Explore outcome differences of a 12-week home-based RAS-enhanced walking program completed by Veterans with PD with and without STN-DBS.

Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for some motor symptoms of Parkinson’s disease (PD) due to mitigation of beta oscillations. Rhythmic auditory stimulation (RAS)-enhanced gait training is known to improve gait and motor dysfunction in PD through external cueing but has not been well-studied when paired with STN-DBS. Internal cueing from STN-DBS coupled with external cueing from music may potentially contribute to further mitigation of beta oscillations and therefore confer enhanced benefits.

Veterans were instructed to walk 30-45 minutes, three times per week, listening to a personalized RAS-enhanced music playlist and wearing a FitBit to track activity. Weekly phone calls were made by an exercise coach to assess safety and compliance during the intervention. Motor and neuropsychological assessments were collected pre-, mid-, and post-intervention.

Currently, one (female) Veteran with STN-DBS and four (three male; one female) Veterans without STN-DBS have completed the intervention. The MDS-UPDRS Motor III Subscale score improved in all 5 participants from baseline to endpoint, with the STN-DBS participant demonstrating superior overall improvements. Timed Up and Go (TUG) improved in all participants from baseline to midpoint, with only the STN-DBS participant improving from midpoint to endpoint. The seven-day average total step count reported by the FitBit increased in all participants from baseline to endpoint. Data collection is ongoing.