Article

Turning has been associated with instability, falls, and freezing in
people with Parkinson's disease (PD). OBJECTIVE: To investigate the effect of
different modalities of rhythmic cueing on the duration of a functional turn in
freezers and nonfreezers. METHODS: A total of 133 patients with idiopathic PD
while in the on phase of the medication cycle participated in this study as part
of a subanalysis from the RESCUE trial. The effect of 3 different cue modalities
on functional turning performance was investigated, involving a 180 degrees turn
while picking up a tray. Time to perform this task was measured using an activity
monitor. Tests were performed without cues and with auditory, visual, and
somatosensory cues delivered in a randomized order at preferred straight-line
stepping frequency. RESULTS: Cueing (all types) increased the speed of the turn
in all subjects. There was no difference between turn performance of freezers and
nonfreezers in cued and noncued conditions. Auditory cues made turning
significantly faster than visual cues (P < .01) but not compared with
somatosensory cues, except in nonfreezers. There was a short-term carryover in
the final noncued trial. CONCLUSIONS: Rhythmical cueing yielded faster
performance of a functional turn in both freezers and nonfreezers. This may be
explained by enhancing attentional mechanisms during turning. Although no harmful
effects were recorded, the safety of cueing for turning as a therapeutic strategy
needs further study.

Langue : ANGLAIS