Using a Portable Gait Rhythmogram to Examine the Effect of Music Therapy on Parkinson's Disease-Related Gait Disturbance.

External cues improve walking by evoking internal rhythm formation related to gait in the brain in patients with Parkinson's disease (PD). This study examined the usefulness of using a portable gait rhythmogram (PGR) in music therapy on PD-related gait disturbance. A total of 19 subjects with PD who exhibited gait disturbance were evaluated for gait speed and step length during a 10 m straight walking task. Moreover, acceleration, cadence, and trajectory of the center of the body were estimated using a PGR. Walking tasks were created while incorporating music intervention that gradually increased in tempo from 90 to 120 beats per minute (BPM). We then evaluated whether immediate improvement in gait could be recognized even without music after walking tasks by comparing pre- (pre-MT) and post-music therapy (post-MT) values. Post-MT gait showed significant improvement in acceleration, gait speed, cadence, and step length. During transitions throughout the walking tasks, acceleration, gait speed, cadence, and step length gradually increased in tasks with music. With regard to the trajectory of the center of the body, we recognized a reduction in post-MT medio-lateral amplitude. Music therapy immediately improved gait disturbance in patients with PD, and the effectiveness was objectively shown using PGR.

The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients.

BACKGROUND: The assessment of gait function is important for stroke rehabilitation. Gait function of patients with stroke often depends on the type of orthosis. There are however few gait assessments that assess the type of orthosis. OBJECTIVE: The purpose of this study was to investigate the reliability and validity of our newly developed Ambulation Independence Measure (AIM), which assesses the gait function, type of orthoses and physical assistance, for acute stroke patients. METHODS: A total of 73 acute stroke patients participated in this prospective study. The AIM discriminates 7 levels of gait ability on the basis of the amount of physical assistance required and orthoses that are used during walking. Interrater reliability, concurrent validity with the Functional Ambulation Category (FAC) and predictive validity were examined. RESULTS: The weighted kappas of AIM at the start of gait training (baseline) and discharge were 0.990 and 0.978, respectively. The AIM scores were significantly correlated with the FAC scores at both baseline (r = 0.808) and discharge (r = 0.934). Multiple regression analyses showed that the AIM at baseline was a stronger predictor of the FAC at discharge (R2 = 0.80). CONCLUSIONS: The AIM has excellent reliability, concurrent validity, predictive validity, and good responsiveness in acute stroke patients.

Early clinical evaluation of total hip arthroplasty by three-dimensional gait analysis and muscle strength testing.

BACKGROUND: As improvement of gait is an important reason for patients to undergo total hip arthroplasty (THA) and they generally tend to evaluate its success based on postoperative walking ability, objective functional evaluation of postoperative gait is important. However, the patient's normal gait before osteoarthritis is unknown and the changes that will occur postoperatively are unclear. We investigated the change in gait and hip joint muscle strength after THA by using a portable gait rhythmograph (PGR) and muscle strength measuring device. PATIENT AND METHODS: The subjects were 46 women (mean age: 65.9 years) with osteoarthritis of the hip. Gait analysis and muscle strength testing were performed before THA, as well as 3 weeks and 3 months after surgery. We measured the walking speed, step length, and gait trajectory using PGR prospectively. PGR is attached to the patient's waist and records signals at a sampling rate of 100 Hz. Isometric torque of hip flexion and abduction were measured by using a hand-held dynamometer. RESULTS: There was no improvement at 3 weeks postoperatively, but the walking speed, stride length and muscle strength were clearly showed improvement at 3 months postoperatively. The walking trajectory was not normal preoperatively, since the trajectory was not symmetrical and did not intersect in the midline or form a butterfly pattern, and abnormality of the trajectory tended to persist postoperative 3 months despite resolution of hip joint pain after surgery. CONCLUSION: Since postoperative improvement of gait is an important consideration for patients undergoing THA, it seems relevant to evaluate changes in the gait after surgery and three-dimensional analysis with a PGR may be useful for this purpose.