• Physical Therapy Korea
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• v.25 no.2
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• pp.53-61
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• 2018

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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.95-103
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• 2018

PURPOSE: The present study was conducted to investigate the effects of functional electrical stimulation gait training with rhythmic auditory stimulation on balance and gait ability in stroke patients. METHODS: In this blinded randomized controlled study, 26 stroke patients were assigned to either experimental group (n=13) consisting of 30 min of gait training 5 days per week for 4 weeks while performing functional electrical stimulation gait training with rhythmic auditory simulation, or a control group (n=13) performing the same gait training program, also consisting of 30 minutes 5 days a week and lasting for 4 weeks, but without functional electrical stimulation and rhythmic auditory stimulation. At baseline and after the 4 week intervention, balance was measured using the timed up and go test (TUG). Gait velocity was measured using the 10-meter walk test (10 MWT) and gait ability was assessed using the functional gait assessment (FGA). RESULTS: After the intervention, the experimental group showed statistically significant differences in gait velocity and ability (10 MWT, FGA) (p<.05). Between-group differences were statistically significant in gait velocity and ability (10 MWT, FGA) (p<.05). CONCLUSION: The findings suggest that functional electrical stimulation gait training with a rhythmic auditory stimulation gait training program may help improve gait ability in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.137-145
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• 2018

PURPOSE: The purpose of this study was to investigate the effect of action observational physical training with rhythmic auditory stimulation on muscle activity and gait ability in patients with stroke. METHODS: Twenty-six chronic stroke patients participated in this study were assigned into three groups, experimental group 1 (10% faster tempo rhythmic auditory stimulation with action observation training) n=8, experimental group 2 (average tempo rhythmic auditory stimulation with action observation training) n=9, and control group (action observation training) n=9. In this experiment, the corresponding exercise were applied into the subjects of three group for 30 minute a day, 3 time a week during 4 weeks. All participants were measured to muscle activity of lower limb, 10 meter walking test, Figure of 8 walk test, Dynamic gait Index. The collected data were analyzed by using SPSS (version 18.0 for window) and verified that each data was a normal distribution based on Shapiro-Wilk test. Between-group and within-group comparison was analyzed by using One-way ANOVA test, Paired t-test respectively. In all statistical analyses, significance level, ${\alpha}$ was set by .05. RESULTS: The above results revealed that the all experimental group 1 and experimental group 2 and control group were all effective to improve the lower limb muscle activities, gait ability. However more positive effects shown action observational physical training with rhythmic auditory stimulation experimental group. CONCLUSION: This study suggest that action observation physical training with rhythmic auditory stimulation is effective intervention for improvement of muscle activity and walking ability in chronic stroke patients.

• PNF and Movement
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• v.12 no.3
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• pp.151-158
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• 2014

Purpose: The purpose of the study is to see the effect of walking when training for chronic stroke patients, Affected side vision impairment induced gait training with rhythmic auditory stimulation in parallel. Methods: This study was the general walking training group, the training group was divided damage induced affected side view, affected side view damage induced by rhythm auditory stimulation training three groups. Intervention period was 4 weeks. 5 times per week, per 30 min entered arbitration. Affected Side vision impairment induced induction training was conducted by installing a red cones, rhythmic auditory stimulation was applied to a regular rhythm training using a smartphone application (Metronome). Paired t-test was performed to see the difference between each group and before the intervention. One-way ANOVA was used to find out the significance probability between each group. Statistical significance was set at 0.05 probability. Results: Regular walking group, rather than affected side vision guided walking group could see increases in the FGA and DGI (P<0.05). And vision impairment induced affected side view and rhythmic auditory stimulation induction training this group than in the combination group walking group obtained higher scores on the FGA, DGI score(P<0.05). Conclusion: If you want to enforce certain rhythmic auditory stimulation of the visual field and side damage induced during gait training for stroke patients will be able to expect a better effect.

• PNF and Movement
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• v.15 no.1
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• pp.41-50
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• 2017

Purpose: This study aimed to determine how inclined-treadmill walking training with rhythmic auditory stimulation affects balance and gait in stroke patients. Methods: Ten chronic stroke patients, admitted to B hospital in Gangwon-do between August and October 2015, were trained 5 times per week for 4 weeks; each session lasted 30 minutes. To assess balance and gait before and after the training, the timed up and go (TUG) test, Berg balance scale (BBS), six minute walking test (6MWT), and three-dimensional spatiotemporal gait ability were used to measure the relevant variables. The data were analyzed using the paired t-test, and the statistical significance level was 0.05. Results: There were significant differences in the TUG, BBS, 6MWT, gait speed, cadence, single limb support (SLS), and symmetric index (SI) before and after training (p < 0.05). Conclusion: The results showed that the inclined-treadmill walking training with rhythmic auditory stimulation was effective at improving the balance and walking ability of stroke patients. Hearing training, using one of the basic procedures of proprioceptive neuromuscular stimulation, is considered to be an important aspect.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.4
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• pp.9-14
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• 2013

Purpose : The purpose of this study was to investigate the effect of visual Auditory rhythmic stimulation(VARS) in gait ability and proprioception with chronic stroke patients. Twenty-one persons after six months post stroke participated in pre test-post test control. Method : The subjects were randomly assigned to a visual Auditory rhythmic stimulation(VARS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the FRT(functional reach test) by static balance and TUG(timed up and go test) by dynamic balance. Results : In static balance, FRT distance was significantly different between two group. In dynamic balance, TUG time was significantly different between two group. This study showed that the VARS training increase a balance by postural adjustment of chronic stroke patients more than control group. And so, the VARS training of hemiplegic patients was very important to successive rehabilitation. Conclusion : A continuous examination of VARS training could practical used of physical therapy with exercise.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.5
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• pp.2187-2196
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• 2011

The objective of this study was to investigate the effect of gait training using rhythmic auditory stimulation on gait symmetry of stroke patients. Forty chronic stroke patients were divided into four groups by intervention. Group A and B received auditory stimulation when they walk with comfortable gait speed. Group A received auditory stimulation to paralyzed side while group B to non-paralyzed side. Group C and D received auditory stimulation with 10% faster gait speed than their comfortable gait speed. Group C received auditory stimulation to paralyzed side while group D to non-paralyzed side. Gait training using auditory stimulation was done in each group during five minutes. Gait symmetry was evaluated by formula and temporal variables of gait were measured by gait analysis system. Step time was decreased significantly in all groups except group A (P<.05), and gait symmetry was also improved significantly in all groups except group A (P<.05). Cadence was increased significantly in all groups except group A (p<.05), but velocity was not increased in all groups. Therefore we conclude that RAS gait training is effective in improving gait symmetry and can be useful to stroke patient's gait training.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.12
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• pp.6237-6245
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• 2013

This study examined the effects of backward walking with rhythmic auditory stimulation on the gait and balance of stroke patients. Twenty-one people were divided randomly into three groups; group I(n=7, forward walking), group II(n=7, backward walking), group III(n=7, backward walking by rhythmic auditory stimulation). Each group was trained for 30 minutes 5 times per week for 3 weeks, and was evaluated using a 10m walking test, time up and go test, functional reach test, stride length and step length asymmetry ratio. As a result, the pre- to post-test measures revealed a significant effect in each group on the gait speed, gait symmetry and balance(p<.05). The walking speed, gait symmetry and balance were higher in group II (p<.05) than in group I and it was the highest in group III(p<.05). The stride length was higher in group II and group III(p<.05) than in group I. In conclusion, for stroke patients, backward walking training with rhythmic auditory stimulation is effective on the gait speed, gait symmetry and balance.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.71-79
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• 2013

■ Objectives The goal of this pilot study is to observe the change of stroke gait by auditory cue training. ■ Methods An intracranial hemorrhage patient was trained for 4 weeks. For the 1^st consecutive 6days(the 1^st week), the patient was trained to walk with auditory cue, what was called auditory cue gait training condition. For the 2^nd consecutive 6days(the 2^nd week), the patient was trained to walk naturally without auditory cue, what was called free gait training condition. For the 3^rd consecutive 6days(the 3^rd week), the patient was trained to walk under auditory cue gait training condition. For the 4^th consecutive 6days(the 4^th week), the patient was trained to walk under free gait training condition. We analyzed the gait using a treadmill gait analysis system 3 hours after the 6^th gait training. ■ Results Auditory cue gait training showed effects on gait parameters, which were increasing walking velocity, step length, stride length, decreasing cadence, step time and stride time. ■ Conclusion Auditory cue gait training improved gait parameters of a stroke patient.

• Physical Therapy Korea
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• v.22 no.3
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• pp.81-90
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• 2015

This study aimed to determine the effects of Rhythmic Auditory Stimulation (RAS) using music and a metronome on the gait of stroke patients. 13 female and 15 male volunteers were randomly allocated to two groups: namely a group to receive RAS using music and a metronome group (the experimental group; $n_1=14$) and a group to receive RAS using a metronome only (the control group; $n_2=14$). The affected side was the left side in 15 subjects and the right side in 13 subjects. The mean age of the subjects was 56.6 years, and the mean onset duration of stroke was 8.6 months. Intervention was applied for 30 minutes per session, once a day, 5 times a week for 4 weeks. To measure the patients' gait improvement, we measured gait velocity, cadence, stride length, double limb support using GAITRite, body center sway angle using an accelerometer, and Timed Up-and-Go test. Functional Gait Assessment were conducted before and after the experiment. The paired t-test was used for comparisons before and after the interventions in each group. Analysis of covariance was used for comparisons between the groups after the interventions. Statistical significance was set at ${\alpha}=.05$. Within each of the two groups, significant differences in all of the dependent variables before and after the experiment (p<.05) were observed. However, in the comparison between the two groups, the experimental group showed more significant improvements in all dependent variables than the control group (p<.05). Our results also suggest that in applying RAS in stroke patients, the combination of music and a metronome is more effective than using a metronome alone in improving patients' gait.