Awareness and Use of Sound- and Music-Based Gait Training in People with Parkinson's Disease in Japan: A Cross-Sectional Survey

Sound- and music-based gait training (SM-GT), including rhythmic auditory stimulation and music-based movement approaches, has been shown to improve gait and functional outcomes in people with Parkinsons disease (PD). However, little is known about how such interventions are recognized and implemented in real-world settings. This study investigated awareness and actual use of SM-GT among people with PD in Japan across inpatient rehabilitation, home-based rehabilitation, and daily-life contexts. A cross-sectional questionnaire survey was conducted among 62 people with PD recruited from public lectures and exercise programs. Participants reported their awareness of SM-GT, experiences of use in different contexts, types of auditory cues employed, and functional status including activities of daily living, gait and balance, and freezing of gait. Overall, 57.4% of participants reported being aware of SM-GT, whereas actual use remained limited across contexts (26.1% in inpatient rehabilitation, 9.1% in home-based rehabilitation, and 31.1% in daily-life contexts). Awareness was higher among participants with inpatient rehabilitation experience than among those with home-based rehabilitation experience; however a substantial gap between awareness and actual use was observed across all settings. While metronomes were the most frequently recognized auditory cue, hand clapping or verbal cueing and music were more commonly used in practice. Awareness and use of SM-GT also varied according to functional status, with relatively higher implementation among individuals with mild functional impairment. These findings reveal a pronounced discrepancy between recognition and real-world implementation of SM-GT in Japan, highlighting the need for strategies that facilitate translation of evidence-based auditory interventions into routine rehabilitation and everyday walking for people with PD.