1. Introduction
chronic neurological disorders, anxiety, gait initiation, Parkinsonian, gait impairments, MSK, Parkinson’s disease, PD, psychiatric, mobility difficulties
DISEASE, NEURODEGENERATIVE DISORDER, CORTEX
The aim of the present study is to examine the acute effects of a specially designed musicokinetic (MSK) program for patients with Parkinson’s disease (PD) on (a) anxiety levels, (b) select kinematic and kinetic parameters, and (c) frontal cortex hemodynamic responses, during gait initiation and steady-state walking. Parkinson’s disease (PD) is a neurodegenerative disorder with increasing rates in Western civilization. According to the World Health Organization, the prevalence of the disease has increased by 81% since 2000 [Increased levels of anxiety, gait impairments, and lack of coordination are common non-motor and motor symptoms in PD, and can seriously impact patients’ overall quality of life. For instance, anxiety is a common psychiatric commonality in PD with symptoms occurring in between 20 and 52% of patients, while motor fluctuations—which are often accompanied by alterations in non-motor symptoms—can be seen in up to 75% of PD patients [As anxiety is associated with mobility difficulties in this population [The potential mechanistic link between increased anxiety and gait-impairment severity of PD patients may be two-fold: Firstly, through increased conscious motor control. It has been previously hypothesized that decreases in automatization and rhythmicity, and their corresponding detrimental effects on gait, may be compensated for by enhanced conscious motor control. This process is mediated by increased activation of the pre-frontal cortex and, in particular, the dorsolateral pre-frontal cortex (DLPFC) [Humans have the tendency to synchronize their steps with the beat of the music they are listening to [Rhythmics or musicokinetic education considers the human as a physical mental and spiritual entity. It is based on Francois Delsarte’s (1811–1871) and Jaque Dalcroze’s eurhythmics method (JDE), while more kinetic elements have been added throughout the years, especially for dance purposes, without neglecting the rules of music [The aim of the proposed study is to examine the acute effects of a MSK program on select kinematic and kinetic parameters alongside DLPFC hemodynamics during gait initiation and steady-state walking in individuals with PD, performed in the following conditions: (a) a synchronous learning format and (b) an asynchronous remote video-based format. The program is customized for PD patients without deviating from the objectives of musicokinetic education. Primary outcomes will be the acute effects of a MSK protocol in people with PD on anxiety and locomotion. Secondary outcomes will be the effectiveness of an asynchronous remote video-based format for those patients that are not able to attend classes on site.The novelty of the current design is the combined implementation of functional near-infrared spectroscopy (f-NIRS) in parallel with 3D gait analysis, which, until now, has yet to be evaluated in Parkinsonian patients following a MSK intervention. f-NIRS is extensively employed in chronic neurological disorders associated with aging, enabling direct measurements of the absolute concentrations of oxygenated and deoxygenated hemoglobin in the brain [