Exploring maintenance of spatiotemporal gait parameters during internal and external rhythmic auditory cueing in Parkinson's disease

INTRODUCTION: Rhythmic auditory cueing is a well-researched intervention to address gait impairment in Parkinson's disease (PD). Both external and internal music-based cues improve spatiotemporal gait variables. However, less is known about individuals' ability to maintain rhythm and stabilize gait within cued walking bouts, which is critical for real-world application. METHODS: = 30) gait trials; one uncued and two cued conditions set at 120% preferred cadence: Music (external) and Mental (internal). APDM sensors measured gait variables. Data were binned and repeated-measures ANOVAs assessed effects of cue condition and time on velocity, stride length, cadence, and coefficients of variation (CV) within a trial, focusing on the beginning and end. RESULTS: Both cues led to significant increases in velocity and cadence compared to uncued walking. Small but statistically significant gait decrements occurred within both 30-s and 3-min walking assessments. Generally, mental cues resulted in longer strides, while Music cues led to higher cadence, suggesting differences in strategy to match cue. CONCLUSIONS: Re-presenting the cue, using more moderate cues, or implementing adaptive cueing may be beneficial to address potential gait decrements during cued walks. Future research should explore strategy differences to optimize cue-based gait training.