BEATS and music may have negative effects on Alzheimer disease (AD) patients’ ability to walk, new research has found.
Prof Hill says further research is required to explore possible benefits of further practice and exposure to RACs, especially for people with more advanced deterioration in executive function. Image: Terry Jones
The findings, published in Archives of Physical Medicine and Rehabilitation, suggest rhythmic auditory cues (RACs) do not have the same positive effect for patients with AD as that found in trials with patients of other neurologic disorders―at least in a single session.
In the study led by La Trobe University’s Joanne Wittwer, 30 people diagnosed with probable AD were asked to walk four times on an electronic walkway while either a metronome or rhythmic music with strong beats played in the background.
The results showed that contrary to expectations, the participants’ gait did not become faster or less varied.
In fact, both types of RACs had temporary negative effects: gait speed and stride length decreased, while variability in stride length rose.
Interestingly, timing variability (such as variability in time taken to complete a step or a stride) was not impacted.
Paper co-author Professor Keith Hill, from Curtin University’s School of Physiotherapy, says walking requires very fine precision, thus increased gait variability may suggest less automaticity of fine control.
“For example we normally walk with an approximately one centimetre clearance between the toe of the stepping foot and the ground with every step we take, with minimal awareness or concentration when walking is low challenge,” Prof Hill says.
“Higher gait variability indicates less rhythm and consistency in the walking pattern―two characteristics of normal, unimpaired walking.”
The researchers suggest that by asking the participants to match their steps to the RACs, they may have inadvertently created a ‘dual task’ effect, causing an overburden on cognitive function and contributing to the negative effects on gait.
Prof Hill says further research is required to explore possible benefits of further practice and exposure to RACs, especially for people with more advanced deterioration in executive function.
“Exercise programs targeting balance performance…become more difficult to undertake in people with more severe levels of dementia from the perspective of following instructions,” he says.
“However, an advantage of RACs, if they can be shown to be safe and feasible and improve gait measures, is that the approach can be applied in more advanced stages of dementia without the need for following instructions because of the possible automatic or sub-conscious effects of the approach.”
The research team is currently finalising an additional pilot to examine whether sustained training sessions can lead to improved gait measures.