Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Grahn, Jessica A.

2nd Supervisor

Holmes, Jeffrey D.

Joint Supervisor

Abstract

This dissertation explores a common, rehabilitative strategy for mitigating gait impairments in Parkinson’s disease (PD) called Rhythmic Auditory Stimulation (RAS). The effects of this intervention on gait in PD are well documented but highly variable, which poses difficulty for appropriate therapeutic application. Part of this variability may be related to individual musical abilities, such as beat perception accuracy, as most RAS interventions involve synchronizing with a beat. However, music is complex and variable. Therefore, factors inherent in the music itself may play a role in these differences, such as how much the music makes you want to move (groove), or how familiar it is. The studies in this thesis address these questions by examining the effects of different musical features (e.g., groove, familiarity) in auditory stimuli on the gait of different populations (younger adults, older adults, people with PD). The immediate effects of instructions to synchronize or to walk freely to the auditory stimuli on spatiotemporal gait parameters were compared between those with good beat perception and with poor beat perception in each of the populations.

This research supports overall that high groove music and metronome cues have markedly different effects on spatiotemporal gait parameters than low groove cues, and that low groove cues have the potential to hinder spatial and temporal gait parameters. This indicates that music in RAS should be carefully assessed before use. This thesis also supports that synchronizing to RAS may be helpful to maximize the effects of cueing on temporal gait parameters across healthy adults and the PD group. However, these studies also highlight the various ways in which synchronizing can potentially compromise gait (e.g., shortening strides, increasing variability) and that this is not necessarily dependent on how well one can find a musical beat. Further research is required to understand what additional factors can be manipulated to best individualize music-based RAS for optimal gait management in clinical populations.

Summary for Lay Audience

This dissertation explores a common therapy for managing walking patterns in Parkinson’s disease (PD) called Rhythmic Auditory Stimulation (RAS). Clinically implementing RAS can be challenging, as walking patterns do not always change consistently with RAS. Many RAS interventions involve people walking with the beat in music, therefore individual musical abilities (such as how well a person can find a musical beat) may contribute to this variability. However, music itself is complex and variable. Therefore, factors inherent in the music itself may play a role in these differences, such as how much the music makes you want to move (groove), or how familiar it is. The studies in this thesis address these questions by examining the effects of different musical features (e.g., groove, familiarity) in music on the walking patterns of different groups (younger adults, older adults, people with PD). The immediate effects of instructions to synchronize or to walk freely to the music on walking patterns were compared between those with good beat perception and with poor beat perception in each of the groups.

This research supports overall that high groove music and metronome cues have markedly different effects on walking patterns than low groove cues, and that low groove cues have the potential to hinder how people walk. This indicates that music in RAS should be carefully assessed before use. This thesis also supports that synchronizing to RAS, or walking in time to the beat, might help people to adapt their walking patterns. Importantly, these studies also highlight that synchronizing can potentially compromise how a person walks (e.g., taking short steps, fluctuating step length and speed) and that this is not necessarily dependent on how well one can find a musical beat. Further research is required to understand what additional factors can be manipulated to best individualize music-based RAS for the most optimal walking patterns in clinical populations.

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