Effect of step training and rhythmic auditory stimulation on functional performance in parkinson patients

Zahra Kadivar, Daniel M. Corcos, James Foto, Jan M. Hondzinski*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


Background. Rhythmic auditory stimulation (RAS) can influence movement during straight line walking and direction transition in individuals with Parkinson disease (PD). Objective. The authors studied whether multidirectional step training with RAS would generalize to functional gait conditions used in daily activities and balance. Methods. In a matched-pairs design, 8 patients practiced externally paced (EP) stepping (RAS group), and 8 patients practiced internally paced (IP) stepping (no RAS group) for 6 weeks. Participants were evaluated on the first and last days of practice, and 1 week, 4 weeks, and 8 weeks after practice termination. Evaluations included a primary measurement-the Dynamic Gait Index (DGI)-and secondary measurements-the Unified Parkinson's Disease Rating Scale (UPDRS), Tinetti-gait and balance tests, Timed-Up-and-Go (TUG), and Freezing of Gait Questionnaire (FOGQ). Results. The RAS group significantly improved performance on the DGI and several secondary measures, and they maintained improvements for the DGI, Tinetti, FOGQ, and balance and gait items of the UPDRS above pretraining values at least 4 weeks after practice termination. The no RAS group revealed several improvements with training but could not maintain these improvements for as long as the other group. Conclusions. Individuals with PD can generalize motor improvements achieved during multidirectional step training to contexts of functional gait and balance. Training with RAS is advantageous for enhancing functional gait improvements and the maintenance of functional gait and balance improvements over 8 weeks.

Original languageEnglish (US)
Pages (from-to)626-635
Number of pages10
JournalNeurorehabilitation and Neural Repair
Issue number7
StatePublished - Sep 2011


  • Parkinson disease
  • motor learning
  • movement disorder
  • rehabilitation for walking
  • rhythmic auditory stimulation

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology


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