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

Not Applicable

Completed

• Conditions: Walking, Difficulty; Parkinson Disease; Gait, Festinating
• Interventions: Other: 20-minute gait training

• Registration Number: NCT06073028
• Lead Sponsor: Henri Mondor University Hospital

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2021-02-01
• Primary Completion: 2021-02-02
• Study Completion: 2022-02-01
• Status Verified: 2023-10
• Study First Submitted: 2023-10-03
• Study First Submitted QC: 2023-10-03
• Last Update Submitted: 2023-10-09
• Study First Posted: 2023-10-10
• Last Update Posted: 2023-10-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 15

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Adaptive spatial auditory cueing	20-minute gait training	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.
Rhythmic auditory cueing	20-minute gait training	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.

Primary Outcome Measures

Name	Time	Method
Walking speed	Before and just after the intervention	Speed in free walking condition over 10 meters barefoot, without any assistance

Trial Locations

Locations (1)

Laboratoire Analyse et Restauration du Mouvement; 🇫🇷 Créteil, France