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Walking training with auditory cueing improves walking speed more than walking training alone in ambulatory people with Parkinson's disease: a systematic review.

Journal of physiotherapy
July 1, 2024
Lucas R Nascimento et al. (5 authors)
Journal ArticleSystematic ReviewMeta-AnalysisResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

The researchers aimed to determine whether adding external cueing (visual, auditory, or somatosensory) to walking training improves walking, mobility, balance, fear of falling, and freezing in people with Parkinson's disease compared to walking training alone.

Results Summary

Walking training with auditory cueing improved walking speed by 0.09 m/s more than walking training alone, but effects on stride length were uncertain. Visual cueing did not improve walking speed or stride length, and results for other outcomes (cadence, mobility, balance, fear of falling, freezing) remained inconclusive.

Population

Ambulatory adults with Parkinson's disease.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Walking training with auditory cueing
increase
walking speed
Ambulatory adults with Parkinson's disease
0.09 m/s (95% CI 0.02 to 0.15) more than walking training alone
improved
#1
Walking training with auditory cueing
increase
stride length
Ambulatory adults with Parkinson's disease
5 cm (95% CI -2 to 11)
may also improve
#2
Walking training with visual cueing
no change
walking speed
Ambulatory adults with Parkinson's disease
-
did not improve
#3
Walking training with visual cueing
no change
stride length
Ambulatory adults with Parkinson's disease
-
did not improve
#4
Walking training with external cueing
neutral
cadence
Ambulatory adults with Parkinson's disease
-
remain uncertain
#5
Walking training with external cueing
neutral
mobility
Ambulatory adults with Parkinson's disease
-
remain uncertain
#6
Walking training with external cueing
neutral
balance
Ambulatory adults with Parkinson's disease
-
remain uncertain
#7
Walking training with external cueing
neutral
fear of falling
Ambulatory adults with Parkinson's disease
-
remain uncertain
#8
Walking training with external cueing
neutral
freezing
Ambulatory adults with Parkinson's disease
-
remain uncertain
#9
Walking training with external cueing
neutral
maintenance of benefits beyond the intervention period
Ambulatory adults with Parkinson's disease
-
remain uncertain
#10
Abstract

QUESTIONS: In people with Parkinson's disease, what is the effect of adding external cueing (ie, visual, auditory or somatosensorial cueing) to walking training compared with walking training alone in terms of walking, mobility, balance, fear of falling and freezing? Are any benefits carried over to participation or maintained beyond the intervention period? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Ambulatory adults with Parkinson's disease. INTERVENTION: Walking training with external cueing compared with walking training without external cueing. OUTCOME MEASURES: Walking (ie, speed, stride length and cadence), mobility, balance, fear of falling, freezing and participation. RESULTS: Ten trials involving a total of 309 participants were included. The mean PEDro score of the included trials was 5 (range 4 to 8). Walking training with auditory cueing improved walking speed by 0.09 m/s (95% CI 0.02 to 0.15) more than walking training alone. Although the best estimate was that auditory cueing may also improve stride length by 5 cm, this estimate was imprecise (95% CI -2 to 11). The addition of visual cueing to walking training did not improve walking speed or stride length. Results regarding cadence, mobility, balance, fear of falling, and freezing and maintenance of benefits beyond the intervention period remain uncertain. CONCLUSION: This systematic review provided low-quality evidence that walking training with auditory cueing is more effective than walking training alone for improving walking speed in Parkinson's disease. Cueing is an inexpensive and easy to implement intervention, so the mean estimate might be considered clinically worthwhile, although the confidence interval spans clinically trivial and worthwhile effects. REGISTRATION: PROSPERO CRD42021255065.

Medical Subject Headings (MeSH)
HumansParkinson DiseaseCuesWalking SpeedExercise TherapyWalkingPostural BalanceAccidental FallsGait Disorders, NeurologicRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations2
Citations/Year2.0
Research Impact Scores
APT Score0.25
Weight Score2.60
Normalized Score0.61
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