Model-based Cueing-as-needed for Walking in Parkinson's Disease (GAITPARK)

Henri Mondor University Hospital

Status: Completed

Conditions: Walking, Difficulty; Parkinson Disease; Gait, Festinating

Treatments: Other: 20-minute gait training

Study type: Interventional

Funder types: Other

Identifiers

NCT06073028

GAITPARK

Details and patient eligibility

About

Correcting of the lack of regularity in steps is a key component of gait rehabilitation in Parkinson's disease. The proposal is to introduce adaptive spatial auditory cueing (ASAC) based on verbal instruction "lengthen the step" automatically delivered when the stride length decreased below a predetermined threshold. The present study compared the effect of usual rhythmic auditory cueing versus ASAC used during a walking training in Parkinson's disease.

Full description

Correcting of the lack of regularity in steps is a key component of gait rehabilitation in Parkinson's disease. The proposal is to introduce adaptive spatial auditory cueing (ASAC) based on verbal instruction "lengthen the step" automatically delivered when the stride length decreased below a predetermined threshold. The present study compared the effect of usual rhythmic auditory cueing versus ASAC used during a walking training in Parkinson's disease. Fifteen patients with Parkinson's disease performed both interventions in randomized order, one week apart: a 20-minute walking training with rhythmic auditory cueing, in form of a metronome adjusted on 110% of the patient's own cadence, or ASAC delivered when the stride length is less than 110% of the patient's own stride length. Assessment criteria were walking distance covered during the intervention, speed, step length, cadence, coefficients of variation of step length and step duration, and indexes of spatial and temporal asymmetry during a walking test before and just after the intervention.

Enrollment: 15 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• the diagnosis of idiopathic PD based on the United Kingdom-Parkinson's Disease Society Brain Bank criteria;
• stage 2 or 3 on the Hoehn and Yahr scale;
• comfortable walking speed over 10 meters ≤ 1 m/s;
• ability to walk over 20 minutes without aids or antiparkinsonian medications;
• a stable antiparkinsonian medication regime;
• cognitive abilities to understand the verbal instructions for a walking test according to the investigator's judgment;
• written consent for the participation.

Exclusion criteria

• intercurrent disease other than PD, affecting gait;
• any intercurrent medical condition preventing them from participating in two consecutive gait training one week apart;
• medical diagnosis of hearing loss;
• non-affiliation to the social security regime.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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15 participants in 2 patient groups

Rhythmic auditory cueing

Experimental group

Description:

The rhythmic auditory cueing (RAC) is a constant stimulation ("bip" signal) delivered by a numeric metronome, which is adjusted on 110% of the patient's own cadence.

Treatment:

Other: 20-minute gait training

Adaptive spatial auditory cueing

Experimental group

Description:

Adaptive spatial auditory cueing (ASAC) is a verbal instruction stimulation delivered by an application when the stride length of the patient is less than a predetermined threshold, during two consecutive strides. The instruction is given in the patient's native language, which is French: "allongez le pas" (i.e. "lengthen the step"). The predetermined threshold is 110% of the patient's own stride length.

Treatment:

Other: 20-minute gait training