Effect of different music genres on gait patterns in Parkinson’s disease

  • D. De Bartolo
  • G. Morone
  • G. Giordani
  • G. Antonucci
  • V. Russo
  • A. Fusco
  • F. Marinozzi
  • F. Bini
  • G. F. Spitoni
  • S. Paolucci
  • M. IosaEmail author
Original Article


The timing and size of repetitive, internally generated, automatic sequences of movements are particularly affected in Parkinson’s disease. The most evident consequence of this deficit is the alteration of gait patterns, with a loss of rhythmicity, shorter steps, slower walking, and trunk instability. Several studies have highlighted a potential benefit of listening to music on the normalization of walking patterns. However, most of these studies investigated the effect of a single specific music. We hypothesized that different musical genres may induce different modifications of spatiotemporal parameters and trunk oscillations during walking. In this study, we enrolled healthy young subjects, healthy elderly, and patients with Parkinson’s disease. They were asked to walk listening, by a wireless headset, one of six different music tracks (related to four different musical genres) while wearing an inertial measurement unit at pelvis level used to assess their walking patterns. The main effect of music tracks resulted statistically significant in all the gait parameters (p < 0.05), but for symmetry of lower trunk movements. This effect was independent by group. The only significant interaction between music and group, in fact, was found for pelvis obliquity range of motion (p = 0.019). Post hoc analyses showed as classical music reduced speed and trunk tilting (p < 0.01), whereas the range of pelvic obliquity movements in frontal plane were increased by rock, motivational, and heavy metal songs (p < 0.015). In conclusion, the gait patterns were altered by listening music depending by the musical genre, and these adaptations occurred similarly among the three groups, including patients with Parkinson’s disease.


Walking Music Gait Locomotion Dual task Music therapy 



We thank Castellucci R., Cianti E., Pollio S., and Lupo A. for having helped in the data collection. We also thank the Italian Society of Neurological rehabilitation (SIRN) for the BTS-SIRN 2018 prize for the best scientific work on the theme of Neurological Rehabilitation that allowed us to use the G-Walk in this study.

Funding information

This study was funded by the Italian Ministry of Health, Line D of Current Research of IRCCS Fondazione Santa Lucia, project: “Golden gait: pattern frattali nel movimento umano, valutazione e riabilitazione nei soggetti con danni cerebrali e cerebellari.”

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

Independent Local Ethical Committee of Santa Lucia Foundation approved the study and all the participants signed the informed consent.


  1. 1.
    Xia R, Mao ZH (2012) Progression of motor symptoms in Parkinson’s disease. Neurosci Bull 28(1):39–48CrossRefGoogle Scholar
  2. 2.
    Jones D, Rochester L, Birleson A, Kwakkel G (2008) Everyday walking with Parkinson’s disease: understanding personal challenges and strategies. Disabil Rehabil 30(16):1213–1221CrossRefGoogle Scholar
  3. 3.
    Morris M (2006) Locomotor training in people with Parkinson’s disease. Phys Ther. 2006; 86:1426 – 1435CrossRefGoogle Scholar
  4. 4.
    McIntosh GC, Brown SH, Rice RR, Thaut MH (1997) Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 62(1):22–26CrossRefGoogle Scholar
  5. 5.
    Hass CJ, Buckley TA, Pitsikoulis C, Barthelemy EJ (2012) Progressive resistance training improves gait initiation in individuals with Parkinson’s disease. Gait Posture 35(4):669–673CrossRefGoogle Scholar
  6. 6.
    Wearden JH, Smith-Spark JH, Cousins R, O’Boyle DJ (2008) Stimulus timing by people with Parkinson’s disease. Brain Cogn 67(3):264–279CrossRefGoogle Scholar
  7. 7.
    Plotnik M, Hausdorff JM (2008) The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson’s disease. Mov Disord 23(S2):S444–S450CrossRefGoogle Scholar
  8. 8.
    Staum MJ (1983) Music and rhythmic stimuli in the rehabilitation of gait disorders. J Music Ther 20(2):69–87CrossRefGoogle Scholar
  9. 9.
    Thaut MH (2005) The future of music in therapy and medicine. Ann N Y Acad Sci 1060:303–308CrossRefGoogle Scholar
  10. 10.
    Rochester L, Rafferty D, Dotchin C, Walker RW (2010) The effect of cueing therapy on single and dual-task gait in a drug naive population of people with Parkinson’s disease in northern Tanzania. Mov Disord 25:906–911CrossRefGoogle Scholar
  11. 11.
    Ashoori A, Eagleman DM, Jankovic J (2015) Effects of auditory rhythm and music on gait disturbances in Parkinson’s disease. Front Neurol 6:234CrossRefGoogle Scholar
  12. 12.
    Bukowska AA, Krężałek P, Mirek E, Bujas P, Marchewka A (2016) Neurologic music therapy training for mobility and stability rehabilitation with Parkinson’s disease–a pilot study. Front Hum Neurosci 9:710CrossRefGoogle Scholar
  13. 13.
    Wittwer JE, Webster KE, Hill K (2013) Music and metronome cues produce different effects on gait spatiotemporal measures but not gait variability in healthy older adults. Gait posture 37(2):219–222CrossRefGoogle Scholar
  14. 14.
    Reychler G, Fabre J, Lux A, Liistro G (2016) Influence of different kinds of music on walking in children. Rehabil Nurs.Google Scholar
  15. 15.
    Leow LA, Rinchon C, Grahn J (2015) Familiarity with music increases walking speed in rhythmic auditory cuing. Ann N Y Acad Sci 1337(1):53–61CrossRefGoogle Scholar
  16. 16.
    Buhmann J, Desmet F, Moens B, Van Dyck E, Leman M (2016) Spontaneous velocity effect of musical expression on self-paced walking. PloS one 11(5):e0154414CrossRefGoogle Scholar
  17. 17.
    de Bruin N, Kempster C, Doucette A, Brown LA (2015) The effects of music salience on the gait performance of young adults. J Music Ther 52(3):394–419CrossRefGoogle Scholar
  18. 18.
    Bernatzky G, Bernatzky P, Hesse HP, Staffen W, Ladurner G (2004) Stimulating music increases motor coordination in patients afflicted with Morbus Parkinson. Neurosci Lett 361(1-3):4–8CrossRefGoogle Scholar
  19. 19.
    Hausdorff JM, Lowenthal J, Herman T, Giladi N (2007) Rhythmic auditory stimulation modulates gait variability in Parkinson’s disease. Eur J Neurol 26(8):2369–2375Google Scholar
  20. 20.
    Roerdink M, Bank PJ, Peper CLE, Beek PJ (2011) Walking to the beat of different drums: practical implications for the use of acoustic rhythms in gait rehabilitation. Gait posture 33(4):690–694CrossRefGoogle Scholar
  21. 21.
    Taylor KSM, Cook JA, Counsell CE (2007) Heterogeneity in male to female risk for Parkinson’s disease. J Neurol Neurosurg Psychiatry 78(8):905–906CrossRefGoogle Scholar
  22. 22.
    Antonini A, Abbruzzese G, Ferini-Strambi L, Di Stasio F (2013) Validation of the Italian version of the movement disorder society—unified Parkinson’s disease rating scale. J Neurol Sci 34(5):683–687CrossRefGoogle Scholar
  23. 23.
    Ottonello M, Pellicciari L, Giordano A, Foti C (2016) Rasch analysis of the fatigue severity scale in Italian subjects with multiple sclerosis. J Rehabil Med 48(7):597–603CrossRefGoogle Scholar
  24. 24.
    Hazzard A, Benford S, & Burnett G (2014, April) Walk this way: musically guided walking experiences. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (pp. 605-614). ACM.Google Scholar
  25. 25.
    Moens B, Muller C, van Noorden L, Leman M (2014) Encouraging spontaneous synchronisation with D-Jogger, an adaptive music player that aligns movement and music. PloS one 9(12):e114234CrossRefGoogle Scholar
  26. 26.
    Krout RE (2007) Music listening to facilitate relaxation and promote wellness: integrated aspects of our neurophysiological responses to music. Arts Psychother 34(2):134–141CrossRefGoogle Scholar
  27. 27.
    Giladi N, Shabtai H, Rozenberg E, Shabtai E (2001) Gait festination in Parkinson’s disease. Parkinsonism. Relat Disord 7(2):135–138CrossRefGoogle Scholar
  28. 28.
    Prochazka A, Bennett DJ, Stephens MJ, Jhamandas JH (1997) Measurement of rigidity in Parkinson’s disease. Mov Disord 12(1):24–32CrossRefGoogle Scholar
  29. 29.
    Gainotti G, Antonucci G, Marra C, Paolucci S (2001) Relation between depression after stroke, antidepressant therapy, and functional recovery. J Neurol Neurosurg Psychiatry 71(2):258–261CrossRefGoogle Scholar
  30. 30.
    Paolucci S, Antonucci G, Pratesi L, Lubich S (1999) Poststroke depression and its role in rehabilitation of inpatients. Arch Phys Med Rehabil 80(9):985–990CrossRefGoogle Scholar
  31. 31.
    Baker F, Roth EA (2004) Neuroplasticity and functional recovery: training models and compensatory strategies in music therapy. Nord J Music Ther 13(1):20–32CrossRefGoogle Scholar
  32. 32.
    Schiavio A, Altenmüller E (2015) Exploring music-based rehabilitation for Parkinsonism through embodied cognitive science. Front Neurol 6:217CrossRefGoogle Scholar
  33. 33.
    Iosa M, Fusco A, Morone G, Paolucci S (2014) Development and decline of upright gait stability. Front Aging Neurosci 6:14CrossRefGoogle Scholar
  34. 34.
    Huang TL, & Charyton C (2008) A comprehensive review of the psychological effects of brainwave entrainment. In Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. Centre for Reviews and Dissemination (UK).Google Scholar
  35. 35.
    Iosa M, Morone G, Fusco A, & Peppe A (2016) Loss of fractal gait harmony in Parkinson’s disease Clin Neurophysiol, 127(2), 1540-1546.Google Scholar
  36. 36.
    Vinciguerra C, De Stefano N, & Federico A (2019) Exploring the role of music therapy in multiple sclerosis: brief updates from research to clinical practice. Neurol Sci. 2019 Jul 12.Google Scholar

Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.PhD Program in Behavioral NeuroscienceSapienza University of RomeRomeItaly
  2. 2.IRCCS Santa Lucia FoundationRomeItaly
  3. 3.Department of PsychologySapienza University of RomeRomeItaly
  4. 4.IRCCS Don Carlo Gnocchi FoundationMilanItaly
  5. 5.Department of Mechanical and Aerospace EngineeringSapienza University of RomeRomeItaly

Personalised recommendations