OBJECTIVE: To test whether rhythmic auditory stimulation (RAS) training reduces the number of falls in Parkinson's disease patients with a history of frequent falls. DESIGN: Randomized withdrawal study design. SUBJECTS: A total of 60 participants (aged 62 to 82 years) diagnosed with idiopathic Parkinson's disease (Hoehn and Yahr stages III or IV) with at least two falls in the past 12 months. INTERVENTION: Participants were randomly allocated to two groups and completed 30 minutes of daily home-based gait training with metronome click-embedded music. The experimental group completed 24 weeks of RAS training, whereas the control group discontinued RAS training between weeks 8 and 16. MAIN MEASURES: Changes in clinical and kinematic parameters were assessed at baseline, weeks 8, 16, and 24. RESULTS: Both groups improved significantly at week 8. At week 16 -- after the control group had discontinued training -- significant differences between groups emerged including a rise in the fall index for the control group (mean 10, SD 6). Resumption of training reduced the number of falls so that group differences were no longer significant at week 24 (mean experimental 3, SD 2.6; mean control 5, SD 4.4; p > 0.05). Bilateral ankle dorsiflexion was significantly correlated with changes in gait, fear of falling, and the fall index, indicating ankle flexion as a potential kinematic mechanism RAS addresses to reduce falls. CONCLUSION: RAS training significantly reduced the number of falls in Parkinson's disease and modified key gait parameters, such as velocity and stride length.

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