Elsevier

Gait & Posture

Volume 68, February 2019, Pages 555-561
Gait & Posture

Full length article
Beat perception ability and instructions to synchronize influence gait when walking to music-based auditory cues

https://doi.org/10.1016/j.gaitpost.2018.12.038Get rights and content

Highlights

  • Instructions to synchronize impact good and poor beat perceivers differently.

  • Low groove music shortens and slows gait more than high groove and metronome cues.

  • Tempo matching is less accurate with low versus high groove/metronome cues.

  • Metronome cues do not produce better performance than high groove cues.

Abstract

Synchronizing gait to music-based auditory cues (rhythmic auditory stimulation) is a strategy used to manage gait impairments in a variety of neurological conditions, including Parkinson’s disease. However, knowledge of how to individually optimize music-based cues is limited. The purpose of this study was to investigate how instructions to synchronize with auditory cues influences gait outcomes among healthy young adults with either good or poor beat perception ability. 65 healthy adults walked to metronome and musical stimuli with high and low levels of perceived groove (how much it induces desire to move) and familiarity at a tempo equivalent to their self-selected walking pace. Participants were randomized to instruction conditions: (i) synchronized: match footsteps with the beat, or (ii) free-walking: walk comfortably. Participants were classified as good or poor beat perceivers using the Beat Alignment Test. In this study, poor beat perceivers show better balance-related parameters (stride width and double-limb support time) when they are not instructed to synchronize their gait with cues (versus when synchronization was required). Good beat perceivers, in contrast, were better when instructed to synchronize gait (versus when no synchronization was required). Changes in stride length and velocity were influenced by musical properties, in particular the perceived ‘groove’ (greater stride length and velocity with high- versus low-groove cues) and, in some cases, this interacted with beat perception ability. The results indicate that beat perception ability and instructions to synchronize indeed influence spatiotemporal gait parameters when walking to music- and metronome-based rhythmic auditory stimuli. Importantly, these results suggest that both low groove cues and instructing poor beat perceivers to synchronize may interfere with performance while walking, thus potentially impacting both empirical and clinical outcomes.

Introduction

Gait impairments in Parkinson’s disease (PD), such as reduced speed, stride length and stability, are debilitating and difficult to manage pharmaceutically [[1], [2], [3], [4]]. These deficits interfere with safe mobility and independence, consequently hindering quality of life [5] and increasing fall risk [6,7]. One highly recommended strategy for mitigating gait impairment in PD is Rhythmic Auditory Stimulation (RAS), which involves synchronizing footsteps to a steady metronome or musical beat while walking [[8], [9], [10], [11], [12], [13], [14]].

Importantly for clinical application, the impact of instructions to synchronize during RAS may be influenced by individual differences in beat perception ability and rhythmic skills; however, this is rarely assessed in clinical interventions. When healthy young adults with poor beat perception ability synchronize to the beat of the music, they show reduced velocity and stride length compared to silence; however, good beat perceivers show faster velocity [15]. Among mild PD patients, greater rhythmic timing skills are predictive of velocity improvements with RAS [16]. Thus, rhythmic ability alters individual responses to RAS in both healthy and PD populations.

Cautious gait patterns, such as those observed during synchronized walking in poor beat perceivers, may result from ‘dual-task’ interference elicited by task instructions [17,18]. Specifically, poor beat perceivers may require more attention to identify and synchronize with a beat than good beat perceivers, resulting in slower gait. We hypothesize that removing instructions to synchronize may reduce attentional costs of RAS among poor beat perceivers and may reflect a more appropriate strategy for people prone to dual-tasking interference, such as people with cognitive or mobility impairment.

Here, we investigate how RAS alters gait when healthy participants are or are not instructed to synchronize. We also manipulated the musical domains of groove (how much music makes a person want to move) and familiarity to replicate previous research on the beneficial effects of these characteristics on stride length and velocity [15,19,20], and to determine whether their effects differed for good and poor beat perceivers.

Section snippets

Participants

102 healthy young adults were recruited from the University of Western Ontario (see Table 1 for demographic data). Eighteen participants were excluded (two due to abnormal gait patterns [shuffling, foot drag], 14 for technical error [computer/headphone malfunction], and three due to language barrier). The final sample consisted of 84 participants (45 female, 1 unidentified) with a mean age of 18.59 (SD = .72). Participants were compensated with 1.5 course credits. Written informed consent was

Data analysis

For this study, only good and poor beat perceivers were analysed (N = 65), as BAT data were distributed bimodally. Participants scoring at/above the higher mode (M = 76.47) or at/below the lower mode (M = 58.82) were considered good (range = 76.47–100) and poor beat perceivers (range = 29.41–58.82), respectively.

Results

Separate one-way ANOVAs confirmed that equivalent groups were achieved for age [F (3, 61) = 0.06, p >  .05], music/dance training [F (3, 61) = 1.96, p >  .05; F (3, 61) = 1.15, p >  .05], and baseline cadence [F (3, 61) = 0.43, p >  .05]. However, Pearson Chi-Square analysis indicated uneven gender across subgroups [χ2 = 8.94, p <  .05] (see Table 1). All spatiotemporal gait parameter results are reported as proportion of change from baseline.

Discussion

The current study examined how instructions to synchronize and individual beat perception abilities affected gait patterns during high groove, low groove, and metronome RAS among healthy young adults. Overall, RAS slowed participants down, mainly through shortening of strides. The only exception to this was high groove music, in which strides were less shortened relative to baseline, particularly in poor beat perceivers. The results replicate previous work that high groove music generally

Conflict of interest

All authors declare no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.

Acknowledgements

We wish to thank the anonymous reviewers for their thoughtful comments on an earlier version of this manuscript. This experiment was supported by the Canadian Institute of Health Research (#3258); Parkinson Society Canada; James S. McDonnell Foundation [Understanding Human Cognition Scholar Award].

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    Present address: Institute of Medical Science, University of Toronto, Canada.

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