Effects of auditory cues on gait initiation and turning in patients with Parkinson's disease.

Abstract Objective To review the available scientific evidence about the effectiveness of auditory cues during gait initiation and turning in patients with Parkinson's disease. Methods We conducted a literature search in the following databases: Brain, PubMed, Medline, CINAHL, Scopus, Science Direct, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Library Plus, CENTRAL, Trip Database, PEDro, DARE, OTseeker, and Google Scholar. We included all studies published between 2007 and 2016 and evaluating the influence of auditory cues on independent gait initiation and turning in patients with Parkinson's disease. The methodological quality of the studies was assessed with the Jadad scale. Results We included 13 studies, all of which had a low methodological quality (Jadad scale score ≤2). In these studies, high-intensity, high-frequency auditory cues had a positive impact on gait initiation and turning. More specifically, they (1) improved spatiotemporal and kinematic parameters; (2) decreased freezing, turning duration, and falls; and (3) increased gait initiation speed, muscle activation, and gait speed and cadence in patients with Parkinson's disease. Conclusions We need studies of better methodological quality to establish the Parkinson's disease stage in which auditory cues are most beneficial, as well as to determine the most effective type and frequency of the auditory cue during gait initiation and turning in patients with Parkinson's disease.