Posters / Parkinsonism and Related Disorders 16S1 (2010) S11S86

219
THE IMMEDIATE EFFECTS OF RHYTHMIC AUDITORY
STIMULATION (RAS) ON GAIT PARAMETERS AND
SYNCHRONIZATION OF ADULTS WITH SEVERE TRAUMATIC
BRAIN INJURY
E. Bristol1,2 , E. Roth1 , J. Hunter2 . 1 Music Therapy, Western Michigan
University, Kalamazoo, 2 Spectrum Health NeuroRehab Services, Grand
Rapids, MI, USA
Background and Aims: Gait parameters and synchronization
capabilities were examined following a one-day experimental
implementation of Rhythmic Auditory Stimulation (RAS) for adults
with severe traumatic brain injury (TBI).
Methods: Eight individuals (N = 8) who had experienced severe TBI
and were living in a 24-hour residential care facility participated in
this study. Participants ambulated four 10-yard trials across a plastic
runner along a at surface with paint applied to their shoes (via the
footprint analysis gait assessment). Trials were timed to measure
cadence and velocity, while stride, step lengths, and symmetry of
step lengths were calculated using the footprint analysis. Trials
were videotaped to provide a qualitative analysis. All participants
ambulated under the following conditions: baseline with no music,
RAS at resonant frequency, RAS with a 10% frequency modulation,
and removal of RAS.
Results: Quantitative data was reported through raw scores as well
as percentage change between trials. Results of quantitative and
qualitative analysis revealed that at least 7 out of 8 participants
showed capacity to synchronize to an external rhythmic auditory
cue for portions of a trial, respond to the frequency modulation,
and/or reproduce a given frequency cue once rhythm was removed.
Conclusions: Gait kinematics appeared optimal for most
participants within the resonant frequency pass (trial 2), especially
including decreases in asymmetry. From prepost RAS trials,
6 out of 8 participants showed increases in velocity and cadence,
5 improved stride length, and 4 improved symmetry.
220
SHORT- AND LONG-TERM EFFECTS OF DBS ON GAIT IN
PARKINSONS DISEASE
H. Brozova1,2 , I. Barnaure1 , E. Ruzicka2 , J. Stochl3 , R. Alterman4 ,
M. Tagliati1 . 1 Department of Neurology, Mount Sinai School of
Medicine, New York, NY, USA; 2 Department of Neurology, 3 Department
of Kinanthropology, Charles University, Prague, Czech Republic;
4
Department of Neurosurgery, Mount Sinai School of Medicine, New
York, NY, USA
Objective: To compare the short- and long-term effects of
subthalamic nucleus (STN) deep brain stimulation (DBS) on
Parkinsons disease (PD) symptoms.
Methods: Two groups of patients were studied. The rst group
(DBS1, N = 8) included patients implanted with STN DBS 12 years
earlier (mean time since DBS implantation 15.8 months, mean
age 58.8, PD duration 13 years); the second group (DBS5, N = 10)
included patients with at least 5 years of DBS therapy (mean
time since DBS implantation was 67.6 months, mean age 61.7,
PD duration 17.1 years). Both groups were examined during four
clinical medication/stimulation states (On/Off; Off/Off; Off/On;
On/On). Unied Parkinsons Disease Rating Scale (UPDRS) and
Gait and Balance scale (GABS) were used for the evaluation. Data
was analyzed using repeated measures ANOVA with time since
implantation (years) between group and therapy or DBS effect
(On, Off) within group.
Results: In group DBS1, active DBS improved all clinical subscores
except tremor, similar to medications (gait improvement 42%,
p = 0.01). In group DBS5, stimulation improved all clinical subscores
with the exception of gait and postural instability. However, the
effect of levodopa on gait was partially preserved.
Conclusions: The effect of STN DBS on PD appears not to be
constant in time. Short-term stimulation has a positive effect on

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the majority of PD symptoms, including gait disorder; however,

long-term stimulation loses its efciency on gait while maintaining
stable effectiveness for other symptoms. Levodopa effect on gait
abnormalities also declined over time, but was still preserved in
patients with long-term stimulation.
221
THE IMPACT OF HIPPOTHERAPY IN GAIT OF POST-STROKE
INDIVIDUALS
F. Beinotti1 , N. Correia2 , G. Christofoletti1 , G. Borges1 . 1 Neurology,
State University of Campinas, 2 Center of Hippotherapy Harmony,
Campinas, Brazil
Background and Aims: The gait is the post-stroke patients most
common complaint. The Hippotherapy causes an osteo-articular
mobilization that facilitates a great number of proprioceptive
information. This study aimed at analyzing the impact of
Hippotherapy in gait of post-stroke individuals.
Methods: 20 subjects with singular stroke were randomly allocated
into two groups: experimental and control. The evaluations were
accomplished by means of FulgMeyer Scale and Functional
evaluation of gait (cadence). The experimental group was submitted
to a sequence of conventional physical therapy exercises with
frequency of 2 sessions and 1 session of Hippotherapy per week
during 16 weeks. The control group was submitted to a sequence
of conventional physical therapy exercises with frequency of
3 sessions per week during 16 weeks. A two-way ANOVA test
was applied, with signicance of 5%.
Results: Analyzing the lower limb sub item of FulgMeyer Scale,
signicant motor improvement (p = 0.01) of experimental group was
observed if compared with the control group. However the balance
sub item did not demonstrate signicant improvement between
groups. It was possible to observe that there were a reduction
four paces and a 0.1-s velocity increase in the cadence of the
experimental group. The control group presented cadence increase
of 5 paces and addition 0.1 s to velocity, however that differences
was not signicant (p = 0.30).
Conclusions: With the Hippotherapy there was signicant
improvement of motor disabilities and a more standardized gait
because the experimental group was able to reduce the amount of
paces and increase velocity and control not.
222
EFFECTS OF A MOTOR AND COGNITIVE DUAL-TASK
PERFORMANCE ON THE GAIT OF TWO NEURODEGENERATIVE
DISEASES
G. Christofoletti1 , G. Borges1 , B.P. Damasceno1 , F. Stella2 , F. Beinotti1 .
1
Neurology, State University of Campinas, Campinas, 2 Education, S
ao
Paulo State University, Rio Claro, Brazil
Background: Degenerative disorders of the encephalon represent
serious medical conditions. Neuropsychiatric disturbances are
frequent and commonly responsible for the patients social
exclusion, particularly when associated to motor disability. This
study aimed to analyze the effects of motor and cognitive dual-task
performance regarding the gait of subjects with Parkinsons (PD)
and Alzheimers disease (AD).
Methods: 96 subjects were evaluated and divided into three groups:
G1 (32 patients with idiopathic PD in stages 24 on HoehnYahr
scale), G2 (31 patients with probable AD staged as moderate
severe on Clinical Dementia Rating) and G3 (33 individuals without
neuropsychiatric and musculoskeletal disorder). The gait analysis
occurred by mean of the Timed Get Up and Go test TUG,
in three different situations: normal test, motor sensitized dualtask test (carrying a glass of water) and cognitive sensitized
dual-task test (counting numbers of progressive odd). Nonparametric KruskalWallis and Wilcoxon analyses were applied,
with signicance of 1%.