The Effect of Internal Cueing Strategies on Gait in Parkinson’s Disease and Underlying Mechanisms: A Structured Review
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People with Parkinson’s (PWP) typically present with postural instability and gait impairment leading to a high number of falls. Gait rehabilitation that incorporates movement guidance training with sensory cueing and augmented feedback has been successfully investigated in the past to facilitate gait improvement in PWP. Despite showing clinical efficacy, there are limitations to the use of external cues such as device cost and the implementation of cue strategies in daily functional activities. An alternative approach is to use internal cueing which, although less commonly used, may yield similar benefits. This structured review examines the underlying mechanisms and efficacy for use of internal cues to reduce gait impairment among people living with Parkinson’s disease. Based on 14 studies, findings suggest that internal cueing improves gait speed and step length. Findings also suggest a selective response of cueing strategies on gait outcomes. While further research is required, internal cueing may offer a low-cost self-management tool to improve gait outcomes.