The Effect of External Rhythmic Cues (Auditory and Visual) on Walking During a Functional Task in Homes of People With Parkinson’s Disease  Lynn Rochester, PhD, Victoria Hetherington, BSc, Diana Jones, PhD, Alice Nieuwboer, PhD, Anne-Marie Willems, MSc, Gert Kwakkel, PhD, Erwin Van Wegen, MS  Archives of Physical Medicine and Rehabilitation  Volume 86, Issue 5, Pages 999-1006 (May 2005) DOI: 10.1016/j.apmr.2004.10.040 Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 Sample raw data from a typical subject during a trial of the functional test. Five accelerometers were attached, and data from each accelerometer are indicated in the left column. Arrows indicate the start and end of the test. The vertical lines indicate the sections of the test from which the number of steps could be determined for walking only and the dual-motor task where subjects carried a tray at the same time. The distance walked was known for each subject, and time could be determined for the placement of each vertical line so that the average mean step length and walking speed could be calculated. Archives of Physical Medicine and Rehabilitation 2005 86, 999-1006DOI: (10.1016/j.apmr.2004.10.040) Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 The effects of external rhythmic cues (auditory and visual) in people with PD (n=18) and the control group (n=10). (A) Walking speed, (B) mean step length, and (C) step frequency are shown. Changes during walking only (without a dual task) are shown in the left column and with a dual-motor task in the right column. Data are expressed as the percentage change (mean ± SD) from the baseline (the first noncued trial) during walking without a dual task (left column) and walking with a dual task (right column). PD subjects are shown in black and the control group in white. Archives of Physical Medicine and Rehabilitation 2005 86, 999-1006DOI: (10.1016/j.apmr.2004.10.040) Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 The interference effect of a dual-motor task on gait with and without the use of cues in PD subjects only (n=18). The mean values ± SD were obtained during noncued walking, noncued dual-motor task, auditory cued dual-motor task, and visual cued dual-motor task for (A) walking speed, (B) mean step length, and (C) step frequency. Abbreviation: DM, dual motor. Archives of Physical Medicine and Rehabilitation 2005 86, 999-1006DOI: (10.1016/j.apmr.2004.10.040) Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions