Sing for Your Saunter - Dementia Supplement (SFYS-D)

Sing for Your Saunter: Using Self-generated Rhythmic Cues to Enhance Gait in Parkinson's - Dementia Supplement

Older adults, and particularly those with Parkinson disease (PD), may experience walking difficulties that negatively impact their daily function and quality of life. People that have PD plus dementia are also likely to experience walking difficulties. This project will examine the impact of music and mentally singing on walking performance, with a goal of understanding what types of rhythmic cues are most helpful. Pilot work from the investigators suggests that imagined, mental singing (i.e., singing in head) while while walking helps people walk faster with greater stability, whereas walking to music also helps people walk faster but with reduced stability.

In this study, the investigators will recruit people who have PD plus dementia. The investigators will compare walking while mentally singing, walking while singing out loud, and walking while listening to music, using personalized cues tailored to each person's walking performance. The investigators hypothesize temporal variability of gait will be lower in the mental singing and singing conditions compared to listening to music; and that mental singing, singing, and listening to music will elicit similar improvements in stride length.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease; Parkinson Disease Dementia
• Intervention / Treatment: Behavioral: Mentally Singing; Behavioral: Listening to music; Behavioral: Singing

Detailed Description

During this observational study, participants will attend one visit in the laboratory. The visit will include participants wearing wearable sensors during the following tasks: walking with no cues (UNCUED), walking while listening to music (MUSIC), walking while singing out loud (SINGING), and walking while mentally singing (MENTAL SINGING). The wearable sensors will measure gait parameters including gait speed, stride length, and stride time variability.

• Study Type: Interventional
• Enrollment (Actual): 17
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Martha Hessler; Phone Number: 3142861478; Email: mjhessler@wustl.edu
• Study Contact Backup: Name: Kerri Rawson; Phone Number: 3142731053; Email: rawson@wustl.edu

Study Locations

• United States
  • Missouri
    • Saint Louis, Missouri, United States, 63110
      • Washington University School of Medicine Program in Physical Therapy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 30 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• at least 30 years of age
• diagnosis of idiopathic, typical Parkinson disease according to the UK Brain Bank Criteria
• Hoehn & Yahr stages 2-3 (mild to moderate disease severity)
• normal or corrected hearing
• stable on all PD medications for at least 2 months prior to study entry
• dementia as defined by a Clinical Dementia Rating (CDR) score of 0.5-1.0 (very mild to mild dementia)
• score of ≥ 1 on the MDS-UPDRS-III Item #10 indicating observable gait impairment
• a score of 1 or less on item #7 on the freezing of gait questionnaire
• able to walk for 10 continuous minutes independently

Exclusion Criteria:

• diagnosis of any other neurological condition
• unstable medical or concomitant illnesses or psychiatric conditions which, in the opinion of the investigators, would preclude successful participation
• cardiac problems that interfere with ability to safely participate (i.e., uncontrolled congestive heart failure, myocardial infarction in past 6 months, complex cardiac arrhythmias, significant left ventricular dysfunction, dyspnea on exertion, chest pain or pressure, resting tachycardia (>100 beats/min); uncontrolled BP (resting systolic BP >160 mmHg or diastolic BP >100 mmHg))
• orthopedic problems in the lower extremities or spine that may limit walking (i.e., severe arthritis, spinal stenosis)
• uncontrolled tremor or dyskinesia while on PD medications

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Parkinson disease plus dementia; Participants will have a diagnosis of Parkinson disease plus dementia.	Behavioral: Mentally Singing; Participants sing their song in their head and match their footfalls to the beat.; Behavioral: Listening to music; Participants listen to their song and match their footfalls to the beat.; Behavioral: Singing; Participants will sing their song out loud and match their footfalls to the beat.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stride Time Variability	Measured with wearable sensors by APDM Wearable Technology	Baseline
Stride length	Measured with wearable sensors by APDM Wearable Technology	Baseline

Collaborators and Investigators

• Sponsor: Washington University School of Medicine
• Investigators: Principal Investigator: Gammon Earhart, Washington University School of Medicine

Study record dates

Study Major Dates

• Study Start (Actual): April 19, 2021
• Primary Completion (Actual): May 15, 2023
• Study Completion (Actual): May 15, 2023

Study Registration Dates

• First Submitted: August 15, 2020
• First Submitted That Met QC Criteria: August 15, 2020
• First Posted (Actual): August 19, 2020

Study Record Updates

• Last Update Posted (Estimated): June 16, 2023
• Last Update Submitted That Met QC Criteria: June 14, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: Gait; Parkinson disease; Music; Mental singing
• Additional Relevant MeSH Terms: Mental Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease; Dementia
• Other Study ID Numbers: AT010753-02S1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No