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Journal of Neural Transmission

, 114:1243 | Cite as

The attentional cost of external rhythmical cues and their impact on gait in Parkinson’s disease: effect of cue modality and task complexity

  • L. Rochester
  • A. Nieuwboer
  • K. Baker
  • V. Hetherington
  • A.-M. Willems
  • F. Chavret
  • G. Kwakkel
  • E. Van Wegen
  • I. Lim
  • D. Jones
Article

Summary

Changes in gait performance in 153 subjects with PD using three rhythmical cues (auditory, visual and somatosensory) were measured during a simple walking task and a dual walking task in the home. Subjects were ‘on’ medication and were cued at preferred step frequency. Accelerometers recorded gait and walking speed, step amplitude and step frequency were determined from raw data. Data were analysed with SAS using linear regression models. Gait performance during a single task reduced with cues in contrast to a dual task where PD subjects appeared to benefit from rhythmical cues (increased speed and step length). Effects were dependent on cue modality with significant improvements for auditory cues compared to others. A significant short-term carry-over effect of cues reduced 3 weeks later. Cues may reduce attentional demands by facilitating attentional allocation, accounting for differences of cue seen during single and dual task. Furthermore cue modality may influence attentional demand which is an important consideration for rehabilitation.

Keywords: Cues, gait, Parkinson’s disease, attention, dual-task interference, stimulus-response compatibility 

References

  1. Behrmann, M, Geng, J, Shomstein, S 2004Parietal cortex and attentionCurr Opin Neurobiol14212217CrossRefPubMedGoogle Scholar
  2. Bloem, B, Valkenburg, V, Slabbekoorn, M, van Dijk, J 2001The multiple tasks test. Strategies in Parkinson’s diseaseExp Brain Res137478486CrossRefPubMedGoogle Scholar
  3. Bond, J, Morris, M 2000Goal-directed secondary motor tasks: their effects on gait in subjects with Parkinson’s diseaseArch Phys Med Rehabil81110116PubMedGoogle Scholar
  4. Cools, R, Barker, R, Sahakian, B, Robbins, T 2001Mechanisms of cognitive set flexibility in Parkinson’s diseaseBrain12425032512CrossRefPubMedGoogle Scholar
  5. Cunnington, R, Iansek, R, Bradshaw, J, Phillips, JG 1995Movement-related potentials in Parkinson’s disease. Presence and predictability of temporal and spatial cuesBrain118935950CrossRefPubMedGoogle Scholar
  6. Cunnington, R, Iansek, R, Bradshaw, JA 1999Movement-related potentials in Parkinson’s disease: external cues and attentional strategiesMov Disord146368CrossRefPubMedGoogle Scholar
  7. Deane K, Jones D, Clarke C, Playford D, Ben-Shlomo Y (2001b) Physiotherapy versus placebo or no intervention in Parkinson’s disease. The cochrane database of systematic reviews. Issue 3: Art. No. CD 002817Google Scholar
  8. Deane K, Jones D, Ellis-Hill C, Clarke C, Playford E, Ben-Shlomo Y (2001a) Physiotherapy for patients with Parkinson’s disease: a comparison of techniques. The cochrane database of systematic reviews. Issue 1: Art. No. CD002815Google Scholar
  9. Debaere, F, Wenderoth, N, Sunaert, S, Van Hecke, P, Swinnen, SP 2003Internal vs external generation of movements: differential neural pathways involved in bimanual coordination performed in the presence or absence of augmented visual feedbackNeuroimage19764776CrossRefPubMedGoogle Scholar
  10. Folstein, M, Folstein, S 1975“Mini-Mental State” A practical method for grading the cognitive state of patients for the clinicianJ Psychiatr Res12189198CrossRefPubMedGoogle Scholar
  11. Goverover, Y 2004Categorisation, deductive reasoning, and self-awareness: association with everyday competence in persons with acute brain injuryJ Clin Exper Neuropsychol26737749CrossRefGoogle Scholar
  12. Hoehn, M, Yahr, M 1967Parkinsonism: onset, progression and mortalityNeurology (Cleveland)5427442Google Scholar
  13. Howe, TE, Lovgreen, B, Cody, F, Ashton, V, Oldham, J 2003Auditory cues can modify the gait of persons with early-stage Parkinson’s disease: a method for enhancing parkinsonian walking performance?Clin Rehabil17363367CrossRefPubMedGoogle Scholar
  14. Hughes, A, Daniel, S, Kilford, L, Lees, A 1992Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 casesJ Neurol Neurosurg Psychiatry55181184CrossRefPubMedGoogle Scholar
  15. Kritikos, A, Leahy, C, Bradshaw, J, Iansek, R, Phillips, J, Bradshaw, J 1995Contingent and non-contingent auditory cueing in Parkinson’s diseaseNeuropsychologia3311931203CrossRefPubMedGoogle Scholar
  16. Lim, I, van Wegen, E, de Goede, C, duetekom, M, Nieuwboer, A, Willems, A,  et al. 2005Effects of external rhythmical cueing on gait in patients with Parkinson’s disease: a systematic reviewClin Rehabil19695713CrossRefPubMedGoogle Scholar
  17. Litvan, I 1999Extrapyramidal disorders and frontal lobe functionMiller, BLCummings, JL eds. The human frontal lobes: functions and disordersGuilford PressLondon402421Google Scholar
  18. McIntosh, G, Brown, S, Rice, R, Thaut, M 1997Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson’s diseaseJ Neurol Neurosurg Psychiatry622226CrossRefPubMedGoogle Scholar
  19. Morris, M, Iansek, R, Matyas, T, Summers, J 1996Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanismsBrain119551568CrossRefPubMedGoogle Scholar
  20. Nieuwboer, A Kwakkel, G Rochester, L Jones, D Van Wegen, E The Rescue Consortium et al. 2007Impact of a therapeutic cueing program in the home on gait related mobility in Parkinson’s disease. A randomised clinical trialJ Neurol Neurosurg Psychiatry78134140CrossRefPubMedGoogle Scholar
  21. O’Shea, S, Morris, M, Iansek, R 2002Dual task interference during gait in people with Parkinson’s disease: effects of motor versus cognitive secondary tasksPhys Ther82888897PubMedGoogle Scholar
  22. Rochester, L, Hetherington, V, Jones, D, Nieuwboer, A, Willems, AM, Kwakkel, G,  et al. 2004Attending to the task: interference effects of functional tasks on walking in Parkinson’s disease and the role of cognition, depression, fatigue and balanceArch Phys Med Rehabil8515781585CrossRefPubMedGoogle Scholar
  23. Rochester, L, Hetherington, V, Jones, D, Nieuwboer, A, Willems, AM, Kwakkel, G,  et al. 2005The effect of external rhythmical cues (auditory and visual) on walking during a functional task in the home in people with Parkinson’s diseaseArch Phys Med Rehabil869991006CrossRefPubMedGoogle Scholar
  24. Thaut, M, McIntosh, G, Rice, R, Miller, R, Rathbun, J, Brault, J 1996Rhythmic auditory stimulation in gait training for Parkinson’s disease patientsMov Disord11193200CrossRefPubMedGoogle Scholar
  25. Weeks, R, Honda, M, Catalan, M, Hallet, M 2001Comparison of auditory, somatosensory, and visually instructed and internally generated finger movements: a PET studyNeuroImage14219230CrossRefPubMedGoogle Scholar
  26. White, D, Wagenaar, R, Ellis, T 2006Monitoring activity in individuals with Parkinson’s disease: a validity studyJ Neurol Phys Ther301221PubMedGoogle Scholar
  27. Willems, A, Nieuwboer, A, Chavret, F, Desloovere, K, Dom, R, Kwakkel, G,  et al. 2006The use of rhythmic auditory cues to influence gait in patients with Parkinson’s disease, the differential effect for freezers and non-freezers, an explorative studyDisabil Rehabil28721728CrossRefPubMedGoogle Scholar
  28. Yogev, G, Giladi, N, Peretz, C, Springer, S, Simon, E, Hausdorff, J 2005Dual tasking, gait rhythmicity, and Parkinson’s disease: which aspects of gait are attention demanding?Eur J Neurosci2212481256CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • L. Rochester
    • 1
    • 4
  • A. Nieuwboer
    • 2
  • K. Baker
    • 1
  • V. Hetherington
    • 1
  • A.-M. Willems
    • 2
  • F. Chavret
    • 2
  • G. Kwakkel
    • 3
  • E. Van Wegen
    • 3
  • I. Lim
    • 2
  • D. Jones
    • 1
  1. 1.Northumbria UniversityNewcastleUK
  2. 2.Katholieke UniversiteitLeuvenBelgium
  3. 3.Vrije Universiteit Medisch CentrumAmsterdamThe Netherlands
  4. 4.Glasgow Caledonian UniversityGlasgowUK

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