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The Effects of Rhythmic Auditory Stimulation on Gait Characteristics in an Individual with Young-Onset Parkinson Disease: A Case Study Ashley Alteri, SPT; Candice Brown, SPT; Caroline Coleman, SPT; Isaac Ford, SPT; Larissa Hilgner, SPT; Nick Murad, SPT Research Advisor: Rumit Singh Kakar, PhD ABSTRACT: Background and Purpose: Parkinson disease (PD) is a neurodegenerative disease affecting up to 10 million people worldwide, with 10% having a young-onset PD (YOPD). The most common signs and symptoms of typical PD (rigidity, tremor, bradykinesia, postural instability, and dystonia) progress at a slower rate with YOPD. Interlimb asymmetries and temporospatial gait deviations are byproducts of varied combinations of symptom presentation causing gait instabilities that may contribute to fall risk in persons with PD. The purpose of this case study was to assess the impact of a single session of rhythmic auditory stimulation (RAS) during treadmill walking on upper and lower extremity gait characteristics and symmetries for a patient with YOPD. Case Description: Participant was an active 35 year old male diagnosed 6 years ago with tremor dominant YOPD. At the time of testing, he was in an ‘ON’ phase of his symptom-managing medications levodopa, monoamine oxidase inhibitors, and dopamine agonists. He displayed symptoms both axially and bilaterally, with his more involved side being the right. He reported an untreated right clavicle fracture 9 months ago. Instrumentation: Noraxon® instrumented pressure treadmill and MR3® software were used to capture cadence, gait velocity, step length, stance symmetry, and double limb support. The iPad® application Sparkmotion® was used to measure arm swing angular displacement (ASAD) in the sagittal plane. Methodology: Baseline gait variables were collected during 2 min warm-up walk on a treadmill. Subsequently, the participant performed 10 min of treadmill walking while matching his cadence to a RAS set 5% above baseline. Data was recorded every 2 min during the intervention. An immediate post-intervention and a 10 min follow-up data collection were performed without RAS for the variables of interest. Outcomes: The greatest differences were noted in single leg stance (SLS) duration symmetry and ASAD. SLS had a 2% increase in symmetry while ASAD increased 11.6° on the right and 13.4° on the left with no change in symmetry. Additionally, cadence and self-selected velocity increased by 4 beats per minute and 0.8 m/s respectively. Step lengths increased by 0.03m on the right and 0.04m on the left without increased symmetry. Double stance increased by 0.6% of the gait cycle. Discussion: The findings in this study suggest that a single 10 min treadmill intervention using RAS can result in immediate improvement in temporospatial gait parameters that potentially correlate to decreased fall risk in the YOPD population. Results were consistent with those reported in the literature for effects of RAS on cadence, gait velocity, and step length. Additionally, RAS can improve ASAD and stance symmetry, which can potentially improve gait and local dynamic stability. Further research is warranted to test efficacy of RAS with a larger sample population and overground walking.