Parkinson’s Ambulation Cueing Expedition: The Effects of Vocalization on Parkinsonian Gait

Impaired gait is detrimental to the overall quality of life in people with Parkinson’s disease (PD). Characteristic shuffling and freezing gait patterns can be ameliorated through auditory cueing methods. Internal mental singing is more effective than external cueing methods such as singing aloud. The absence of small laryngeal vibrations could be the reasoning behind these improvements. PURPOSE: This feasibility study aimed to determine whether humming or whispering is a more effective cueing method for improving Parkinsonian gait and extrapolate the effects of the vocal cords on PD gait. METHODS: Participants walked 28m under four randomized cueing conditions: no cues, mental singing, humming, and whispering. Cued trials were performed to a 100bpm instrumental version of “Row, Row, Row Your Boat”. Participants were equipped with IMUs to determine cadence, velocity, stride length, and gait variability. RESULTS: Preliminary results indicate that the mental singing condition elicited the fastest velocity and lowest variability in cadence stride length compared to all cueing conditions. Humming trials improved velocity and stride length more than whispering trials. On the contrary, whispering conditions elicited more consistent cadences than humming conditions. CONCLUSION: Singing out loud might be detrimental to Parkinsonian gait. The presence of laryngeal vibrations is conducive for more consistent velocity and stride length patterns in people with PD. Thus, humming as a cue might be preferable to whispering for improving PD gait. Future research should directly measure laryngeal vibrations. Understanding the effects of vocalization on Parkinsonian gait could help people with PD traverse the world more easily with free and accessible self-cueing.