The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial
The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2018-09-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.00755/full |
| _version_ | 1818623404550389760 |
|---|---|
| author | Stefan Mainka Jörg Wissel Heinz Völler Stefan Evers |
| author_facet | Stefan Mainka Jörg Wissel Heinz Völler Stefan Evers |
| author_sort | Stefan Mainka |
| collection | DOAJ |
| description | The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SP. The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 ± 8.6 years, mean time between stroke and start of study 42.1 ± 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F(2, 34) = 3.864, p = 0.032; partial η2 = 0.205] and cadence [F(2, 34) = 7.656, p = 0.002; partial η2 = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.Clinical Trial Registration: https://www.drks.de/drks_web/, identifier DRKS00014603 |
| first_indexed | 2024-12-16T18:40:32Z |
| format | Article |
| id | doaj.art-345e2b5493b14b69887bd4a9f3654cb0 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-16T18:40:32Z |
| publishDate | 2018-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-345e2b5493b14b69887bd4a9f3654cb02022-12-21T22:21:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-09-01910.3389/fneur.2018.00755381344The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled TrialStefan Mainka0Jörg Wissel1Heinz Völler2Stefan Evers3Neurological Specialist Hospital for Movement Disorders/Parkinson, Beelitz-Heilstätten, GermanyDepartment of Neurology, Vivantes Hospital Spandau, Berlin, GermanyCenter of Rehabilitation Research, University of Potsdam, Potsdam, GermanyDepartment of Neurology, Lindenbrunn Hospital, Coppenbrügge, GermanyThe use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SP. The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 ± 8.6 years, mean time between stroke and start of study 42.1 ± 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F(2, 34) = 3.864, p = 0.032; partial η2 = 0.205] and cadence [F(2, 34) = 7.656, p = 0.002; partial η2 = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.Clinical Trial Registration: https://www.drks.de/drks_web/, identifier DRKS00014603https://www.frontiersin.org/article/10.3389/fneur.2018.00755/fullstroke rehabilitationexercise movement techniquesmusic therapymusicgait |
| spellingShingle | Stefan Mainka Jörg Wissel Heinz Völler Stefan Evers The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial Frontiers in Neurology stroke rehabilitation exercise movement techniques music therapy music gait |
| title | The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial |
| title_full | The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial |
| title_fullStr | The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial |
| title_full_unstemmed | The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial |
| title_short | The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial |
| title_sort | use of rhythmic auditory stimulation to optimize treadmill training for stroke patients a randomized controlled trial |
| topic | stroke rehabilitation exercise movement techniques music therapy music gait |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.00755/full |
| work_keys_str_mv | AT stefanmainka theuseofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT jorgwissel theuseofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT heinzvoller theuseofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT stefanevers theuseofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT stefanmainka useofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT jorgwissel useofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT heinzvoller useofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial AT stefanevers useofrhythmicauditorystimulationtooptimizetreadmilltrainingforstrokepatientsarandomizedcontrolledtrial |