Page 35 - NAMAH-Jan-2023

Namah Effects of Musical Cueing in Gait Kinematics

In step 2, with the help of pre-gait exercises, the patient is walking.
the therapist is able to help the client to increase
the cadence and start to normalise their gait In the 6th step of gait training, the therapist
pattern so that the client can walk faster. In re-assesses the client with the same procedure
step 3, the therapist begins to speed up the as they did in step 1 to calculate the stride
rhythmic auditory cue by 5-10% in order to length now.
see whether the patient can maintain the
practised gait pattern as they work to bring the
patient’s limit cycle to a more normal range.
During steps 1-3 in RAS gait training under
controlled conditions, therapists should
address the most basic aspects of gait and
mobility. In step 4 therapist creating exercises
using RAS to practice those advanced gait
situation that we encounter in everyday life,
for example, walking on uneven surfaces,
stopping and starting movement, walking
around obstacles, walking up stairs, changing Supportive research
direction during walking, speeding up and
slowing down, and walking with and without People with PD typically walk slowly with
an assistive device. Some exercises are as short shuffling steps, and often fall, due to a
follows: decreased balance, festination, and freezing
of gait. Since walking is an essential for many
1. walking to the beat of music that fluctuates activities of daily living, these problems can
in tempo have a detrimental effect on independence
2. walking outside on different surfaces — and quality of life. Musical cueing provided
grass, sidewalk, ramp by a metronome or electronic tabla can be
3. walking forward when the music starts described as a relatively simple technique for
and stopping when the music stops improving the gait of patients with PD. RAS
4. walking backward to a rhythmic cue. can also include rhythmic cues embedded
in music, which can additionally provide a
In step 5 of RAS gait training the therapist cultural and motivational context.
should gradually start fading the music and
metronome/electronic tabla as the client Von Wilzenben, reported in the year 1942
is walking and finally take the rhythmic for the first time on the facilitation of gait in
auditory stimulus away and observe whether patients of PD with sensory cues. In r 1963,
the patient can maintain the changes in their the detailed study and analysis of the effect
gait pattern without the music. The therapist of external cueing on gait was provided by
can provide the verbal cues if the client is Martine. After a few years, Dr. Trombly
not able or is slowly coping with the new noticed that a patient who used to “freeze”
pattern. Otherwise, they may need to bring while walking did not freeze while dancing.
the rhythmic cue in and out several times as In the year 1987, Gauthier explained in his

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