The Effect of Preferred Music and Entrainment Exercises on the Gait of Persons with Huntington’s Disease
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Author
Meyer, Peter
Date
2008
Degree
Master of Arts in Music Therapy
Abstract
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.