Author(s): JUHL, M., AAGAARD, P., BOJSEN-MØLLER, J., PINGEL, J., Institution: UNIVERSITY OF SOUTHERN DENMARK, Country: DENMARK, Abstract-ID: 743

INTRODUCTION:
Gait impairment is a cardinal feature of Parkinson's disease (PD), characterized by reduced walking speed, increased stride-to-stride variability, and elevated fall risk, all of which profoundly restrict daily activities and diminish quality of life. Rhythmic auditory stimulation (RAS) is a non-invasive external cueing technique that might improve gait performance acutely in PD by entraining stepping rhythm to an auditory beat, thereby compensating for dysfunctional basal ganglia circuits through preserved sensorimotor pathways.

The aim of this study was to investigate the acute effects of RAS on walking distance and rated perceived exertion (RPE) during the 2-minute walk test (2MWT) in individuals with mild-to-moderate PD compared to age-matched healthy controls.
METHODS:
Twenty-eight participants (18 with mild-to-moderate PD, Hoehn & Yahr stages 1–3; 10 healthy controls) performed the 2MWT at self-selected speed under three conditions: no auditory cue, RAS beats per minute matched to preferred cadence (baseline), and RAS at +5% BPM. To minimize potential carry-over effects of RAS on the no-cue condition, testing order was fixed (no cue first). Walking distance and rated perceived exertion (RPE; Borg 6–20 scale) were recorded. Within-group differences (No RAS vs. RAS baseline; No RAS vs. RAS +5% BPM) were assessed using paired t-tests. Between-group comparisons for each condition were conducted using Welch's t-tests to account for unequal variances (confirmed by Levene's test).
RESULTS:
Controls achieved significantly greater distances than PD participants across all conditions (p < 0.05). RAS at +5% BPM significantly increased walking distance versus no cue in both groups (PD: +11.1 m, p = 0.0097; controls: +12.2 m, p = 0.0117), with no significant difference from baseline RAS. Relative improvements were comparable (PD: 6.2%; controls: 5.8%). RPE remained unchanged across conditions, indicating enhanced performance without increased perceived effort.
CONCLUSION:
RAS acutely improves functional walking capacity in both PD and healthy individuals without elevating perceived exertion. These findings highlight RAS as a simple, accessible, and patient-friendly intervention for gait rehabilitation and fall risk reduction in PD.