{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T01:45:17Z","timestamp":1786585517352,"version":"build-2736575974"},"reference-count":88,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>This study presents a secondary analysis of a quasi-randomized clinical trial exploring the effects of immersive virtual reality (VR) rehabilitation alone versus in combination with Neurologic Music Therapy (NMT) in individuals with Parkinson's disease (PD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty participants with idiopathic Parkinson's disease were allocated to two groups using a quasi-randomized procedure. One group received immersive VR-based gait training using the CAREN system (CAREN group), while the other received the same training protocol with the addition of NMT sensory-motor techniques delivered by a certified NMT therapist (CAREN-M group). Participants attended 12 rehabilitation sessions (three sessions per week over four weeks), each lasting approximately 45\u2005min. Both groups underwent the same number, duration, and intensity of rehabilitation sessions. Clinical outcomes (BBS, Tinetti Scale, Barthel Index, 10-meter walking test, Timed-Up-Go) and biomechanical gait parameters (kinematic, kinetic, and electromyography data) were assessed for pre- and post-treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both interventions led to significant improvements in motor function, but group-specific patterns emerged. The CAREN group showed greater gains in spatial parameters, such as gait speed and stride length, alongside increased muscle activation and improved joint kinematics. The CAREN-M group exhibited superior improvements in temporal parameters (e.g., cycle and swing duration), trunk stability, and postural control, suggesting that rhythmic auditory stimulation (RAS) may enhance motor timing and coordination. Between-group comparisons showed a greater reduction in Time Up and Go (TUG) times in the CAREN-M group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>These findings support the hypothesis that combining immersive VR (e.g., CAREN system) with NMT offers additive benefits by targeting distinct components of motor control through multisensory stimulation. The integration of rhythmic auditory cues into immersive VR environments can represent a promising direction for neurorehabilitation in PD, with the potential to improve functional mobility and gait quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration Number<\/jats:title>\n                    <jats:p>NCT07066137.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2026.1707528","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T06:53:39Z","timestamp":1772088819000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Can neurologic music therapy make the difference when using immersive virtual reality in Parkinson disease motor training? Promising findings from a secondary analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Paolo","family":"De Pasquale","sequence":"first","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Bonanno","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Lombardo Facciale","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Maggio","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Thaut","sequence":"additional","affiliation":[{"name":"Music and Health Science Research Collaboratory, Faculty of Music, Faculty of Medicine, Institute of Medical Sciences and Rehabilitation Science Institute, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corene","family":"Hurt","sequence":"additional","affiliation":[{"name":"Music and Health Science Research Collaboratory, Faculty of Music, Faculty of Medicine, Institute of Medical Sciences and Rehabilitation Science Institute, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Quartarone","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]},{"name":"Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Impellizzeri","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"j1951","DOI":"10.1136\/bmj.j1951","article-title":"Parkinson\u2019s disease: summary of updated NICE guidance","volume":"358","author":"Rogers","year":"2017","journal-title":"Br Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"28","DOI":"10.11138\/FNeur\/2017.32.1.028","article-title":"Gait analysis and clinical correlations in early Parkinson\u2019s disease","volume":"32","author":"Pistacchi","year":"2017","journal-title":"Funct Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2025.1541240","article-title":"Beyond clinical scales: an observational study on instrumental gait analysis and biomechanical patterns in patients with Parkinson\u2019s disease","volume":"13","author":"De Pasquale","year":"2025","journal-title":"Front Bioeng Biotechnol"},{"key":"B4","author":"Ernst","year":""},{"key":"B5","author":"Tomlinson","year":""},{"key":"B6","author":"Mehrholz","year":""},{"key":"B7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1471-2377-13-50","article-title":"Robot-assisted walking training for individuals with Parkinson\u2019s disease: a pilot randomized controlled trial","volume":"13","author":"Sale","year":"2013","journal-title":"BMC Neurol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/1743-0003-7-51","article-title":"Reduction of freezing of gait in Parkinson\u2019s disease by repetitive robot-assisted treadmill training: a pilot study","volume":"7","author":"Lo","year":"2010","journal-title":"J Neuroeng Rehabil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.rehab.2019.06.016","article-title":"Clinical effects of robot-assisted gait training and treadmill training for Parkinson\u2019s disease. 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