The Effects of Metronome Frequency Differentially Affects Gait on a Treadmill and Overground in People with Parkinson's Disease

Objective: To determine the effect of different metronome cue frequencies on spatiotemporal gait parameters when walking overground compared to walking on a treadmill in people with Parkinson9s disease Design: Repeated-measures, within-subject design Setting: Research laboratory Participants: Twenty-one people with Parkinson9s disease (Hoehn & Yahr stage 1-3) Interventions: Participants walked overground and on a treadmill with and without metronome cues of 85%, 100%, and 115% of their baseline cadence for one minute each. Main Outcome Measures: Gait speed, step length, and cadence Results: An interaction effect between cue frequency and walking environment revealed that participants took longer steps during the 85% condition on the treadmill only. When walking overground, metronome cues of 85% and 115% of baseline cadence yielded decreases and increases, respectively, in both cadence and gait speed with no concomitant change in step length. Conclusions: These data suggest that people with PD are able to alter spatiotemporal gait parameters immediately when provided the appropriate metronome cue and walking environment. We propose to target shortened step lengths by stepping to the beat of slow frequency auditory cues while walking on a treadmill, whereas the use of fast frequency cues during overground walking can facilitate faster walking speeds.