Yonsei Med J.  2015 Nov;56(6):1703-1713. 10.3349/ymj.2015.56.6.1703.

Effect of Rhythmic Auditory Stimulation on Hemiplegic Gait Patterns

• Shin YK
• Chong HJ
• Kim SJ
• Cho SR

• KMID: 2345903
• DOI: http://doi.org/10.3349/ymj.2015.56.6.1703

Abstract

PURPOSE
The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia.
MATERIALS AND METHODS
Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatial data were collected and analyzed using a three-dimensional motion analysis system.
RESULTS
Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase.
CONCLUSION
Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia, providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.

Keyword

Gait; rhythmic auditory stimulation; hemiplegia

MeSH Terms

Acoustic Stimulation/*methods
Aged
Ankle Joint/physiopathology
Biomechanical Phenomena
Cerebral Palsy/*diagnosis/physiopathology
Female
Foot Joints/physiopathology
*Gait
Gait Disorders, Neurologic/etiology/physiopathology/*rehabilitation
Hemiplegia
Humans
Knee/physiopathology
Knee Joint/physiopathology
Male
Middle Aged
Stroke/*diagnosis/physiopathology

Figure

• 

  Fig. 1 The kinematic changes of proximal pelvic joint and distal ankle joint at pre- and post-RAS treatment. According to the ambulatory status, kinematic analysis showed differential patterns after gait training with RAS in patients with hemiplegia. Especially, community ambulators showed proximal pelvic improvement (A and B), while household ambulators showed distal ankle joint improvement (C and D). Dotted line: pre-treatment; black line: post-treatment; gray line: normal range. RAS, rhythmic auditory stimulation.

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