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Background. The use of rhythmic auditory stimulation (RAS) has been proven useful in the management of gait disturbances associated with Parkinson’s disease (PD). Typically, the RAS consists of metronome or music-based sounds (artificial RAS), while ecological footstep sounds (ecological RAS) have never been used for rehabilitation programmes. Objective. The aim of the present study was to compare the effects of a rehabilitation programme integrated either with ecological or with artificial RAS. Methods. An observer-blind, randomized controlled trial was conducted to investigate the effects of 5 weeks of supervised rehabilitation integrated with RAS. Thirty-eight individuals affected by PD were randomly assigned to one of the two conditions (ecological vs. artificial RAS); thirty-two of them (age 68.2 ± 10.5, Hoehn and Yahr 1,5–3) concluded all phases of the study. Spatio-temporal parameters of gait and clinical variables were assessed before the rehabilitation period, at its end, and after a 3-month follow-up. Results. Thirty-two participants were analyzed. The results revealed that both groups improved in the majority of biomechanical and clinical measures, independently of the type of sound. Moreover, exploratory analyses for separate groups were conducted, revealing improvements on spatio-temporal parameters only in the ecological RAS group. Conclusions. Overall, our results suggest that ecological RAS is equally effective compared to artificial RAS. Future studies should further investigate the role of ecological RAS, on the basis of information revealed by our exploratory analyses. Theoretical, methodological and practical issues concerning the implementation of ecological sounds in the rehabilitation of PD patients are discussed. Trial Registration. ClinicalTrials.gov, NCT03228888

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Open access journal Objective: The aim of the present study was to investigate how ecological sport sounds (i.e., foot-ball impacts of soccer penalty kicks) affect simple reaction times. Design: Three within-subjects, simple reaction time experiments were carried out; they differed among each other for the manipulations performed on the stimuli. Method: In Experiment 1, the loudness of the stimuli was manipulated; instead, in Experiment 2 and 3 shot power was manipulated, using as stimuli impacts of shots with different speeds. Results: The results highlighted an inverse relation between stimuli loudness and reaction times; instead, the natural differences among shots with different power were not sufficient to influence reaction times. Conclusions: Sounds associated to different shot power seem to differ in parameters which are not actually relevant for simple reaction times. Future studies should further investigate on similar issues, better clarifying whether the properties of ecological sounds can naturally influence reaction times.

Previous research has shown that Parkinson's disease (PD) patients can increase the speed of their movement when catching a moving ball compared to when reaching for a static ball (Majsak et al., 1998). A recent model proposed by Redgrave et al. (2010) explains this phenomenon with regard to the dichotomic organization of motor loops in the basal ganglia circuitry and the role of sensory micro-circuitries in the control of goal-directed actions. According to this model, external visual information that is relevant to the required movement can induce a switch from a habitual control of movement toward an externally-paced, goal-directed form of guidance, resulting in augmented motor performance (Bieńkiewicz et al., 2013). In the current study, we investigated whether continuous acoustic information generated by an object in motion can enhance motor performance in an arm reaching task in a similar way to that observed in the studies of Majsak et al. (1998, 2008). In addition, we explored whether the kinematic aspects of the movement are regulated in accordance with time to arrival information generated by the ball's motion as it reaches the catching zone. A group of 7 idiopathic PD (6 male, 1 female) patients performed a ball-catching task where the acceleration (and hence ball velocity) was manipulated by adjusting the angle of the ramp. The type of sensory information (visual and/or auditory) specifying the ball's arrival at the catching zone was also manipulated. Our results showed that patients with PD demonstrate improved motor performance when reaching for a ball in motion, compared to when stationary. We observed how PD patients can adjust their movement kinematics in accordance with the speed of a moving target, even if vision of the target is occluded and patients have to rely solely on auditory information. We demonstrate that the availability of dynamic temporal information is crucial for eliciting motor improvements in PD. Furthermore, these effects appear independent from the sensory modality through-which the information is conveyed. This research was funded by the European Research Council TEMPUS_G project (210007 StIG).

The use of auditory cues for the modulation of movement and physiological parameters has been investigated in different domains. However, most of the previous studies used artificial cues, which did not provide information related to individual’s perceptual experience. In this study, we compared the effects of ecological and artificial cues on breathing. Consistently with the Theory of Event Coding, we hypothesized that the ecological cues would affect breathing more than the artificial ones. Indeed, the more the perceptual experience overlaps the action experience, the more the former would influence the latter. To address this question, we created a database of ecological sounds by manipulating the breathing sounds of a volunteer. We also created a database of artificial sounds which had the same temporal features as the ecological ones. Twenty volunteers were then exposed to three different conditions – ecological sound, artificial sound, and control – while we monitored their breath duration. In each session, participants were first asked to breathe normally, and then to synchronize the beginning of their inspiration with the beginning of the inspiration sound, for each breath. Only in the control condition no cue was provided for this second phase. The statistical analyses then revealed that breath duration variability in the ecological condition was significantly reduced in contrast with the other two conditions. The results seem to confirm our hypothesis that ecological sounds capture the timing of breathing better than artificial sounds, guiding as a consequence participants’ breathing. Our results provide further support to the validity of the Theory of Event Coding, suggesting its possible extension in the domain of physiological functions that are both consciously and unconsciously controlled. If the future research confirmed the effectiveness of ecological sound training, the current intervention techniques could be improved in various domains (e.g. motor rehabilitation, sport performance).