Acute effect of traditional and adaptive metronomes on gait variability in older individuals with a history of falls

Background
Metronome cueing has been shown to reduce gait variability and thereby potentially reduce falls risk in individuals with Parkinson’s disease. It is unclear however, if metronome cueing has a similar effect in healthy older adults with a history of falls.

Aim
To investigate whether a traditional and/or an adaptive metronome, based on an individual’s gait pattern, were effective in reducing gait variability in older adults with a history of falls.

Methods
Twenty older adults (15 women, 71 ± 4.9 years) with a history of falls were included in this cross-over study. Participants received two types of cueing (adaptive and traditional metronome) 1 week apart. The variability of the participants’ stride time, stride length, walking speed and duration of double leg support were recorded during three walking conditions (baseline, during feedback and post-feedback gait). Repeated-measures ANOVA was used to assess the possible effects of the two cueing strategies on gait variables.

Results
Compared with the baseline condition, participants had significantly increased stride time variability during feedback (F (2) = 9.83, p < 0.001) and decreased double leg support time variability post-feedback (F (2) 3.69, p = 0.034). Increased stride time variability was observed with the adaptive metronome in comparison to the traditional metronome.

Conclusion
Metronome cueing strategies may reduce double leg support variability in older adults with a history of falls but seem to increase stride time variability. Further studies are needed to investigate if metronome cueing is more beneficial for individuals with greater baseline gait variability than those included in the current study.