Introduction: Rhythmic auditory cues are used in the rehabilitation of gait in Parkinson's disease patients, as they serve as external cues for steps that replace the damaged internal mechanisms that take care of rhythmic movement. Purpose: Summarize findings on the effectiveness of using external rhythmic auditory cues to improve gait in Parkinson's disease patients. Methods: Literature was searched in PubMed, CINAHL and PEDro databases. Data were obtained by analysis of primary sources. Reference lists of reviewed studies were also assessed. Randomized controlled trials written in English were included. Results: 12 studies involving 580 subjects were included in the review. Auditory cueing was shown to be more effective in improving walking speed when compared to non-rhythm exercise in two of four studies, furthermore, exercise with rhythm improved pre-post-intervention outcomes in the other two studies. Auditory stimuli also affected the improvement of cadence two studies compared to exercise without rhythm, two compared to intervention without exercise), some step spatial variables, and functional tests. Auditory cueing had no additional effect on Timed Up and Go test when compared to training without it. In comparison with intervention without exercise, rhythm exercise was more effective in improving gait in almost all parameters in three studies. In comparison to visual stimuli rhythm had more effect only on stride length. Discussion and conclusion: Auditory cueing is more effective in rehabilitating gait in Parkinson’s disease patients than exercise alone or a non-exercise program. Exercise with music that has an emphasized rhythm, which is appropriately progressed, professionally supervised and sufficiently intense, could have the greatest effects. More extensive and better-quality studies are needed to establish guidelines for exercise with rhythmic auditory cueing for Parkinson’s disease patients.
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