The feasibility of singing to improve gait in Parkinson disease
The feasibility of singing to improve gait in Parkinson disease
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DOI：
10.1016/j.gaitpost.2017.02.008
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发表时间：
2017-03-01
期刊：
影响因子：
2.4
通讯作者：
Earhart, Gammon M.
中科院分区：
文献类型：
--
作者：
Harrison, Elinor C.;McNeely, Marie E.;Earhart, Gammon M.
大脑中控制运动的重要区域也负责节奏处理。在帕金森氏症（PD）中，大脑内部计时缺陷与节拍识别受损有关，并可能导致维持稳定步态节奏的能力丧失。缺乏节奏的步态本身效率就较低，这可能导致步态损伤，包括速度、节奏和步幅的降低，以及变异性的增加。虽然外界有节奏的听觉刺激（例如节拍器的节拍）被认为是稳定PD患者步态的有效工具，但对于诸如唱歌之类的自我产生的线索是否对PD患者的步态有同样的有益影响，我们知之甚少。因此，我们比较了23名轻度至中度PD患者在五种提示条件下的步态模式：无提示、仅听音乐、仅唱歌、伴着音乐唱歌和言语双任务条件。在我们的单次研究中，边走边唱歌并没有显著地改变速度、节奏或步幅，这表明对帕金森病患者来说，这并不是过分的要求。此外，在唱歌时，行走的变化比在其他提示条件下要小。歌唱试验和口头双任务条件的比较进一步支持了这一点。与唱歌相比，言语双任务对步态表现有负面影响。这些发现表明，唱歌有望成为一种有效的提示技术，在改善PD患者的步态方面，它可能与传统的提示技术一样好，甚至更好。(C) 2017 Elsevier B.V.版权所有
Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single-session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD. (C) 2017 Elsevier B.V. All rights reserved.