This Article Full Text (PDF) All Versions of this Article: 1545968309332879v1 23/7/668    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Roerdink, M. Articles by Beek, P. J. PubMed PubMed Citation Articles by Roerdink, M. Articles by Beek, P. J. Social Bookmarking                         What's this?

Rhythm Perturbations in Acoustically Paced Treadmill Walking After Stroke

Research Institute MOVE, Faculty of Human Movement Sciences, VU University, m.roerdink{at}fbw.vu.nl

Claudine J. C. Lamoth, PhD

Research Institute MOVE, Faculty of Human Movement Sciences, VU University

Joost van Kordelaar, MSc

Research Institute MOVE, Faculty of Human Movement Sciences, VU University, Department of Rehabilitation Medicine, VU University Medical Centre

Peter Elich, PT

Duyvensz-Nagel Research Laboratory, Rehabilitation Centre Amsterdam, Amsterdam

Manin Konijnenbelt, MD

Duyvensz-Nagel Research Laboratory, Rehabilitation Centre Amsterdam, Amsterdam

Gert Kwakkel, PhD

Research Institute MOVE, Faculty of Human Movement Sciences, VU University, Department of Rehabilitation Medicine, VU University Medical Centre, Department of Rehabilitation Medicine, Rudolf Magnus Institute, UMC Utrecht, The Netherlands

Peter J. Beek, PhD

Research Institute MOVE, Faculty of Human Movement Sciences, VU University

Background. In rehabilitation, acoustic rhythms are often used to improve gait after stroke. Acoustic cueing may enhance gait coordination by creating a stable coupling between heel strikes and metronome beats and provide a means to train the adaptability of gait coordination to environmental changes, as required in everyday life ambulation. Objective. To examine the stability and adaptability of auditory—motor synchronization in acoustically paced treadmill walking in stroke patients. Methods. Eleven stroke patients and 10 healthy controls walked on a treadmill at preferred speed and cadence under no metronome, single-metronome (pacing only paretic or nonparetic steps), and double-metronome (pacing both footfalls) conditions. The stability of auditory—motor synchronization was quantified by the variability of the phase relation between footfalls and beats. In a separate session, the acoustic rhythms were perturbed and adaptations to restore auditory—motor synchronization were quantified. Results. For both groups, auditory—motor synchronization was more stable for double-metronome than single-metronome conditions, with stroke patients exhibiting an overall weaker coupling of footfalls to metronome beats than controls. The recovery characteristics following rhythm perturbations corroborated the stability findings and further revealed that stroke patients had difficulty in accelerating their steps and instead preferred a slower-step response to restore synchronization. Conclusions. In gait rehabilitation practice, the use of acoustic rhythms may be more effective when both footfalls are paced. In addition, rhythm perturbations during acoustically paced treadmill walking may not only be employed to evaluate the stability of auditory—motor synchronization but also have promising implications for evaluation and training of gait adaptations in neurorehabilitation practice.

Key Words: Stroke • Gait • Rehabilitation • Acoustic cueing • Treadmill walking • Perturbations

This version was published on September 1, 2009

Neurorehabilitation and Neural Repair, Vol. 23, No. 7, 668-678 (2009)
DOI: 10.1177/1545968309332879


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?