Multimodal Balance Training Supported by Rhythmic Auditory Stimuli in Parkinson Disease: Effects in Freezers and Nonfreezers.

This was a secondary subgroup analysis by freezing status, and no formal power analysis was done for it. Participants had mild to moderate Parkinson disease and no cognitive impairment, so the results may not apply to people with more advanced disease or cognitive impairment. More freezers than nonfreezers were excluded because of cognitive impairment, which may make the freezer group less representative. Freezers in the education control group had a higher baseline daily-living score than freezers in both training groups, so baseline imbalance may affect comparisons. All training and testing were done while participants were taking their usual Parkinson medication, so effects in an OFF-medication state are unknown. Both active groups also received gait training with visual cues, so the benefit over the education control cannot be separated into balance, gait, visual cue, or metronome components. At 6 months, balance scores had deteriorated from immediately after training in both active groups.

The study was funded by the Parkinson's Foundation. The funder played no role in the design, conduct, or reporting of the study.

Do not conclude that metronome cues reduce freezing of gait. Freezers in both training groups did not significantly improve their freezing questionnaire scores directly after treatment or at follow-up.