BeatWalk: Personalized Music-Based Gait Rehabilitation in Parkinson's Disease

Valérie Cochen De Cock; Dobromir Dotov; Loic Damm; Sandy Lacombe; Petra Ihalainen; Marie Christine Picot; Florence Galtier; Cindy Lebrun; Aurélie Giordano; Valérie Driss; Christian Geny; Ainara Garzo; Erik Hernandez; Edith Van Dyck; Marc Leman; Rudi Villing; Benoit G Bardy; Simone Dalla Bella

doi:10.3389/fpsyg.2021.655121

BeatWalk: Personalized Music-Based Gait Rehabilitation in Parkinson's Disease

Front Psychol. 2021 Apr 26:12:655121. doi: 10.3389/fpsyg.2021.655121. eCollection 2021.

Authors

Valérie Cochen De Cock^{1

2}, Dobromir Dotov^{2

3}, Loic Damm², Sandy Lacombe⁴, Petra Ihalainen², Marie Christine Picot^{5

6}, Florence Galtier⁵, Cindy Lebrun⁵, Aurélie Giordano⁵, Valérie Driss⁵, Christian Geny^{2

7}, Ainara Garzo⁸, Erik Hernandez⁸, Edith Van Dyck⁹, Marc Leman⁹, Rudi Villing¹⁰, Benoit G Bardy², Simone Dalla Bella^{2

11

12

13

14}

Affiliations

¹ Department of Neurology, Beau Soleil Clinic, Montpellier, France.
² EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Alès, Montpellier, France.
³ LIVELab, McMaster University, Hamilton, ON, Canada.
⁴ Department of Epidemiology and Biostatistics, Beau Soleil Clinic, Montpellier, France.
⁵ INSERM, Clinical Investigation Centre (CIC) 1411, University Hospital of Montpellier, Montpellier, France.
⁶ Clinical Research and Epidemiology Unit, Medical Information Department, CHU Montpellier, University of Montpellier, Montpellier, France.
⁷ Department of Neurology, University Hospital of Montpellier, Montpellier, France.
⁸ Neuroengineering Area, Health Division, TECNALIA, Basque Research and Technology Alliance (BRTA), Donostia-San Sebastian, Spain.
⁹ Department of Musicology, Institute for Psychoacoustics and Electronic Music (IPEM), Ghent University, Ghent, Belgium.
¹⁰ Department of Electronic Engineering, Maynooth University, Maynooth, Ireland.
¹¹ International Laboratory for Brain, Music, and Sound Research (BRAMS), Montreal, QC, Canada.
¹² Department of Psychology, University of Montreal, Montreal, QC, Canada.
¹³ Centre for Research on Brain, Language and Music, Montreal, QC, Canada.
¹⁴ Department of Cognitive Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland.

Abstract

Taking regular walks when living with Parkinson's disease (PD) has beneficial effects on movement and quality of life. Yet, patients usually show reduced physical activity compared to healthy older adults. Using auditory stimulation such as music can facilitate walking but patients vary significantly in their response. An individualized approach adapting musical tempo to patients' gait cadence, and capitalizing on these individual differences, is likely to provide a rewarding experience, increasing motivation for walk-in PD. We aim to evaluate the observance, safety, tolerance, usability, and enjoyment of a new smartphone application. It was coupled with wearable sensors (BeatWalk) and delivered individualized musical stimulation for gait auto-rehabilitation at home. Forty-five patients with PD underwent a 1-month, outdoor, uncontrolled gait rehabilitation program, using the BeatWalk application (30 min/day, 5 days/week). The music tempo was being aligned in real-time to patients' gait cadence in a way that could foster an increase up to +10% of their spontaneous cadence. Open-label evaluation was based on BeatWalk use measures, questionnaires, and a six-minute walk test. Patients used the application 78.8% (±28.2) of the prescribed duration and enjoyed it throughout the program. The application was considered "easy to use" by 75% of the patients. Pain, fatigue, and falls did not increase. Fear of falling decreased and quality of life improved. After the program, patients improved their gait parameters in the six-minute walk test without musical stimulation. BeatWalk is an easy to use, safe, and enjoyable musical application for individualized gait rehabilitation in PD. It increases "walk for exercise" duration thanks to high observance. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02647242.

Keywords: Parkinson’s disease; cueing; gait rehabilitation; physical activity; precision medicine BeatWalk; rhythmic auditory stimulation.

Associated data

ClinicalTrials.gov/NCT02647242