Research Profile – Walking to the Beat
Parkinson's patients improve their ability to walk with the help of iPods.
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Dr. Bin Hu
A device as simple and as affordable as an iPod is helping people with Parkinson's disease improve their ability to walk. The device, called the Gait Reminder, is already being tested in patients.
As Parkinson's disease progresses, patients have difficulty walking, their steps become shorter and they take on a characteristic shuffle. Over time, patients become increasingly sedentary, suffer depression and have a high risk of falls and injuries, says Dr. Bin Hu, professor of neuroscience at the University of Calgary.
Research has shown that people improve their ability to walk or run while listening to music. Some studies show that marathon runners improve their time if they listen to music while they run, says Dr. Hu. In fact, some competitive marathons now ban the use of iPods because of the advantage they afford.
Other studies show patients with Parkinson's can improve their gait (the movement of their limbs) when they listen to music. Music affects three key areas in the brain: the premotor center (for rhythm perception), the ventral striatum (associated with reward or motivation) and the midbrain (locomotion control). In addition, both walking and enjoying music increase dopamine production in the brain. This could help Parkinson's patients, who are dopamine deficient.
With support from the Canadian Institutes of Health Research, Dr. Hu and his team have been investigating different types of music devices and their usability in Parkinson's patients. Preliminary studies of patients using modified iPods look promising, as the devices appear to help patients improve their gait.
But patients can't simply listen to music – they must walk at the same time. "Gait Reminder is designed so you have to move to keep the music playing. Here, music is a reward, it reinforces you. The motor and acoustic stimuli work together," says Dr. Hu.
The patient wears the iPod strapped to their thigh, and headphones. They are instructed to walk with longer steps – if strides become too short, the music shuts off. It starts up again once the strides become longer. The music reminds the user to take longer steps, and the person is rewarded by having the music play, according to Dr. Hu. The device provides three R's: rhythm, reward and a reminder to walk.
The iPod has several built-in technologies useful for this purpose. It has a sensitive motion detector, which researchers have adapted to measure the size of a person's step. It plays music, and the devices can transmit data over a distance.
In fact, information about a person's gait is transmitted to a research network called In Touch. The network records and analyzes the distance a person has walked, and the number and length of steps taken. Patients can access this information online from their home computer and review their performance.
So far, 18 patients are using the device as a pre-study group. Dr. Hu hopes to launch a larger trial with several hundred patients in about a year. At that point, researchers will collect better data on which types of music help patients the most, and know how best to use the devices.
"Gait Reminder is designed so you have to move to keep the music playing. Here, music is a reward, it reinforces you. The motor and acoustic stimuli work together."
– Dr. Bin Hu, University of Calgary
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