Parkinson Disease, Parkinson Disease Dementia
Conditions
Keywords
Parkinson disease, Music, Mental singing, Gait
Brief summary
Older adults, and particularly those with Parkinson disease (PD), may experience walking difficulties that negatively impact their daily function and quality of life. People that have PD plus dementia are also likely to experience walking difficulties. This project will examine the impact of music and mentally singing on walking performance, with a goal of understanding what types of rhythmic cues are most helpful. Pilot work from the investigators suggests that imagined, mental singing (i.e., singing in head) while while walking helps people walk faster with greater stability, whereas walking to music also helps people walk faster but with reduced stability. In this study, the investigators will recruit people who have PD plus dementia. The investigators will compare walking while mentally singing and walking while listening to music, using personalized cues tailored to each person's walking performance. The investigators hypothesize temporal variability of gait will be lower in the mental singing and singing conditions compared to listening to music; and that mental singing, singing, and listening to music will elicit similar improvements in stride length.
Detailed description
During this observational study, participants will attend one visit in the laboratory. The visit will include participants wearing wearable sensors during the following tasks: walking with no cues (UNCUED), walking while listening to music (MUSIC), and walking while mentally singing (MENTAL SINGING). The wearable sensors will measure gait parameters including gait speed, stride length, and stride time variability.
Interventions
BEHAVIORALMentally Singing
Participants sing their song in their head and match their footfalls to the beat.
BEHAVIORALListening to music
Participants listen to their song and match their footfalls to the beat.
Sponsors
Washington University School of Medicine
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* at least 30 years of age * diagnosis of idiopathic, typical Parkinson disease according to the UK Brain Bank Criteria * Hoehn & Yahr stages 2-3 (mild to moderate disease severity) * normal or corrected hearing * stable on all PD medications for at least 2 months prior to study entry * dementia as defined by a Clinical Dementia Rating (CDR) score of 0.5-1.0 (very mild to mild dementia) * score of ≥ 1 on the MDS-UPDRS-III Item #10 indicating observable gait impairment * a score of 1 or less on item #7 on the freezing of gait questionnaire * able to walk for 10 continuous minutes independently
Exclusion criteria
* diagnosis of any other neurological condition * unstable medical or concomitant illnesses or psychiatric conditions which, in the opinion of the investigators, would preclude successful participation * cardiac problems that interfere with ability to safely participate (i.e., uncontrolled congestive heart failure, myocardial infarction in past 6 months, complex cardiac arrhythmias, significant left ventricular dysfunction, dyspnea on exertion, chest pain or pressure, resting tachycardia (\>100 beats/min); uncontrolled BP (resting systolic BP \>160 mmHg or diastolic BP \>100 mmHg)) * orthopedic problems in the lower extremities or spine that may limit walking (i.e., severe arthritis, spinal stenosis) * uncontrolled tremor or dyskinesia while on PD medications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Velocity | Baseline | Measured with wearable sensors by APDM Wearable Technology |
| Stride Length | Baseline | Measured with wearable sensors by APDM Wearable Technology |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Parkinson Disease Plus Dementia Participants will have a diagnosis of Parkinson disease plus dementia.
Mentally Singing: Participants sing their song in their head and match their footfalls to the beat.
Listening to music: Participants listen to their song and match their footfalls to the beat.
Singing: Participants will sing their song out loud and match their footfalls to the beat. | 17 |
| Total | 17 |
Baseline characteristics
| Characteristic | Parkinson Disease Plus Dementia |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 17 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants |
| Age, Continuous | 72.7 years STANDARD_DEVIATION 5.1 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 16 Participants |
| Region of Enrollment United States | 17 Participants |
| Sex: Female, Male Female | 1 Participants |
| Sex: Female, Male Male | 16 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 17 |
| other Total, other adverse events | 0 / 17 |
| serious Total, serious adverse events | 0 / 17 |
Outcome results
Primary
Stride Length
Measured with wearable sensors by APDM Wearable Technology
Time frame: Baseline
Population: For the uncued column the condition is by definition one with no cues. As such, there are no data for the 90, 100, 110, and 120% cue rows as these are only relevant for the cued conditions. Similarly, the mental singing and music conditions are by definition cued so there are no data for the no cue row as that is only relevant for the uncued condition.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Mental Singing | Stride Length | 90% cue tempo | 1.085 meters | Standard Deviation 0.254 |
| Mental Singing | Stride Length | 110% cue tempo | 1.130 meters | Standard Deviation 0.274 |
| Mental Singing | Stride Length | 100% cue tempo | 1.116 meters | Standard Deviation 0.262 |
| Mental Singing | Stride Length | 120% cue tempo | 1.128 meters | Standard Deviation 0.265 |
| Music | Stride Length | 120% cue tempo | 1.129 meters | Standard Deviation 0.272 |
| Music | Stride Length | 90% cue tempo | 1.089 meters | Standard Deviation 0.26 |
| Music | Stride Length | 100% cue tempo | 1.103 meters | Standard Deviation 0.258 |
| Music | Stride Length | 110% cue tempo | 1.130 meters | Standard Deviation 0.266 |
| Uncued | Stride Length | No cue | 1.12 meters | Standard Deviation 0.03 |
Primary
Velocity
Measured with wearable sensors by APDM Wearable Technology
Time frame: Baseline
Population: For the uncued column the condition is by definition one with no cues. As such, there are no data for the 90, 100, 110, and 120% cue rows as these are only relevant for the cued conditions. Similarly, the mental singing and music conditions are by definition cued so there are no data for the no cue row as that is only relevant for the uncued condition.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Mental Singing | Velocity | 90% tempo cue | .977 meters per second | Standard Deviation 0.234 |
| Mental Singing | Velocity | 100% tempo cue | 1.042 meters per second | Standard Deviation 0.27 |
| Mental Singing | Velocity | 110% tempo cue | 1.070 meters per second | Standard Deviation 0.286 |
| Mental Singing | Velocity | 120% tempo cue | 1.083 meters per second | Standard Deviation 0.29 |
| Music | Velocity | 120% tempo cue | 1.072 meters per second | Standard Deviation 0.301 |
| Music | Velocity | 110% tempo cue | 1.072 meters per second | Standard Deviation 0.279 |
| Music | Velocity | 90% tempo cue | .960 meters per second | Standard Deviation 0.243 |
| Music | Velocity | 100% tempo cue | 1.011 meters per second | Standard Deviation 0.255 |
| Uncued | Velocity | No cue | 1.02 meters per second | Standard Deviation 0.04 |