The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Walking Training according to Rhythmic Auditory Stimulation Speed Control Balance of Stroke Patients

  • Jin Park (Department of Physical Therapy, Drim Sol Hospital) ;
  • Taeho Kim (Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University)
  • Received : 2023.11.20
  • Accepted : 2023.12.26
  • Published : 2023.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: In this study, based on the error augmentation, we performed walking training with increased rhythmic auditory stimulation speed on the affected side (IRAS) and walking training with decreased rhythmic auditory stimulation speed on the unaffected side (DRAS). The purpose of this study was to verify whether motor learning was effective in improving balance ability. Methods: Twenty-eight subjects with chronic stroke were recruited from a rehabilitation center. The subjects were divided into three groups: an IRAS group (10 subjects), a DRAS group (9 subjects), and control group (9 subjects). They received 30minutes of neuro-developmental therapy and walking training for 30minutes, five times a week for three weeks. Static and functional balance ability were measured before and after the training period. Static balance was measured by balancia software. Functional balance was measured by the timed up and go test (TUG) and the berg balance scale (BBS). Results: After the training periods, the IRAS group showed a significant improvement in TUG, BBS, area 95% COP, and weight distribution on the affected side when compared to both the DRAS group and control group (p<0.05). Conclusion: Based on the results of this study, it is possible to consider error augmentation methods of motor learning if rhythmic auditory stimulation is applied to stroke patients in clinical practice. If the affected side is shorter than the unaffected side, the affected side should be adjusted to the increased rhythmic auditory stimulation speed, which is considered to be an effective intervention to improve balance ability.

Keywords

References

  1. Lamontagne A, De Serres SJ, Fung J et al. Stroke affects the coordination and stabilization of head, thorax and pelvic during voluntary horizontal head motions performed in walking. Clin Neurophysiol. 2005;116(1):101-11.  https://doi.org/10.1016/j.clinph.2004.07.027
  2. Januario F, Campos I, Amaral C. Rehabilitation of postural stability in ataxic/hemiplegic patients after stroke. Disabil Rehabil. 2010;32(21):1775-9.  https://doi.org/10.3109/09638281003734433
  3. Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007;88(11):1410-5.  https://doi.org/10.1016/j.apmr.2007.08.109
  4. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction on balance: suggestion from the field. Phys Ther. 1986;66(10):1548-50.  https://doi.org/10.1093/ptj/66.10.1548
  5. Horak FB. Clinical measurement of postural control in adults. Phys Ther. 1987;67(12):1881-5.  https://doi.org/10.1093/ptj/67.12.1881
  6. Cha YJ, Kim JD, Choi YR et al. Effects of gait training with auditory feedback on walking and balancing ability in adults after hemiplegic stroke: a preliminary, randomized, controlled study. Int J Rehabil Res. 2018;41(3):239-43.  https://doi.org/10.1097/MRR.0000000000000295
  7. 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. 
  8. Mainka S, Wissel J, Voller H et al. The use of rhythmic auditory stimulation to optimize treadmill training for stroke patients: a randomized controlled trial. Front Neurol. 2018;9:755. 
  9. Yang YR, Chen YH, Chang HC et al. Effects of interactive visual feedback training on post-stroke pusher syndrome: a pilot randomized controlled study. Clin Rehabil. 2015;29(10):987-93.  https://doi.org/10.1177/0269215514564898
  10. 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):455-9.  https://doi.org/10.1177/1545968307300523
  11. Sibley KM, Tang A, Brooks D. Feasibility of adapted aerobic cycle ergometry tasks to encourage paretic limb use after stroke: a case series. J Neurol Phys Ther. 2008;32(2):80-7.  https://doi.org/10.1097/NPT.0b013e318176b466
  12. Thaut MH, Kenyon GP, Hurt CP. Kinematic optimization of spatiotemporal patterns in paretic arm training with stroke patients. Neuropsychologia. 2002;40(7):1073-81.  https://doi.org/10.1016/S0028-3932(01)00141-5
  13. Whitall J, McCombe-Waller S. Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke. 2000;31(10):2390-5.  https://doi.org/10.1161/01.STR.31.10.2390
  14. Roerdink M, Lamoth CJ, van Kordelaar J et al. Rhythm perturbations in acoustically paced treadmill walking after stroke. Neurorehabil Neural Repair. 2009;23(7):668-78.  https://doi.org/10.1177/1545968309332879
  15. Lewek MD, Braun CH, Wutzke C et al. The role of movement errors in modifying spatiotemporal gait asymmetry post stroke: a randimized controlled trial. Clin Rehabil. 2018;32(2):161-72.  https://doi.org/10.1177/0269215517723056
  16. Madhavan S, Lim H, Sivaramakrishnan A et al. Effects of high intensity speed-based treadmill training on ambulatory function in people with chronic stroke: a preliminary study with long-term follow-up. Sci Rep. 2019;9(1):1985. 
  17. Reisman DS, Wityk R, Silver K et al. Locomotor adaptation on a split-belt treadmill can improve walking symmetry post-stroke. Brain. 2007;130(Pt 7):1861-72.  https://doi.org/10.1093/brain/awm035
  18. Wutzke CJ, Faldowski RA, Lewek MD. Individuals poststroke do not perceive their spatiotemporal gait asymmetries as abnormal. Phys Ther. 2015;95:1244-53.  https://doi.org/10.2522/ptj.20140482
  19. Arias P, Cudeiro J. Effects of rhythmic sensory stimulation (auditory, visual) on gait in parkinson's disease patients. Exp Brain Res. 2008;186(4):589-601.  https://doi.org/10.1007/s00221-007-1263-y
  20. Roerdink M, Lamoth CJ, Kwakkel G. Gait coordination after stroke: benefits of acoustically paced treadmill walking. Phys Ther. 2007;87(8):1009-22.  https://doi.org/10.2522/ptj.20050394
  21. Hayden R, Clair AA, Johnson G. The effect of rhythmic auditory stimulation on physical therapy outcomes for patients in gait training following stroke: a feasibility study. Int J Neurosci. 2009;119(12):2183-95.  https://doi.org/10.3109/00207450903152609
  22. Hausdorff JM, Lowenthal J, Herman T. Rhythmic auditory stimulation modulates gait variability in parkinson's disease. Eur J Neurosci. 2007;26(8):2369-75.  https://doi.org/10.1111/j.1460-9568.2007.05810.x
  23. Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86(8):1641-7.  https://doi.org/10.1016/j.apmr.2005.01.011
  24. Faria CD, Teixeira-Salmela LF, Nadeau S. Effects of the direction of turning on the timed up & go test with stroke subjects. Top Stroke Rehabil. 2009;16(3):196-206.  https://doi.org/10.1310/tsr1603-196
  25. Berg KO, Wood-Dauphinee SL, Williams JI et al. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(Suppl2):S7-11. 
  26. Di Fabio RP, Badke MB. Relationship of sensory organization to balance function in patients with hemiplegia. Phys Ther. 1990;70:542-8.  https://doi.org/10.1093/ptj/70.9.542
  27. Betschart M, McFayden BJ, Nadeau S. Lower limb joint moments on the fast belt contribute to a reduction of step length asymmetry over ground after split-belt treadmill training in stroke: a pilot study. Physiother Theory Pract. 2018:1-11. 
  28. Hyun DS, Choi JD. The effects of backward walking with rhythmic auditory stimulation on gait and balance in patients with stroke. Journal of the Korea Academia-Industrial Cooperation Society. 2013;14(12):6237-45.  https://doi.org/10.5762/KAIS.2013.14.12.6237
  29. 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
  30. 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):1853-61.  https://doi.org/10.1001/jama.292.15.1853
  31. Mieville C, Lauziere S, Betschart M et al. More symmetrical gait after split-belt treadmill walking does not modify dynamic and postural balance in individuals post-stroke. J Electromyogr Kinesiol. 2018;41:41-9.  https://doi.org/10.1016/j.jelekin.2018.04.008
  32. O'Brien K, Crowell CR, Schmiedeler J. Error augmentation feedback for lateral weight shifting. Gait Posture. 2017;554:178-82.  https://doi.org/10.1016/j.gaitpost.2017.03.003
  33. Huberdeau DM, Krakauer JW, Haith AM. Dual-process decomposition in human sensorimotor adaptation. Curr Opin Neurobiol. 2015;33:71-7.  https://doi.org/10.1016/j.conb.2015.03.003
  34. Marchal-Crespo L, Michels L, Jaeger L et al. Effect of error augmentation on brain activation and motor learning of a complex locomotor task. Front Neurosci. 2017;11:526.