Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes
Background/Purpose: Although gait disorders occur early in the course of Alzheimer's disease (AD) and increase the risk of falling, methods to improve walking in the home setting are poorly understood. This study aimed to determine the feasibility of a home-based gait training program using rhy...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-01-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fmed.2019.00335/full |
| _version_ | 1819183059483754496 |
|---|---|
| author | Joanne E. Wittwer Margaret Winbolt Meg E. Morris Meg E. Morris |
| author_facet | Joanne E. Wittwer Margaret Winbolt Meg E. Morris Meg E. Morris |
| author_sort | Joanne E. Wittwer |
| collection | DOAJ |
| description | Background/Purpose: Although gait disorders occur early in the course of Alzheimer's disease (AD) and increase the risk of falling, methods to improve walking in the home setting are poorly understood. This study aimed to determine the feasibility of a home-based gait training program using rhythmic auditory cues for individuals living with mild to moderately severe AD.Methods: Participants had probable AD with no other major conditions affecting locomotion. The intervention consisted of eight progressively modified 45-min gait training sessions delivered during home visits over 4 weeks. Experienced physiotherapists provided the therapy that incorporated rhythmic music cues for a range of locomotor tasks and ambulatory activities. On the days when the physiotherapist did not attend, participants independently performed a seated music listening activity. Walking speed, cadence, stride length, double limb support duration, and gait variability (coefficient of variation) were measured using an 8-m GAITRite® computerized walkway immediately before and after the physiotherapy intervention. Participant satisfaction was also assessed using a purpose-designed questionnaire.Results: Eleven (median age, 77.0 years; median ACE III score, 66/100; 3 females and 8 males) community-dwelling adults living with AD participated. Wilcoxon signed rank tests revealed statistically significant increases in gait speed following the home-based physiotherapy intervention (baseline = 117.5 cm/s, post-intervention = 129.9 cm/s, z = −2.40, p < 0.05). Stride length also improved (baseline = 121.8 cm, post-intervention = 135.6 cm, z = −2.67, p < 0.05). There was no significant change in gait variability. The program was found to be feasible and safe, with no attrition. Participant satisfaction with the home-based music-cued gait training was high, and there were no adverse events.Conclusion: A progressively modified gait training program using rhythmic auditory cues delivered at home was feasible, safe, and enjoyable. Music-cued gait training can help to reduce the rate of decline in gait stride length and speed in some individuals living with AD.Trial Registration:http://www.anzctr.org.au/Default.aspx, ACTRN12616000851460.Universal Trial Number: U1111-1184-5735. |
| first_indexed | 2024-12-22T22:56:00Z |
| format | Article |
| id | doaj.art-80f1caeb749c413b952cafc920d01c71 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-22T22:56:00Z |
| publishDate | 2020-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-80f1caeb749c413b952cafc920d01c712022-12-21T18:09:49ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-01-01610.3389/fmed.2019.00335500378Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and OutcomesJoanne E. Wittwer0Margaret Winbolt1Meg E. Morris2Meg E. Morris3Physiotherapy Discipline, La Trobe Centre for Sport and Exercise Medicine Research, Faculty of Health Sciences, School of Allied Health, La Trobe University, Melbourne, VIC, AustraliaAustralian Institute for Primary Care & Ageing, La Trobe University, Melbourne, VIC, AustraliaNorth Eastern Rehabilitation Centre, Melbourne, VIC, AustraliaAcademic and Research Collaborative in Health (ARCH), SHE College, La Trobe University, Melbourne, VIC, AustraliaBackground/Purpose: Although gait disorders occur early in the course of Alzheimer's disease (AD) and increase the risk of falling, methods to improve walking in the home setting are poorly understood. This study aimed to determine the feasibility of a home-based gait training program using rhythmic auditory cues for individuals living with mild to moderately severe AD.Methods: Participants had probable AD with no other major conditions affecting locomotion. The intervention consisted of eight progressively modified 45-min gait training sessions delivered during home visits over 4 weeks. Experienced physiotherapists provided the therapy that incorporated rhythmic music cues for a range of locomotor tasks and ambulatory activities. On the days when the physiotherapist did not attend, participants independently performed a seated music listening activity. Walking speed, cadence, stride length, double limb support duration, and gait variability (coefficient of variation) were measured using an 8-m GAITRite® computerized walkway immediately before and after the physiotherapy intervention. Participant satisfaction was also assessed using a purpose-designed questionnaire.Results: Eleven (median age, 77.0 years; median ACE III score, 66/100; 3 females and 8 males) community-dwelling adults living with AD participated. Wilcoxon signed rank tests revealed statistically significant increases in gait speed following the home-based physiotherapy intervention (baseline = 117.5 cm/s, post-intervention = 129.9 cm/s, z = −2.40, p < 0.05). Stride length also improved (baseline = 121.8 cm, post-intervention = 135.6 cm, z = −2.67, p < 0.05). There was no significant change in gait variability. The program was found to be feasible and safe, with no attrition. Participant satisfaction with the home-based music-cued gait training was high, and there were no adverse events.Conclusion: A progressively modified gait training program using rhythmic auditory cues delivered at home was feasible, safe, and enjoyable. Music-cued gait training can help to reduce the rate of decline in gait stride length and speed in some individuals living with AD.Trial Registration:http://www.anzctr.org.au/Default.aspx, ACTRN12616000851460.Universal Trial Number: U1111-1184-5735.https://www.frontiersin.org/article/10.3389/fmed.2019.00335/fullAlzheimer's diseaseauditory stimulationgaitphysiotherapymusic therapy |
| spellingShingle | Joanne E. Wittwer Margaret Winbolt Meg E. Morris Meg E. Morris Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes Frontiers in Medicine Alzheimer's disease auditory stimulation gait physiotherapy music therapy |
| title | Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes |
| title_full | Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes |
| title_fullStr | Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes |
| title_full_unstemmed | Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes |
| title_short | Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes |
| title_sort | home based gait training using rhythmic auditory cues in alzheimer s disease feasibility and outcomes |
| topic | Alzheimer's disease auditory stimulation gait physiotherapy music therapy |
| url | https://www.frontiersin.org/article/10.3389/fmed.2019.00335/full |
| work_keys_str_mv | AT joanneewittwer homebasedgaittrainingusingrhythmicauditorycuesinalzheimersdiseasefeasibilityandoutcomes AT margaretwinbolt homebasedgaittrainingusingrhythmicauditorycuesinalzheimersdiseasefeasibilityandoutcomes AT megemorris homebasedgaittrainingusingrhythmicauditorycuesinalzheimersdiseasefeasibilityandoutcomes AT megemorris homebasedgaittrainingusingrhythmicauditorycuesinalzheimersdiseasefeasibilityandoutcomes |