This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Lim, I Articles by Kwakkel, G Search for Related Content PubMed PubMed Citation Articles by Lim, I Articles by Kwakkel, G Pubmed/NCBI databases Medline Plus Health Information Parkinson's Disease Patient Rights Social Bookmarking                         What's this?

Effects of external rhythmical cueing on gait in patients with Parkinson's disease: a systematic review

E van Wegen

C de Goede

Department of Physiotherapy, VU University Medical Center, Amsterdam, The Netherlands

M Deutekom

Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands

A Nieuwboer

A Willems

Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Katholieke Universiteit Leuven, Belgium

D Jones

L Rochester

School of Health, Community and Education Studies, Northumbria University, Newcastle upon Tyne, UK

G Kwakkel

Department of Physiotherapy, VU University Medical Center, Amsterdam, The Netherlands

Objective: To critically review studies evaluating the effects of external rhythmical cueing on gait in patients with Parkinson's disease.

Methods: Articles published from 1966 to January 2005 were searched by two physiotherapists in MEDLINE, PiCarta, PEDRo, Cochrane, DocOnline, CINAHL and SUMSEARCH. To be included, articles had to investigate the effects of external rhythmical cueing (i.e., auditory, visual or tactile cueing) on gait parameters in patients with idiopathic Parkinson's disease. Both controlled and noncontrolled studies were included. Based on the type of design and methodological quality a meta-analysis or best-evidence synthesis was applied.

Results: Twenty-four studies (total number of patients = 626) out of the 159 screened studies were evaluated in this systematic review. Two out of 24 were randomized controlled trails (RCT), both of high methodological quality. One RCT did not focus specifically on external rhythmical cueing of individual patients with Parkinson's disease, but on group exercises in general, including walking with cues. All other studies were pre-experimental studies. Best-evidence synthesis showed strong evidence for improving walking speed with the help of auditory cues. Insufficient evidence was found for the effectiveness of visual and somatosensory cueing.

Conclusion: Only one high-quality study, specifically focused on the effects of auditory rhythmical cueing, suggesting that the walking speed of patients with Parkinson's disease can be positively influenced. However, it is unclear whether positive effects identified in the laboratory can be generalized to improved activities of daily living (ADLs) and reduced frequency of falls in the community. In addition, the sustainability of a cueing training programme remains uncertain.

Clinical Rehabilitation, Vol. 19, No. 7, 695-713 (2005)
DOI: 10.1191/0269215505cr906oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Nieuwboer, K. Baker, A.-M. Willems, D. Jones, J. Spildooren, I. Lim, G. Kwakkel, E. Van Wegen, and L. Rochester The Short-Term Effects of Different Cueing Modalities on Turn Speed in People with Parkinson's Disease Neurorehabil Neural Repair, October 1, 2009; 23(8): 831 - 836. [Abstract] [PDF]

				J. McAuley, P. Daly, and C. Curtis A preliminary investigation of a novel design of visual cue glasses that aid gait in Parkinson's disease Clinical Rehabilitation, August 1, 2009; 23(8): 687 - 695. [Abstract] [PDF]

				S. A. Olivo, L. G. Macedo, I. C. Gadotti, J. Fuentes, T. Stanton, and D. J Magee Scales to Assess the Quality of Randomized Controlled Trials: A Systematic Review Physical Therapy, February 1, 2008; 88(2): 156 - 175. [Abstract] [Full Text] [PDF]

				K. Maitra Enhancement of reaching performance via self-speech in people with Parkinson's disease Clinical Rehabilitation, May 1, 2007; 21(5): 418 - 424. [Abstract] [PDF]

				A Nieuwboer, G Kwakkel, L Rochester, D Jones, E van Wegen, A M Willems, F Chavret, V Hetherington, K Baker, and I Lim Cueing training in the home improves gait-related mobility in Parkinson's disease: the RESCUE trial J. Neurol. Neurosurg. Psychiatry, February 1, 2007; 78(2): 134 - 140. [Abstract] [Full Text] [PDF]