individuals with PD.
Implications: The potential exists to positively influence an individual with PD's gait pattern with the more customized PSE approach of the SOAR tool. The findings of this study support the use of the SOAR tool for gait intervention by a PT when RAS and PSE are deemed appropriate.
Keywords: Parkinson's disease, RAS, gait
Funding acknowledgements: Study possible through a grant from University of St. Augustine for Health Sciences
Topic: Neurology
Ethics approval required: Yes
Institution: University of St. Augustine for Health Sciences
Ethics committee: Institutional Review Board
Ethics number: 1org0009210
All authors, affiliations and abstracts have been published as submitted.
