CuePD: Investigating the Effect of Personalised Auditory Cueing on Gait in Parkinson's Disease

NCT ID: NCT06941779

Last Updated: 2025-04-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-21

Study Completion Date

2025-12-31

Brief Summary

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Parkinson's Disease (PD) is a major cause of disability, globally. PD affects a person's movement speed, fluency, quality, and ease of walking. PD has the fastest-growing incidence rate, with its prevalence expected to double over the next three decades, currently affecting 10 million people worldwide. PD often leads to disturbances in walking/gait characteristics such as abnormal/variable stride lengths and step times. Those disturbances increase the risk of falls, with about 39% of people with PD (PwPD) experiencing an average of 20.8 falls/year.

Research has examined cueing by leveraging auditory, visual, and tactile cues to normalize variable gait characteristics and improve mobility to reduce falls. Auditory cueing is the most effective at improving gait and most practical to apply in all settings (via headphones) but one size does not fit all when using auditory cueing paradigms i.e., there is a need for personalised approaches to ensure cueing interventions are tailored to the individual and their specific functional limitations. Furthermore, the long-term effectiveness of auditory mechanisms (e.g., metronome-based repetitive beep) suffer from their lack of continuous engagement.

This research project aims to examine personalised auditory cueing to improve gait in PwPD. Inertial sensors will capture and analyze validated gait-related characteristics and personalised auditory cues will be examined for their ability to correct variable gait. To reduce burden on PwPD (i.e., minimal number of wearable sensors) and to streamline data capture and deliver auditory cues, a single smartphone will be used only.

The project involves a multidisciplinary study between Computing and Exercise and Rehabilitation at Northumbria University, testing cueing modalities in a controlled laboratory environment under trained researcher supervision. The study will enrol PwPD, focusing on the ability of personalised auditory cueing to improve gait and PwPD preference of auditory cues.

Detailed Description

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A researcher will contact identified participants to explain the study further and provide the approved patient information sheet (PIS, via post or email - subject to the potential participant's preference). If after reading the information the potential participant is agreeable, arrangements will be made to book a suitable date and time to visit the Clinical Gait Laboratory, Coach Lane Campus, Northumbria University. Arrangements will be made to ensure the participant has clarity on how s/he can attend the Lab e.g., mode of transport and accessibility.

Upon attending the gait lab informed written consent procedures will be undertaken, then participants (n=60) will be required to answer some demographic questions, such as education level, falls history and activity level. They they will complete pen and paper based clinical assessments such as the Unified Parkinson's Disease Rating scale (UPDRS), Montreal Cognitive Assessment (MoCA), Falls Efficacy Scale-International (FES-I), Falls History Questionnaire, International Physical Activity Questionnaire and Physical Activity questionnaire for Elderly.

Upon completion of the above pen-and-paper tasks, all participants will engage in walking/gait-based tests that assess the effectiveness of a personalised auditory cueing on their gait. All assessments will take place at the Coach Lane Clinical Gait Lab, Northumbria University. During the session, all participants will be asked to wear a smartphone on their person (lower-back via belt attachment), as well as a pair of headphones over their ears and a wearable sensor on each of their feet (the latter are commercial reference standard wearables will be worn on the feet as a gold standard comparison to verify gait data from the smartphone).

Participants will then be asked to perform a series of forward walks around a 25m loop for 1 minute while trying to match their steps to the metronome and musical beats. Walk #1 will determine baseline stepping cadence for each participant. During walks #2-#4 the participant will listen to metronome and musical beats at a +10% increase on the cadence measured during walk #1. After walks #2 and #3, participants will (i) count backwards in their head from 30 to 0 in increments of 1 to disengage psychological responses evoked by each cueing modality and minimize any carryover effects and (ii) perform a 1 min walk with no cue at usual pace.

Specifically, walks and wash-out are:

* Walk 1: Walk for 1-minute at usual pace to determine baseline gait cadence (listening to no sound or no music),

\>\> No washout,
* Walk 2: Walk for 1-minute with metronome cueing set at +10% baseline cadence,

\>\> Washout (count backwards from 30 to 0 in increments of 1 + 1min walk no cue),
* Walk 3: Walk for 1-minute with instrumental music cueing set at +10% baseline cadence,

\>\> Washout (count backwards from 30 to 0 in increments of 1 + 1min walk no cue),
* Walk 4: Walk for 1-minute with vocal music cueing set at +10% baseline cadence.

After the walks, all participants will be asked to answer some questions in the form of a semi-structured interview to explore their experiences of the personalised auditory cueing, administered via a smartphone (System Usability Scale). Goldsmiths Musical Sophistication Index will be used to examine participants' musical experience and skills, and provide valuable insights into the potential of the personalised auditory cueing approach to enhance gait in PwPD. Total time for lab participation is approx 1-hour. The immediate impact of personalised auditory cueing on gait performance in participants will be evaluated based on the collected data and participants' experiences.

Conditions

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Parkinson's Disease (PD)

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Cueing

Group Type EXPERIMENTAL

Cueing

Intervention Type DEVICE

Inertial sensors (via a smartphone worn on the lower back) will capture and analyze validated gait-related characteristics (via a gold-standard inertial system worn on both feet). Personalised auditory cues (via smartphone) will be examined for their ability to correct variable gait. To reduce burden on participants (i.e., minimal number of wearable sensors) and to streamline data capture and deliver auditory cues, a single smartphone and a gold standard reference (2 inertial wearables on each foot) will only be used. All devices attached over clothes via belt attachments.

Interventions

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Cueing

Inertial sensors (via a smartphone worn on the lower back) will capture and analyze validated gait-related characteristics (via a gold-standard inertial system worn on both feet). Personalised auditory cues (via smartphone) will be examined for their ability to correct variable gait. To reduce burden on participants (i.e., minimal number of wearable sensors) and to streamline data capture and deliver auditory cues, a single smartphone and a gold standard reference (2 inertial wearables on each foot) will only be used. All devices attached over clothes via belt attachments.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Able to walk unaided.
* Diagnosis of idiopathic PD, as defined by the UK Brain Bank criteria.
* Score ≥21/30 on Montreal Cognitive Assessment (MoCA) which is used to classify non-demented PD (PD dementia is \<21/30).

Exclusion Criteria

* Non-English speakers
* History of stroke, traumatic brain injury or other neurological disorders (other than PD)
* Acute lower back or lower extremity pain, peripheral neuropathy, and musculoskeletal disorders that would affect tasks.
* Unstable medical condition including cardio-vascular instability in the past 6 months
* Unable to comply with the testing protocol or currently participating in another interfering research project
Minimum Eligible Age

50 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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North Tyneside General Hospital

OTHER_GOV

Sponsor Role collaborator

Northumbria Healthcare NHS Foundation Trust

OTHER

Sponsor Role collaborator

Northumbria University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Northumbria University

Newcastle, , United Kingdom

Site Status RECRUITING

North Tyneside General Hospital

North Shields, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Facility Contacts

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Conor Wall

Role: primary

01912373642

Conor Wall

Role: primary

01912373642

References

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Brooke J. SUS: a retrospective. Journal of usability studies. 2013;8: 29-40. https://dl.acm.org/doi/10.5555/2817912.2817913

Reference Type BACKGROUND

Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005 Nov;34(6):614-9. doi: 10.1093/ageing/afi196.

Reference Type BACKGROUND
PMID: 16267188 (View on PubMed)

Voorrips LE, Ravelli AC, Dongelmans PC, Deurenberg P, Van Staveren WA. A physical activity questionnaire for the elderly. Med Sci Sports Exerc. 1991 Aug;23(8):974-9.

Reference Type BACKGROUND
PMID: 1956274 (View on PubMed)

Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson's disease. Lancet Neurol. 2021 May;20(5):385-397. doi: 10.1016/S1474-4422(21)00030-2.

Reference Type BACKGROUND
PMID: 33894193 (View on PubMed)

Sweeney D, Quinlan LR, Browne P, Richardson M, Meskell P, OLaighin G. A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson's Disease. Sensors (Basel). 2019 Mar 13;19(6):1277. doi: 10.3390/s19061277.

Reference Type BACKGROUND
PMID: 30871253 (View on PubMed)

Rose D, Ott L, Guerin SMR, Annett LE, Lovatt P, Delevoye-Turrell YN. A general procedure to measure the pacing of body movements timed to music and metronome in younger and older adults. Sci Rep. 2021 Feb 5;11(1):3264. doi: 10.1038/s41598-021-82283-4.

Reference Type BACKGROUND
PMID: 33547366 (View on PubMed)

Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x.

Reference Type BACKGROUND
PMID: 15817019 (View on PubMed)

Mullensiefen D, Gingras B, Musil J, Stewart L. The musicality of non-musicians: an index for assessing musical sophistication in the general population. PLoS One. 2014 Feb 26;9(2):e89642. doi: 10.1371/journal.pone.0089642. eCollection 2014.

Reference Type BACKGROUND
PMID: 24586929 (View on PubMed)

Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord. 2003 Jul;18(7):738-50. doi: 10.1002/mds.10473.

Reference Type BACKGROUND
PMID: 12815652 (View on PubMed)

Fiorente N, Calabro RS. Music in Parkinson's Disease Rehabilitation: Are We Heading in the Right Direction? Innov Clin Neurosci. 2023 Spring;20(4-6):11-13.

Reference Type BACKGROUND
PMID: 37387705 (View on PubMed)

Dotov DG, Cochen de Cock V, Geny C, Ihalainen P, Moens B, Leman M, Bardy B, Dalla Bella S. The role of interaction and predictability in the spontaneous entrainment of movement. J Exp Psychol Gen. 2019 Jun;148(6):1041-1057. doi: 10.1037/xge0000609.

Reference Type BACKGROUND
PMID: 31180717 (View on PubMed)

GBD 2016 Parkinson's Disease Collaborators. Global, regional, and national burden of Parkinson's disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018 Nov;17(11):939-953. doi: 10.1016/S1474-4422(18)30295-3. Epub 2018 Oct 1.

Reference Type BACKGROUND
PMID: 30287051 (View on PubMed)

Allen NE, Schwarzel AK, Canning CG. Recurrent falls in Parkinson's disease: a systematic review. Parkinsons Dis. 2013;2013:906274. doi: 10.1155/2013/906274. Epub 2013 Mar 5.

Reference Type BACKGROUND
PMID: 23533953 (View on PubMed)

Other Identifiers

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327241

Identifier Type: OTHER

Identifier Source: secondary_id

24/PR/0684

Identifier Type: OTHER

Identifier Source: secondary_id

CuePD

Identifier Type: -

Identifier Source: org_study_id

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