Walking economy associated with or without auditory cueing during treadmill walking in participants with Parkinson's disease

Gait impairment is common in Parkinson's disease (PD) and may result in poorer walking economy during activities of daily living. Auditory cueing is used to improve walking gait; however little is known about its effects on walking economy from an energy perspective. The purpose of this dissertation was to compare walking economy between PD and control participants and to determine the effects of auditory cueing on walking economy in participants with PD at a range of treadmill walking speeds. This dissertation consists of a series of two separate, but related studies.;The first study aimed to determine if persons with PD had poorer walking economy and higher energy expenditure during treadmill walking when compared with age-and gender matched control participants. This study also investigated whether auditory cueing improved walking economy during cued versus non-cued walking in persons with PD at set treadmill speeds, representing the high and low ranges of walking speeds used in previous work. The second study aimed to determine the effects of auditory cueing on walking economy in persons with PD during treadmill walking at a self-selected speed. Two additional speeds, slightly faster and slower than self-selected walking, were used to represent a bracket of walking speeds that would encompass variations in walking speeds.;Findings from the first study demonstrated that persons with PD had worse walking economy and higher energy expenditure than did control participants during cued and non-cued walking at set walking speeds of 0.69 m·sec -1 and 1.12 m·sec-1. When cued for walking, participants with and without PD had poorer walking economy and higher energy expenditure. We concluded that persons with PD use more energy and have worse walking economy than adults without PD. Walking economy declined further with auditory cueing at the two set treadmill speeds.;The second study demonstrated that poorer walking economy and higher energy expenditure occurred in persons with PD when cued for walking at self-selected and slightly faster treadmill speeds. There were no differences in walking economy for cued or non-cued walking at the slower speed. These results suggest that potential improvements in gait gained by use of auditory cueing may come at an energy cost and result in poorer walking economy.