Effects of auditory or visual stimuli on gait in Parkinsonic patients: a systematic review

BACKGROUND: External stimuli can improve gait performance in Parkinsons Disease (PD): auditory stimuli can increase velocity and visual stimuli may act at step length. OBJECTIVE: To systematize the scientific evidence about the effects of auditory or visual stimuli on gait in patients with PD. METHODS: From January 2016 to December 2018, a systematic literature research was conducted in the PubMed/Medline and Web of Science databases. Study designs considered were randomized controlled trials (RCTs) and observational studies, which evaluated the effects of auditory or visual stimuli on gait in PD. The methodological quality was assessed by the Critical Appraisal Skills Program. RESULTS: Five articles were included with 232 participants and a methodological rank of mean of 10.3 on the cohort studies (n = 3), 8 on the case control studies (n = 1), and 6 on the RCTs (n = 1). Although 3 evaluated the effects of auditory stimuli on gait in PD, 2 analyzed those of visual stimuli. Based on these, it was verified a significant improvement of diverse gait parameters. CONCLUSION: The application of auditory or visual stimuli have beneficial effects on gait parameters. Further investigation is required.