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Effects of Visual Feedback and Rhythmic Auditory Stimulation on Walking of Stroke Patients Induced by Treadmill Walking Training

시각적 피드백과 리듬청각자극을 통한 트레드밀 보행훈련이 뇌졸중 환자의 보행능력에 미치는 영향

  • Park, Jin (Dept. of Physical Therapy, The Graduate School, Daegu University) ;
  • Kim, Beom-ryong (Dept. of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Kim, Tae-ho (Dept. of Physical Therapy, College of Rehabilitation Science, Daegu University)
  • 박진 (대구대학교 대학원 물리치료학과) ;
  • 김범룡 (삼육대학교 대학원 물리치료학과) ;
  • 김태호 (대구대학교 물리치료학과)
  • Received : 2018.04.03
  • Accepted : 2018.05.08
  • Published : 2018.05.21

Abstract

Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.

Keywords

References

  1. Ada L, Dean CM, Lindley R, et al. Improving community ambulation after stroke: The ambulate Trial. BMC Neurol. 2009;9:8. https://doi.org/10.1186/1471-2377-9-8
  2. Aaslund MK, Moe-Nilssen R. Treadmill walking with body weight support effect of treadmill, harness and body weight support systems. Gait Posture. 2008;28(2):303-308. https://doi.org/10.1016/j.gaitpost.2008.01.011
  3. Barbeau H. Locomotor training in neurorehabilitation: emerging rehabilitation concepts. Neurorehabil Neural Repair. 2003;17(1):3-11. https://doi.org/10.1177/0888439002250442
  4. Bayat R, Barbeau H, Lamontagne A. Speed and temporal-distance adaptations during treadmill and overground walking following stroke. Neurorehabil Neural Repair. 2005;19(2):115-124. https://doi.org/10.1177/1545968305275286
  5. Bonan IV, Yelnik AP, Colle FM, et al. Reliance on visual information after stroke. Part II: Effectiveness of balance rehabilitation program with visual cue deprivation after stroke: A randomized controlled trial. Arch Phys Med Rehabil. 2004;85(2):274-278. https://doi.org/10.1016/j.apmr.2003.06.016
  6. Brasileiro A, Gama G, Triqueiro L, et al. Influence of visual and auditory biofeedback on partial body weight support treadmill training of individuals with chronic hemiparesis: A randomized controlled clinical trial. Eur J Phys Rehabil Med. 2015;51(1):49-58.
  7. Druzbicki M, Guzik A, Przysada G, et al. Efficacy of gait training using a treadmill with and without visual biofeedback in patients after stroke: A randomized study. J Rehabil Med. 2015;47(5):419-425. https://doi.org/10.2340/16501977-1949
  8. Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: A synthesis of the evidence. Expert Rev Neurother. 2007;7(10):1417-1436. https://doi.org/10.1586/14737175.7.10.1417
  9. Ford MP, Wagenaar RC, Newell KM. The effects of auditory rhythms and instruction on walking patterns in individuals post stroke. Gait Posture. 2007;26(1):150-155. https://doi.org/10.1016/j.gaitpost.2006.08.007
  10. Gharib NM, El-Maksoud GM, Rezk-Allah SS. Efficacy of gait trainer as an adjunct to traditional physical therapy on walking performance in hemiparetic cerebral palsied children: A randomized controlled trial. Clin Rehabil. 2011;25(10):924-934. https://doi.org/10.1177/0269215511400768
  11. Hase K, Suzuki E, Matsumoto M, et al. Effects of therapeutic gait training using a prosthesis and a treadmill for ambulatory patients with hemiparesis. Arch Phys Med Rehabil 2011;92(12):1961-1966. https://doi.org/10.1016/j.apmr.2011.07.005
  12. Hausdorff JM, Lowenthal J, Herman T, et al. Rhythmic auditory stimulation modulates gait variability in parkinson's disease. Eur J Neurosci. 2007;26(8):2369-2375. https://doi.org/10.1111/j.1460-9568.2007.05810.x
  13. Hayden R, Clair AA, Johnson G, et al. The effect of rhythmic auditory stimulation (RAS) on physical therapy outcomes for patients in gait training following stroke: A feasibility study. Int J Neurosci. 2009;119(12):2183-2195. https://doi.org/10.3109/00207450903152609
  14. Hollands KL, Pelton T, Wimperis A, et al. Visual cue training to improve walking and turning after stroke: A study protocol for a multi-centre, single blind randomised pilot trial. Trials. 2013;14:276. https://doi.org/10.1186/1745-6215-14-276
  15. Hollands KL, Pelton TA, Wimperis A, et al. Feasibility and preliminary efficacy of visual cue training to improve adaptability of walking after stroke: Multi-centre, single-blind randomised control pilot trial. PLoS One. 2015;10(10):e0139261. https://doi.org/10.1371/journal.pone.0139261
  16. Khallaf ME, Gabr AM, Fayed EE. Effect of task specific exercises, gait training, and visual biofeedback on equinovarus gait among individuals with stroke: Randomized controlled study. Neurol Res Int. 2014;2014:693048. https://doi.org/10.1155/2014/693048
  17. Lau KW, Mak MK. Speed-dependent treadmill training is effective to improve gait and balance performance in patients with sub-acute stroke. J Rehabil Med. 2011;43(8):709-713. https://doi.org/10.2340/16501977-0838
  18. Lewek MD, Feasel J, Wentz E, et al. Use of visual and proprioceptive feedback to improve gait speed and spatiotemporal symmetry following chronic stroke: A case series. Phys Ther. 2012;92(5):748-756. https://doi.org/10.2522/ptj.20110206
  19. Luft AR, McCombe-Waller S, Whitall J, et al. Repetitive bilateral arm training and motor cortex activation in chronic stroke: A randomized controlled trial. JAMA. 2004;292(15):1853-1861. https://doi.org/10.1001/jama.292.15.1853
  20. Park J, Park SY, Kim YW, et al. Comparison between treadmill training with rhythmic auditory and ground walking with rhythmic auditory stimulation on gait ability in chronic stroke patients: A pilot study. NeuroRehabilitation. 2015;37(2):193-202. https://doi.org/10.3233/NRE-151252
  21. Pelton TA, Johannsen L, Huiya Chen, et al. Hemiparetic stepping to the beat: Asymmetric response to metronome phase shift during treadmill gait. Neurorehabil Neural Repair. 2010;24(5):428-434. https://doi.org/10.1177/1545968 309353608
  22. Peurala SH, Kononen P, Pitkanen K, et al. Postural instability in patients with chronic stroke. Restor Neurol Neurosci. 2007;25(2):101-108.
  23. Pizzi A, Carlucci G, Falsini C, et al. Gait in hemiplegia: Evaluation of clinical features with the Wisconsin gait scale. J Rehabil Med. 2007;39(2):170-174. https://doi.org/10.2340/16501977-0026
  24. Prassas S, Thaut M, McIntosh G, et al. Effect of auditory rhythmic cuing on gait kinematic parameters of stroke patients. Gait Posture. 1997;6(3):218-223. https://doi.org/10.1016/S0966-6362(97)00010-6
  25. Roerdink M, Lamoth CJ, Kwakkel G, et al. Gait coordination after stroke: Benefits of acoustically paced treadmill walking. Phys Ther. 2007;87(8):1009-1022. https://doi.org/10.2522/ptj.20050394
  26. Roerdink M, Lamoth CJ, van Kordelaar J, et al. Rhythm perturbations in acoustically paced treadmill walking after stroke. Neurorehabil Neural Repair. 2009;23(7):668-678. https://doi.org/10.1177/1545968309332879
  27. Sackley CM, Baguley BI, Gent S, et al. The use of a balance performance monitor in the treatment of weight-bearing and wight-transference problems after stroke. Physiotherapy. 1992;78(12):907-913. https://doi.org/10.1016/S0031-9406(10)60498-1
  28. Schauer M, Mauritz KH. Musical motor feedback (MMF) in walking hemiparetic stroke patients: Randomized trials of gait improvement. Clin Rehabil. 2003;17(7):713-722. https://doi.org/10.1191/0269215503cr668oa
  29. Shin J, Chung Y. Influence of visual feedback and rhythmic auditory cue on walking of chronic stroke patient induced by treadmill walking in real-time basis. NeuroRehabilitation. 2017;41(2):445-452. https://doi.org/10.3233/NRE-162139
  30. Thaut MH, McIntosh GC, Rice RR. Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation. J Neurol Sci. 1997;151(2):207-212. https://doi.org/10.1016/S0022-510X(97)00146-9
  31. Thaut MH, Leins AK, Rice RR, et al. Rhythmic auditory stimulation improves gait more than NDT/Bobath training in near-ambulatory patients early poststroke: A single-blind, randomized trial. Neurorehabil Neural Repair. 2007;21(5):455-459. https://doi.org/10.1177/1545968307300523
  32. Van de Crommert HW, Mulder T, Duysens J. Neural control of locomotion: sensory control of the central pattern generator and its relation to treadmill training. Gait Posture. 1998;7(3):251-263. https://doi.org/10.1016/S0966-6362(98)00010-1
  33. Wagenaar RC, Beek WJ. Hemiplegic gait: A kinematic analysis using walking speed as a basis. J Biomech. 1992;25(9):1007-1015. https://doi.org/10.1016/0021-9290(92)90036-Z

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