EFFECTIVENESS OF RHYTHMIC AUDITORY STIMULATION COMBINED WITH TREADMILL TRAINING ON GAIT SYMMETRY IN PATIENTS WITH PARKINSON’S DISEASE: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder commonly associated with gait abnormalities, including reduced step length, decreased walking speed, impaired cadence, and gait asymmetry. Rhythmic auditory stimulation (RAS) provides external rhythmic cues that may facilitate auditory-motor synchronization and improve gait performance. Combining RAS with treadmill training may provide additional benefits in improving gait symmetry and functional walking ability.

Objective: To determine the effectiveness of rhythmic auditory stimulation combined with treadmill training on gait symmetry in patients with Parkinson's disease and compare its effects with treadmill training alone.

Methods: A two-arm, parallel-group randomized controlled trial was conducted at IIMCT – Railway General Hospital, Rawalpindi, Pakistan. A total of 54 patients with Parkinson's disease were enrolled and randomly allocated into two equal groups. Group A (n = 27) received rhythmic auditory stimulation combined with treadmill training, whereas Group B (n = 27) received treadmill training alone. The primary outcome was gait symmetry, assessed using the Symmetry Index (SI). Secondary outcomes included step length, stride length, cadence, and walking speed. Assessments were performed at baseline and immediately after completion of the intervention. Data was analyzed using IBM SPSS Statistics version 27, with statistical significance set at p < 0.05.

Results: Both groups demonstrated improvements in gait-related outcomes following their respective interventions. In Group A, the mean Symmetry Index decreased from 18.25 ± 5.05 to 10.45 ± 4.25, representing a mean reduction of 7.80 points (p < 0.001). In Group B, the SI decreased from 18.35 ± 4.90 to 15.40 ± 4.55, representing a mean reduction of 2.95 points (p = 0.012). The between-group difference in gait symmetry was statistically significant (p < 0.001), favoring Group A. Significant between-group differences were also observed in step length (p = 0.003), stride length (p = 0.001), cadence (p = 0.021), and walking speed (p = 0.005), with greater improvements in the experimental group.

Conclusion: Rhythmic auditory stimulation combined with treadmill training was more effective than treadmill training alone in improving gait symmetry, step length, stride length, cadence, and walking speed in patients with Parkinson's disease. Incorporating rhythmic auditory stimulation into treadmill-based rehabilitation may provide additional benefits for improving gait performance and bilateral coordination.