Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease
Rhythmic auditory cueing (RAC) using an isochronous metronome is an effective approach to immediately enhance spatiotemporal aspects of gait for people with Parkinson disease (PwPD). Whereas entraining to RAC typically occurs subconsciously via cerebellar pathways, the use of metronome frequencies t...
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description | Rhythmic auditory cueing (RAC) using an isochronous metronome is an effective approach to immediately enhance spatiotemporal aspects of gait for people with Parkinson disease (PwPD). Whereas entraining to RAC typically occurs subconsciously via cerebellar pathways, the use of metronome frequencies that deviate from one’s typical cadence, such as those used in rehabilitation, may require conscious awareness. This heightened awareness may increase cognitive load and limit the persistence of gait training gains. Here, we explore the immediate effects of incorporating an implicit motor learning approach (i.e., error-based recalibration) to gait training with RAC. Twenty older adults (10 with PD and 10 controls) were asked to match their footfalls to both isochronous and subtly varying metronomes while walking on a treadmill and overground. Our findings revealed intriguing differences between treadmill and overground walking. During treadmill walking to a slower metronome frequency, both groups reduced their cadence and increased step lengths, but did not make the necessary adjustments to match the subtly varying metronome. During overground walking, both groups modified their cadence in response to a 3–4% change in metronome frequency (
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p
< 0.05). Both metronomes yielded evidence of implicit and explicit retention during overground and treadmill walking. Furthermore, during overground walking the PD group showed greater implicit retention of cadence changes following the varying metronome, compared to the isochronous metronome. Our results suggest that incorporating implicit motor learning approaches to gait training during a single session of overground walking may enhance short term implicit retention of gait behaviors for PwPD.</description><identifier>ISSN: 0014-4819</identifier><identifier>ISSN: 1432-1106</identifier><identifier>EISSN: 1432-1106</identifier><identifier>DOI: 10.1007/s00221-024-06933-5</identifier><identifier>PMID: 39361030</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acoustic Stimulation - methods ; Aged ; Auditory discrimination learning ; Biomedical and Life Sciences ; Biomedicine ; Cerebellum ; Cues ; Female ; Fitness equipment ; Gait ; Gait - physiology ; Gait Disorders, Neurologic - etiology ; Gait Disorders, Neurologic - physiopathology ; Gait Disorders, Neurologic - rehabilitation ; Humans ; Learning - physiology ; Male ; Middle Aged ; Motor skill learning ; Movement disorders ; Neurodegenerative diseases ; Neurology ; Neurosciences ; Parkinson Disease - complications ; Parkinson Disease - physiopathology ; Parkinson Disease - rehabilitation ; Parkinson's disease ; Psychomotor Performance - physiology ; Research Article ; Walking ; Walking - physiology</subject><ispartof>Experimental brain research, 2024-12, Vol.242 (12), p.2853-2863</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-37c219f6e989b1ab338be467927b93743eac8c46a8a580565732bb1e459421ad3</cites><orcidid>0000-0001-8181-779X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00221-024-06933-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00221-024-06933-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39361030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duppen, Chelsea Parker</creatorcontrib><creatorcontrib>Sachdeva, Nikhil</creatorcontrib><creatorcontrib>Wrona, Hailey</creatorcontrib><creatorcontrib>Dayan, Eran</creatorcontrib><creatorcontrib>Browner, Nina</creatorcontrib><creatorcontrib>Lewek, Michael D.</creatorcontrib><title>Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease</title><title>Experimental brain research</title><addtitle>Exp Brain Res</addtitle><addtitle>Exp Brain Res</addtitle><description>Rhythmic auditory cueing (RAC) using an isochronous metronome is an effective approach to immediately enhance spatiotemporal aspects of gait for people with Parkinson disease (PwPD). Whereas entraining to RAC typically occurs subconsciously via cerebellar pathways, the use of metronome frequencies that deviate from one’s typical cadence, such as those used in rehabilitation, may require conscious awareness. This heightened awareness may increase cognitive load and limit the persistence of gait training gains. Here, we explore the immediate effects of incorporating an implicit motor learning approach (i.e., error-based recalibration) to gait training with RAC. Twenty older adults (10 with PD and 10 controls) were asked to match their footfalls to both isochronous and subtly varying metronomes while walking on a treadmill and overground. Our findings revealed intriguing differences between treadmill and overground walking. During treadmill walking to a slower metronome frequency, both groups reduced their cadence and increased step lengths, but did not make the necessary adjustments to match the subtly varying metronome. During overground walking, both groups modified their cadence in response to a 3–4% change in metronome frequency (
p
< 0.05). Both metronomes yielded evidence of implicit and explicit retention during overground and treadmill walking. Furthermore, during overground walking the PD group showed greater implicit retention of cadence changes following the varying metronome, compared to the isochronous metronome. Our results suggest that incorporating implicit motor learning approaches to gait training during a single session of overground walking may enhance short term implicit retention of gait behaviors for PwPD.</description><subject>Acoustic Stimulation - methods</subject><subject>Aged</subject><subject>Auditory discrimination learning</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cerebellum</subject><subject>Cues</subject><subject>Female</subject><subject>Fitness equipment</subject><subject>Gait</subject><subject>Gait - physiology</subject><subject>Gait Disorders, Neurologic - etiology</subject><subject>Gait Disorders, Neurologic - physiopathology</subject><subject>Gait Disorders, Neurologic - rehabilitation</subject><subject>Humans</subject><subject>Learning - physiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor skill learning</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson Disease - rehabilitation</subject><subject>Parkinson's disease</subject><subject>Psychomotor Performance - physiology</subject><subject>Research Article</subject><subject>Walking</subject><subject>Walking - physiology</subject><issn>0014-4819</issn><issn>1432-1106</issn><issn>1432-1106</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2P1DAMhiMEYmcX_gAHFIkLl0CcrzZHWMGCtBIc4BylrTvToU1KkmrFvyfDLCBx4GTZfvza8kvIM-CvgPPmdeZcCGBcKMaNlZLpB2QHSgoGwM1DsuMcFFMt2AtymfPxlMqGPyYX0koDXPIdGd_OGIYp7OkSS0x0Rp_CKfXrmqLvD5jpWOv5EFNhBdNC_XDcclkwlExLpHs_FToFumJcZ6R3UznQzz59m0KOgQ5TRp_xCXk0-jnj0_t4Rb6-f_fl-gO7_XTz8frNLeuFNoXJphdgR4O2tR34Tsq2Q2UaK5rOykZJ9H3bK-Nbr1uujW6k6DpApa0S4Ad5RV6edevx3zfMxS1T7nGefcC4ZScBhJZcGKjoi3_QY9xSqNdVSliuuYS2UuJM9SnmnHB0a5oWn3444O7kgju74KoL7pcLTteh5_fSW7fg8Gfk99srIM9Arq2wx_R3939kfwJj9ZHn</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Duppen, Chelsea Parker</creator><creator>Sachdeva, Nikhil</creator><creator>Wrona, Hailey</creator><creator>Dayan, Eran</creator><creator>Browner, Nina</creator><creator>Lewek, Michael D.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8181-779X</orcidid></search><sort><creationdate>20241201</creationdate><title>Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease</title><author>Duppen, Chelsea Parker ; 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Whereas entraining to RAC typically occurs subconsciously via cerebellar pathways, the use of metronome frequencies that deviate from one’s typical cadence, such as those used in rehabilitation, may require conscious awareness. This heightened awareness may increase cognitive load and limit the persistence of gait training gains. Here, we explore the immediate effects of incorporating an implicit motor learning approach (i.e., error-based recalibration) to gait training with RAC. Twenty older adults (10 with PD and 10 controls) were asked to match their footfalls to both isochronous and subtly varying metronomes while walking on a treadmill and overground. Our findings revealed intriguing differences between treadmill and overground walking. During treadmill walking to a slower metronome frequency, both groups reduced their cadence and increased step lengths, but did not make the necessary adjustments to match the subtly varying metronome. During overground walking, both groups modified their cadence in response to a 3–4% change in metronome frequency (
p
< 0.05). Both metronomes yielded evidence of implicit and explicit retention during overground and treadmill walking. Furthermore, during overground walking the PD group showed greater implicit retention of cadence changes following the varying metronome, compared to the isochronous metronome. Our results suggest that incorporating implicit motor learning approaches to gait training during a single session of overground walking may enhance short term implicit retention of gait behaviors for PwPD.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39361030</pmid><doi>10.1007/s00221-024-06933-5</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8181-779X</orcidid></addata></record> |
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subjects | Acoustic Stimulation - methods Aged Auditory discrimination learning Biomedical and Life Sciences Biomedicine Cerebellum Cues Female Fitness equipment Gait Gait - physiology Gait Disorders, Neurologic - etiology Gait Disorders, Neurologic - physiopathology Gait Disorders, Neurologic - rehabilitation Humans Learning - physiology Male Middle Aged Motor skill learning Movement disorders Neurodegenerative diseases Neurology Neurosciences Parkinson Disease - complications Parkinson Disease - physiopathology Parkinson Disease - rehabilitation Parkinson's disease Psychomotor Performance - physiology Research Article Walking Walking - physiology |
title | Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease |
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