Introduction: One of the most debilitating motor symptoms of Parkinson’s disease (PD) is gait dysfunction. Despite the benefits of current pharmacological and surgical therapies for patients with PD, treatment effectiveness and options for gait difficulties, remain limited. Evidence exists to support the use of rhythmic external auditory signals to improve PD patients’ gait.
We analysed the effects on gait of an original smartphone app that generates auditory rhythmic cues matching step frequency to the auditory rhythm aiming to improve walking in PD patients.
Methods: The application- Listenmee® (Brainmee, Madrid-Spain [www.brainmee.com]) was developed on a mathematical basis allowing users to choose an intra-individually auditory cueing rate (beats/min). The employed technology is simple and easy to use. Users can access it through a direct touch screen ordering system with commands such as "PLAY", "PAUSE" and a circle type interface on the screen. The user is able to use the mobile touch screen to increase (clockwise) or decrease (against clockwise) the cueing rate. The application has different cueing rates as follows: very slow [0% -50%], slow [51% -100%], fast [101% -150%] or very fast [151% -200%]. The applied frequencies can vary between 60 to 480 Hz. Patient and physician together can choose the sound set and cueing rate that is best suited for the patient.A volunteer sample of 10 PD patients between 45 to 65 years old (3 women and 7 men) (5 with previously implanted STN DBS) were studied, all with gait disturbances. Auditory rhythmic cues were administered through the device -Listenmee® app in a single session.
Results: Gait performance in this study achieved an important mean improvement in the three major dependent variables: in walking speed (meters per second) of 63,38%, cadence (steps/min) 22,11% and stride length in meters 109,19% in a singular session analyses.
Conclusions: Listenmee© is a safe and effective adjunct help for symptomatic improvement of gait in patients with PD including freezing of gait. Clinical application of auditory cues may be another model in the armamentarium of therapies for treatment of patients with PD. Further analysis also should involve chronic responses to the cues in PD patients and in other diseases.
Patient Care: Our results suggest that Listenmee® app may be an interesting co-adjuvant treatment option for gait disturbances in PD.
Learning Objectives: To understand the importance of auditory cues to improve PD gaits disturbances, which are employed by practical means of cueing serching to generate auditory rhythmic cues using a metronome with instruction to match step frequency to the auditory rhythm. The ideal frequency of such cues has yet to be fully elucidated and is the subject of ongoing studies.