Music-based rhythm improves gait in Parkinson’s patients
GAINESVILLE, Fla. — Whether it’s the simple tick of a metronome or the thumping bassline in a disco classic, not all beats are created equal.
A University of Florida Health research team that tested how rhythmic cues influence walking found that both those with Parkinson’s disease and healthy older adults demonstrated improved gait when walking to music compared with a metronome, a device that produces a constant, evenly timed beat, or no auditory cue at all.
People with Parkinson’s disease often walk slowly, take shorter steps and have reduced arm swing and irregular strides. Researchers wanted to know if the Parkinsonian brain remains responsive to external sensory cues. The study, published in the journal JAMA Network Open, included 15 participants with Parkinson’s disease and 15 control-group patients recruited through the Norman Fixel Institute for Neurological Diseases.
Gait parameters, including walking speed, stride length and arm swing, were assessed as participants walked under four auditory conditions: no sound, a regular metronome (a fixed, steady beat), a fractal metronome (variable, beat pattern with subtle fluctuations found in nature) and the Bee Gees’ song “Stayin’ Alive.”
When each walking measure was analyzed individually, researchers found significant differences in patients’ stride. Walking to music was associated with increased walking speed, longer stride, higher arm swing velocity and changes in stride time compared with the walking to a regular metronome. Music was also associated with significantly greater stride length and arm swing velocity compared with the fractal metronome.
In contrast, the fractal metronome was associated with stride time fluctuations closer to healthy gait levels compared with the regular metronome and music walkers.
“These findings suggest we may be tapping into emotional, dopamine, motor and nonmotor brain pathways; not just those important to timing and rhythm,” said Kristen Sowalsky, Ph.D., D.C., the study’s lead author.
Rhythmic auditory cues can influence how pleasant a sound feels, which is linked to activity in brain regions involved in reward and may involve dopamine release in the striatum, a key part of the brain that helps control movement and reward.
In this study, music led to greater improvements in gait than either metronome; however, researchers say there is still much to learn.
Future studies will focus on identifying specific types of music that naturally support healthy rhythmic patterns.
“In simple terms, this study pushes us to rethink therapy,” said Michael Okun, M.D., a distinguished professor, director of the Fixel Institute and a study co-author. “Sometimes, the best treatment for walking may not be a pill or a device, but the right kind of sound delivered in the right way.”
Other researchers from the University of Florida involved in the study include Chris Hass, Ph.D.; Leonardo Almeida, M.D.; Nikiolaus McFarland, M.D., Ph.D.; Matthew Terza, Ph.D.; and Enrique Martinez-Nunez, M.D. External researchers on the study include Hyokeun Lee, Ph.D., and Nikolaos Stergiou, Ph.D.