Sing For Your Saunter Part 2 R33

Study Overview
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Brief Summary
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The goal of this clinical trial is to compare to rhythm-based walking interventions to enhance gait in people with Parkinson's disease. The main questions it aims to answer are: How does rhythm-based training influence walking performance? How does brain activity change following rhythm-based training? Participants will perform walking to music and walking while singing, and will train on the use of these rhythms for 12 weeks. The investigators will compare the effects of training with music to training with singing.

Official Title
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Sing for Your Saunter: Using Self-Generated Rhythmic Cues to Enhance Gait in Parkinson's

Conditions
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Parkinson Disease

Intervention / Treatment
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* Behavioral: Self Cueing Training
* Behavioral: External Cueing Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: at least 30 years of age diagnosis of idiopathic, typical Parkinson disease according to the UK Brain Bank Criteria Hoehn & Yahr stages 2-3 (mild to moderate disease severity) evidence of walking impairment (score at least 1 on gait item of MDS_UPDRS) 4) stable on all Parkinson disease medications for at least 2 months prior to study entry 5) willing and able to provide informed consent 6) right-handed Exclusion Criteria: diagnosis of any other neurological condition a score of 2 or greater on item # 3 on the freezing of gait questionnaire significant cognitive impairment unstable medical or concomitant illnesses or psychiatric conditions which, in the opinion of the investigators, would preclude successful participation cardiac problems that interfere with ability to safely participate orthopedic problems in the lower extremities or spine that may limit walking contraindications for magnetic resonance imaging unable to walk for 10 continuous minutes independently left-handed uncontrolled tremor or dyskinesia

Ages Eligible for Study
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Minimum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Self cueing<br>Self-cueing training using singing, one hour sessions twice weekly for 12 weeks. | Behavioral: Self Cueing Training<br>* Group classes led by a music therapist and using singing as a self-generated cue, with a focus on rhythm perception, rhythm generation and synchronization of movement to rhythms.<br>|
| Experimental: External cueing<br>External cueing using music, one hour sessions twice weekly for 12 weeks. | Behavioral: External Cueing Training<br>* Group classes led by a music therapist and using music as an external cue, with a focus on rhythm perception, rhythm generation and synchronization of movement to rhythms.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gait speed | How quickly someone walks | Baseline and 12 weeks | 
| MRI Bold Beta Weights | Measure of blood oxygen levels in different brain regions indicative of level of activity within different brain regions | Baseline and 12 weeks |