WALKING TRAINING WITH AUDITORY CUEING IS SUPERIOR TO WALKING TRAINING ALONE FOR IMPROVING WALKING SPEED IN PARKINSON'S DESEASE: A SYSTEMATIC REVIEW WITH META-ANALYSIS.

Background: People with Parkinson's disease have reduced walking ability. Aim: To examine the effect of the addition of auditory cueing to walking training on walking, mobility, fear of falling, and balance. Methods: A systematic review of randomized trials was performed. Searches were conducted on MEDLINE, EMBASE, and PEDro databases. Participants were ambulatory adults with Parkinson's disease. The experimental intervention was auditory cueing in addition to walking training. Outcome data were combined in meta-analyses. The quality of trials was assessed by the PEDro scores, and the quality of evidence was determined according to GRADE. Results: Nine trials (PEDro 5), involving 289 participants (mean age: 57 to 74 years old; Hoehn and Yahr: I to IV), were included. Low-quality evidence suggested that the addition of auditory cueing improves walking speed (MD 0.09 m/s; 95% CI 0.02 to 0.15). Auditory cueing may also improve stride length (MD 5 cm); however, the estimate was imprecise (95% CI -2 to 11). Low to moderate-quality evidence suggested no or negligible effects on cadence (2 steps/min; 95% CI -12 to 16), mobility (-0.2 sec; 95% CI -1 to 0.6), fear of falling (MD -3 out of 100; 95% CI -8 to 2), and balance (1 point out of 56; 95% CI -3 to 6). Conclusion: The addition of auditory cueing to walking training (30 min, 3 times per week, 6 weeks) improved walking speed in Parkinson's disease more than walking training alone. [ABSTRACT FROM AUTHOR]