Rhythmic auditory stimulation promotes gait recovery in Parkinson's patients: A systematic review and meta-analysis

Xiaofan Ye, Ling Li, Rong He, Yizhen Jia, Waisang Poon, Xiaofan Ye, Ling Li, Rong He, Yizhen Jia, Waisang Poon

Abstract

Objective: Using rhythmic auditory stimulation (RAS) to improve gait disturbance in Parkinson's disease (PD) is an available treatment option, yet a consensus on its effectiveness remains controversial. We summarized the effects of RAS on gait, functional activity and quality of life in PD patients through a systematic review and meta-analysis.

Methods: PubMed, Embase, Web of Science, Medline, and Cochrane Library databases were initially searched to identify relevant literature up to August 2021. Next, the methodological quality of eligible comparative studies was assessed by the Physiotherapy Evidence Database Scale. The treatment effects to clinical outcome in relation to gait, motor activities, and quality of life were analyzed.

Results: A total of 18 studies consisted of 774 subjects were included in this meta-analysis. Comparing with the control group, RAS had significantly increased stride length (p < 0.001), accelerated gait speed (p < 0.001), reduced the occurrence of freezing events during walking (P = 0.009), achieved an improvement in Unified Parkinson's Disease Rating Scale (UPDRS) II (P = 0.030), UPDRS-III (P < 0.001) and Parkinson's Disease Quality of Life Questionnaire (PDQL) (p = 0.009) scores over an interval of 1-26 months.

Conclusion: In this meta-analysis of 18 randomized controlled trials, we have demonstrated that RAS improves the general motor functions (UPDRS-III), particularly in gait, mobility and quality of life, in patients with Parkinson's disease.

Keywords: Parkinson's patients; gait; meta-analysis; mobility; rhythmic auditory stimulation.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Ye, Li, He, Jia and Poon.

Figures

Figure 1
Figure 1
Flow chart of the search and screening of the included literature.
Figure 2
Figure 2
Forest plot of RAS vs. the control group for stride length (A), stride duration (B), and speed (C).
Figure 3
Figure 3
Forest plot of RAS vs. the control group for step frequency (A), swing (B), and TUG (C). TUG, Timed Up-and-Go.
Figure 4
Figure 4
Forest plot of RAS vs. the control group for BBS (A), FES (B), and FOGQ (C). BBS, Berg Balance Scale; FES, Falls Efficacy Scale; FOGQ, Freezing of Gait Questionnaire.
Figure 5
Figure 5
Forest plot of RAS vs. the control group for UPDRS-II (A), UPDRS-III (B), and PDQL (C). UPDRS, Unified Parkinson's Disease Rating Scale; UPDRS-II, UPDRS- Activities of Daily Living; UPDRS-III, UPDRS- Motor Symptoms; PDQL, Parkinson's Disease Quality of Life Questionnaire.
Figure 6
Figure 6
Funnel plot of UPDRS-III (A), FOGQ (B), Speed (C). UPDRS-III, Unified Parkinson's Disease Rating Scale - Motor Symptoms; FOGQ, Freezing of Gait Questionnaire.

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