The Effect of Preferred Music and Entrainment Exercises on the Gait of Persons with Huntington’s Disease

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Meyer, Peter
Master of Arts in Music Therapy
From 1990 to 2008 several studies emerged regarding the use of music in physical rehabilitation and the treatment of neurological impairments. Strong evidence suggests that music can be used to treat the gait disorder associated with Parkinson’s disease (PD), a neurologic disorder of the basal ganglia (Thaut, Miltner, Lange, Hurt & Hoemburg, 1999; Thaut, et al., 1996). Little research exists regarding the use of music with other basal ganglia disorders such as Huntington’s disease (HD). Studies have shown that people with HD can modulate their velocity with an external auditory cue, however, they have difficult entraining (synchronizing there steps to the cue) (Thaut, Miltner et al.). Another study demonstrated that people with HD maintain the ability to learn new motor tasks, although that mechanism is strongly impaired (Smith & Shadmehr, 2004). The hypothesis emerged was that it may be possible for people with HD to improve their gait by practicing it using an auditory cue. Since no study had demonstrated the effects of preferred music on gait, it was also hypothesized that familiarity to the music may help facilitate entrainment. The current study tested the effect of preferred music and entrainment exercises with music on the gait of persons with HD. Participants in this study were in the middle to late stages of HD and had significant motor impairment. The study was conducted at a long-term care facility in the Midwest over the course of three weeks. Participants in the study were videotaped walking both pre- and post-intervention. The videos were analyzed by a music therapist and a physical therapist who observed for entrainment. The physical therapist evaluated quality of movement. The primary researcher recorded the objective data of cadence, stride length and velocity. The results of the findings were then evaluated. This study appeared to confirm other findings that people with HD are more able to synchronize their gait to a metronome than any other auditory cue. The study confirmed other findings suggesting that entrainment will probably not be obtained. Cadence, stride length and velocity remained significantly unchanged. The study did not show any degradation of gait over time, which js encouraging. The study also showed that quality of movements may be influenced by external auditory cuing as well as practiced movement to musie. Recommendations for further research are discussed.