The Effects of Visual and Auditory Cues on Freezing of Gait in Patients with Parkinson Disease

Lee SJ, Yoo JY, Ryu JS, Park HK, Chung SJ: The effects of visual and auditory cues on freezing of gait in patients with Parkinson disease. Am J Phys Med Rehabil 2012;91:2Y11. Objective: The aims of this study was to investigate the effects of visual and auditory cues on the freezing of gait in Parkinson disease patients (PDF) compared with Parkinson disease patients without freezing of gait (PDNF). Design: Fifteen PDF, 10 PDNF, and 10 age-matched healthy volunteers were recruited. Subjects walked back and forth on a 7-m walkway under three different conditions: baseline condition without cues, with visual cues, and with auditory cues. Visual cues consisted of white stripes located along the walkway. For auditory cues, a metronome was used. Gait was analyzed using three-dimensional computerized analysis. Results: In the PDF group, both visual and auditory cues significantly affected visuospatial and kinematic gait parameters. PDF group benefited more from visual cues than auditory cues. In the PDNF and healthy volunteer groups, visual cues significantly decreased patient velocity. Auditory cues affected some kinematic parameters on PDNF group. Compared among three groups, visual cues more positively affected the PDF group, and auditory cues more positively affected kinematic parameters in the PDNF group. Conclusions: This study suggests that gait training using visual and auditory cues can improve PDF patient gait and that auditory cues enhance gait in PDNF patients with hypokinetic gait patterns.