Article

OBJECTIVE: To determine whether rhythmic music and metronome cues alter
spatiotemporal gait measures and gait variability in people with Alzheimer
disease (AD). DESIGN: A repeated-measures study requiring participants to walk
under different cueing conditions. SETTING: University movement laboratory.
PARTICIPANTS: Of the people (N=46) who met study criteria (a diagnosis of
probable AD and ability to walk 100m) at routine medical review, 30 (16 men; mean
age +/- SD, 80+/-6y; revised Addenbrooke's Cognitive Examination range, 26-79)
volunteered to participate. INTERVENTIONS: Participants walked 4 times over an
electronic walkway synchronizing to (1) rhythmic music and (2) a metronome set at
individual mean baseline comfortable speed cadence. MAIN OUTCOME MEASURES: Gait
spatiotemporal measures and gait variability (coefficient of variation [CV]).
Data from individual walks under each condition were combined. A 1-way
repeated-measures analysis of variance was used to compare uncued baseline, cued,
and retest measures. RESULTS: Gait velocity decreased with both music and
metronome cues compared with baseline (baseline, 110.5cm/s; music, 103.4cm/s;
metronome, 105.4cm/s), primarily because of significant decreases in stride
length (baseline, 120.9cm; music, 112.5cm; metronome, 114.8cm) with both cue
types. This was coupled with increased stride length variability compared with
baseline (baseline CV, 3.4%; music CV, 4.3%; metronome CV, 4.5%) with both cue
types. These changes did not persist at (uncued) retest. Temporal variability was
unchanged. CONCLUSIONS: Rhythmic auditory cueing at comfortable speed tempo
produced deleterious effects on gait in a single session in this group with AD.
The deterioration in spatial gait parameters may result from impaired executive
function associated with AD. Further research should investigate whether these
instantaneous cue effects are altered with more practice or with learning methods
tailored to people with cognitive impairment.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS