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Objective:To explore any effect of upper limb swing training guided by rhythmic auditory stimulation (RAS) on the walking ability of stroke survivors.Methods:Eighty stroke survivors were randomly divided into an observation group and a control group. Both groups received conventional rehabilitation treatment, including neuromuscular facilitation, muscle strength training, balance training and gait training, but the observation group was additionally provided with RAS-guided upper limb swing training for 20min once a day, 5d per week for 6 weeks. Before and after the intervention, balance and lower limb function were quantified in both groups using Holden′s walking function classification, the Fugl-Meyer lower extremity motor function scale (FMA-LE), the Berg Balance Scale (BBS) and the 10m walk test (10MWT). Limits of stability were also quantified.Results:After the treatment, the average Holden, FMA-LE and BBS scores, as well as the average 10MWT time were significantly better in the observation group than in the control group. The average stability limits and their maintenance were also superior.Conclusion:RAS-guided upper limb swing training can improve the gait, walking ability, walking stability, walking speed and balance of stroke survivors.
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ObjectiveTo systematically review the effect of rhythmic auditory stimulation on gait of patients with cerebral palsy. MethodsRelevant literature on gait improvement of patient with cerebral palsy by rhythmic auditory stimulation were retrieved from Web of Science, PubMed, EBSCO, CNKI and Wanfang database from establishment to December, 2022. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the articles, and the relevant data was extracted. A systematic review was conducted. ResultsA total of 1 339 literatures were retrieved, and ten were finally included. The patients mainly came from America, Egypt, Israel, South Korea and Greece. The intervention sites were mainly in hospitals and communities, and some patients received home-based intervention. The publication date was mainly after 2010. Adding rhythmic auditory stimulation on the basis of conventional rehabilitation training increased the range of motion of the joints of patients with cerebral palsy; improved the walking speed, step length and stride length; improved the movement mode, and enhanced the intervention effect of gait training. ConclusionRhythmic auditory stimulation is effective on the range of motion, walking speed, step length and stride length of patient with spastic cerebral palsy, which can improve gait.
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@#Through providing rhythmic stimulation to movement center, rhythmic auditory stimulation (RAS) may encourage hemiplegic patients to adjust movement pattern and external rhythm in time to improve the walking function after stroke. As an emerging intervention to treat the hemiplegic patients after stroke, RAS could effectively improve temporospatial gait parameters (gait velocity, stride length, cadence, and symmetry, etc.), joint movement pattern (angle of pelvis anterior tilt, and peak angle of knee flexion in mid-swing, etc.) and balance, which may be related to rhythmic entrainment movement system and the theory of auditory-movement synchronization. Simultaneously, frequency and dosage of RAS and the patient's lesions all have effect on the outcome of intervention.
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Objective Discuss the effect of the Rhythmic auditory stimulation with treadmill training on freezing of gait in patients with parkinson's disease.Method 68 patients with parkinson's disease randomly divided into 2 groups.The control group uses conventional drug treatment in parkinson's disease patients according to the condition of patients.The comprehensive training group using body weight support treadmill training combined with rhythmic stimulation training for 8 weeks.The two group subjects were proceeded gait tests by freezing of gait questionnaire 、functional independence measure、five time sit to stand test、timed up and go test、berg balance Scale eight weeks after training.Result The comprehensive training group had a significant difference compared with the control group (P ＜ 0.01)in decreased freezing of gait questionnaire score,decreased functional independence measure score,decreased five time sit to stand test times,decreased timed up and go test score,increased berg balance Scale score.Conclusion Rhythmic auditory stimulation with treadmill training can improve freezing of gait function of patients with parkinson's disease.
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Objective To observe the effect of rhythmic auditory stimulation (RAS) on gait of stroke hemiplegic patients. Methods From April, 2014 to April, 2015, eleven stroke hemiplegic patients were divided into RAS group (n=6) and control group (n=5) randomly. Both groups accepted routine rehabilitation, and the RAS group accepted RAS walking exercise, while the control group accepted verbal in-structed walking exercise. They were tested with Brunnstrom's Stage and gait analysis before and three weeks after training. Results There was no significant increase in Brunnstrom's Stage (Z0.05) in both groups after training. The RAS group increased in stride length, velocity and cadence (t>4.829, P0.05). Conclusion Walking exercise under RAS facilitates to improve gait in stroke hemiplegic patients.
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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.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Acoustic Stimulation/methods , Ankle Joint/physiopathology , Biomechanical Phenomena , Cerebral Palsy/diagnosis , Foot Joints/physiopathology , Gait , Gait Disorders, Neurologic/etiology , Hemiplegia , Knee/physiopathology , Knee Joint/physiopathology , Stroke/diagnosisABSTRACT
Objective To investigate the effect of rhythmic auditory stimulation on the gait of patients with Parkinson's disease.Methods Forty-two patients with Parkinson's disease were divided into an auditory stimulation group and a control group with 21 cases in each.Both groups received conventional drug treatment,but the auditory stimulation group also received rhythmic auditory stimulation training for 10 minutes,3 times daily for 3 weeks.This involved their attempting to walk in time with a beat.The 2 groups were assessed with gait tests using a 3-dimensional motion analysis system before training and after the 3 weeks of training.Assessments using the united Parkinson's disease rating scale (UPDRS),Berg's balance scale and the 6-minute walk test were carried out.Results The auditory stimulation group's average stride length and stride frequency improved significantly after 3 weeks of treatment,and were then significantly better than the control group averages.Conclusion Rhythmic auditory stimulation helps improve the gait of Parkinson's disease sufferers and promotes the recovery of motor function.
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Neuromuscular coordination is the process in the activation of muscle contraction patterns with appropriate forces and sequences coupled with simultaneous inhibition of other muscles to carry out desired activity. Through coordination training, engram can be developed as automatic preprogrammed multi-muscular patterns in extrapyramidal system by repetitive training millions of time, whereas control is the ability to voluntarily activate a single muscle in pyramidal system with conscious awareness. The development of coordination depends on voluntary repetition of precise performance with simple components until engram is formed. Balance training begins with therapeutic standing using a tilt table and a prone stander. Thereafter, patients with stable static posture proceed to dynamic balance training and progressive gait training using parallel bars and gait aids such as walker or cane. Balance training as a comprehensive early rehabilitation program can effectively improve balance performance. As a therapeutic modality for balance and coordination, neurologic music therapy for sensorimotor training consists of rhythmic auditory stimulation (RAS), patterned sensory enhancement, and therapeutic instrumental music performance (TIMP). RAS has been shown to increase the effect of gait training by stimulating reticulospinal tract in extrapyramidal system as the underlying mechanism. TIMP using keyboard playing has been introduced as therapeutic modality to enhance sequential and programmed coordination with precise execution and independent movement of individual fingers. Therefore, clinical application of neurologic music therapy might be considered to improve balance and coordination in patients with neurological diseases.