Effects of Physical Rehabilitation Integrated with Rhythmic Auditory Stimulation on Spatio-Temporal and Kinematic Parameters of Gait in Parkinson's Disease

Movement rehabilitation by means of physical therapy represents an essential tool in the management of gait disturbances induced by Parkinson's disease (PD). In this context, the use of rhythmic auditory stimulation (RAS) has been proven useful in improving several spatio-temporal parameters, but concerning its effect on gait patterns, scarce information is available from a kinematic viewpoint. In this study, we used three-dimensional gait analysis based on optoelectronic stereophotogrammetry to investigate the effects of 5\u2009weeks of supervised rehabilitation, which included gait training integrated with RAS on 26 individuals affected by PD (age 70.4\u2009\ub1\u200911.1, Hoehn and Yahr 1-3). Gait kinematics was assessed before and at the end of the rehabilitation period and after a 3-month follow-up, using concise measures (Gait Profile Score and Gait Variable Score, GPS and GVS, respectively), which are able to describe the deviation from a physiologic gait pattern. The results confirm the effectiveness of gait training assisted by RAS in increasing speed and stride length, in regularizing cadence and correctly reweighting swing/stance phase duration. Moreover, an overall improvement of gait quality was observed, as demonstrated by the significant reduction of the GPS value, which was created mainly through significant decreases in the GVS score associated with the hip flexion-extension movement. Future research should focus on investigating kinematic details to better understand the mechanisms underlying gait disturbances in people with PD and the effects of RAS, with the aim of finding new or improving current rehabilitative treatments

Athletic Performance and Recovery-Stress Factors in Cycling: An Ever Changing Balance

We sought to examine whether the relationship between recovery-stress factors and performance would differ at the beginning (Stage 1) and the end (Final Stage) of a multi-stage cycling competition. Sixty-seven cyclists with a mean age of 21.90 years (SD = 1.60) and extensive international experience participated in the study. The cyclists responded to the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) and rated their performance (1 = extremely poor to 10 = excellent) in respect to the first and last stage. Two step-down multiple regression models were used to estimate the relationship among recovery (nine factors; e.g., Physical Recovery, Sleep Quality) and stress factors (10 factors; e.g., Lack of Energy, Physical Complaints), as assessed by the RESTQ and in relation to performance. Model-1 pertained to Stage 1, whereas Model-2 used data from the Final Stage. The final Model-1 revealed that Physical Recovery (β = .46, p = .01), Injury (β = -.31, p = .01) and General Well-being (β = -.26, p = .04) predicted performance in Stage 1 (R2 = .21). The final Model-2 revealed a different relationship between recovery-stress factors and performance. Specifically, being a climber (β = .28, p = .01), Conflicts/Pressure (β = .33, p = .01), and Lack of Energy (β = -.37, p = .01) were associated with performance at the Final Stage (R2 = .19). Collectively, these results suggest that the relationship among recovery and stress factors changes greatly over a relatively short period of time, and dynamically influences performance in multi-stage competitions

The Use of Footstep Sounds as Rhythmic Auditory Stimulation for Gait Rehabilitation in Parkinson’s Disease: A Randomized Controlled Trial

BackgroundThe use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson’s disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs.ObjectiveThe aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS.MethodsAn observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5–3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up.ResultsThirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group.ConclusionOverall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03228888

Measuring the meter: on the constancy of lightness scales seen against different backgrounds

The constancy of a 16-step achromatic Munsell scale was tested with regards to background variations in two experiments. In experiment 1 three groups of observers were asked to find lightness matches for targets in simultaneous lightness displays by using a 16-step achromatic Munsell scale placed on a white, black, or white-black checkered background. In experiment 2, a yellow-blue checkered background and a green-red checkered background replaced Munsell scales on the black and on the white backgrounds. Significant effects of scale background on matches were found only in experiment 1, suggesting that background luminance is a crucial factor in the overall appearance of the scale. The lack of significant differences in experiment 2, however, may stand for an overall robustness of the scale with respect to background luminance changes occurring within certain luminance ranges

audio_1_The Use of Footstep Sounds as Rhythmic Auditory Stimulation for Gait Rehabilitation in Parkinson’s Disease: A Randomized Controlled Trial.mp3

Background<p>The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson’s disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs.</p>Objective<p>The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS.</p>Methods<p>An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5–3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up.</p>Results<p>Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group.</p>Conclusion<p>Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.</p>Clinical Trial Registration<p>www.ClinicalTrials.gov, identifier NCT03228888.</p

data_sheet_1_The Use of Footstep Sounds as Rhythmic Auditory Stimulation for Gait Rehabilitation in Parkinson’s Disease: A Randomized Controlled Trial.docx

Background<p>The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson’s disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programs.</p>Objective<p>The aim of this study was to compare the effects of a rehabilitation program integrated either with ecological or with artificial RAS.</p>Methods<p>An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1.5–3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up.</p>Results<p>Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group.</p>Conclusion<p>Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological, and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed.</p>Clinical Trial Registration<p>www.ClinicalTrials.gov, identifier NCT03228888.</p