The immediate effect of a novel audio-visual cueing strategy (simulated traffic lights) on dual-task walking in people with Parkinson's disease

Abstract

Background: Gait deficits are exacerbated during the addition of a concurrent cognitive task in individuals with Parkinson's disease (PD). The provision of auditory and/or visual cues has been reported to facilitate gait performance in these patients.

Aim: To investigate whether individuals with PD could use traffic lights as an audio-visual cueing strategy to enhance dual-task walking performance.

Design: Cross-sectional comparative study.

Setting: The Hong Kong Polytechnic University.

Population: Fifteen PD and 13 healthy individuals.

Methods: All participants were instructed to walk at their natural pace, followed by 2 randomized conditions: 1) walking while doing serial subtractions of three, starting from a random number between 60 to 100; 2) doing the same tasks with the addition of traffic lights signals as audio-visual cues. Primary outcomes included stride length, cadence and gait velocity.

Results: Individuals with PD had more deterioration in all gait parameters than healthy controls for both single- and dual-task walking. With the use of traffic lights, individuals with PD showed significant increases in stride length (by 8.8%), cadence (by 9.6%), and gait velocity (by 21.0%, P=0.000).

Conclusion: Traffic lights could be used as combined preparatory and ongoing audio-visual cues to enhance dual-task walking performance in people with PD.

Clinical rehabilitation impact: Positive findings from the present study suggest a promising treatment intervention to benefit people with PD, who often have to conduct concurrent cognitive task during walking in their daily activities.