Objective: To test the efficacy of an auditory metronome on walking speed and freezing in patients with Parkinson's disease (PD).
Background: No pharmacological treatment is effective in managing on freezing in PD. Like visual cues that can help overcome freezing, rhythmic auditory stimulation may provide cues that help normalize walking pace.
Design/ Methods: Non-demented PD patients with freezing walked under 2 conditions, in randomized order: unassisted walking and walking with the use of an audiocassette with a metronome recording. The metronome pace was set individually for each patient at the average non-freezing walking speed derived from a baseline observation. Patients walked two times in each condition through a standard 60 foot course. Outcome measures were total walking time (total trial time Οͺ total freezing time), freezing time, average duration of a freeze and number of freezes. All outcomes were averaged across trials for each person and then compared across conditions using Signed Rank tests.
Results: Twelve non-demented PD patients with a mean age of 65.8 Ο© 11.2 years , and mean PD duration of 12.4 Ο© 7.3 years were included. The use of the metronome increased the total walking time on initial testing, (P Ο½ 0.0005), but had no significant effect on any freezing variable. In the 9 patients who took the metronome recording home and used it daily for one week while walking, on their second evaluation, there was again no significant improvement in freezing.
Conclusions: Though advocated in prior publications as a walking aid for PD patients, auditory metronome tapes did not improve any element of freezing in this study. In the absence of any indication of improvement after daily practice, we do not consider this therapy a likely benefit for freezing in PD.