Title page for ETD etd-10092009-211126

Type of Document Dissertation
Author Kadivar, Zahra
Author's Email Address zkadiv1@tigers.lsu.ed, zkadivar@yahoo.com
URN etd-10092009-211126
Title Does Practice of Multi-directional Stepping with Auditory Stimulation Improve Movement Performance in Patients with Parkinsonís Disease?
Degree Doctor of Philosophy (Ph.D.)
Department Kinesiology
Advisory Committee
Advisor Name Title
Hondzinski, Jan M. Committee Chair
Corcos, Daniel M. Committee Member
Elliott, Emily M. Committee Member
Li, Li. Committee Member
Magill, Richard A. Committee Member
Donovan, Neila J. Dean's Representative
  • Balance
  • Gait
  • Kinematics
  • Motor learning
  • Movement Disorder
  • Rhythmic auditory stimulation
Date of Defense 2009-09-21
Availability unrestricted
Parkinsonís disease (PD) is a debilitating neurodegenerative disorder causing many physical limitations. Rhythmic auditory stimulation (RAS) influences motor complications not alleviated by medicine and has been used to modify straight line walking in this population. However, motor complications are exacerbated during more complex movements including those involving direction changes. Thus immediate RAS effects on direction switch duration (DSD) and other kinematic measures during a multi-directional step task were investigated in PD patients. Long term RAS application was also explored by evaluating functional gait and balance and kinematic step measures before and after 6 weeks of multi-directional stepping either with (Cue, C group) or without (No cue, NC group) RAS use. Evaluations were also administered 1, 4 and 8 weeks after training termination. Kinematic measures were collected during stepping without, then with RAS for the C group and without RAS for the NC group. Step testing/training was performed at slow, normal and fast speeds in forward, back and side directions.

Participants with PD switched step direction during the stepping task faster with RAS use before training. Like straight line walking RAS application influenced the more complex task of direction switching and counteracted the well-known bradykinesia in PD.

After training both groups improved their functional gait and balance measures and maintained balance improvements for at least 8 weeks. Only the C group retained gait improvements for at least 8 weeks after training termination. Adding RAS resulted in functional benefits not observed in training without it.

Kinematic measures compared before and after step training clarified the underlying contributors to functional performances. Both groups reduced the variability of DSD. The C group participants maintained this alteration longer. DSD reduction also occurred after training and was retained for at least 8 weeks for this group. These outcomes further support the advantages of adding RAS to training regiments for those with PD.

The current results indicate that RAS effects are not limited to simple activities like straight line walking. Moreover, RAS can be used for improving and maintaining improvements longer in activities involving various forms of transition which present most difficulties for those with PD.

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