Full length articleBeat perception ability and instructions to synchronize influence gait when walking to music-based auditory cues
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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2021, Gait and PostureCitation Excerpt :Therefore, interventions that do not tailor stimuli based on what is familiar to the patient may not need control for enjoyment to optimize outcomes unless the intention is to improve RAS adherence through enjoyment. Instructions to synchronize and beat perception ability influenced overall gait speed, suggesting that these factors influence RAS outcomes [5], despite rarely being accounted for in clinical populations. Both young and older adults with poor beat perception demonstrated cautious walking patterns when instructed to synchronize, as demonstrated by slower velocity and shorter strides relative to good beat perceivers.
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Present address: Institute of Medical Science, University of Toronto, Canada.