Abstract
BackgroundAlthough laboratory studies demonstrate that training programmes using auditory rhythmical cueing (ARC) may improve gait post-stroke, few studies have evaluated this intervention in the home and outdoors where deployment may be more appropriate. This manuscript reports stakeholder refinement of an ARC gait and balance training programme for use at home and outdoors, and a study which assessed acceptability and deliverability of this programme.MethodsProgramme design and content were refined during stakeholder workshops involving physiotherapists and stroke survivors. A two-group acceptability and deliverability study was then undertaken. Twelve patients post-stroke with a gait related mobility impairment received either the ARC gait and balance training programme or the gait and balance training programme without ARC. Programme provider written notes, participant exercise and fall diaries, adverse event monitoring and feedback questionnaires captured data about deliverability, safety and acceptability of the programmes.ResultsThe training programme consisted of 18 sessions (six supervised, 12 self-managed) of exercises and ARC delivered by a low-cost commercially available metronome. All 12 participants completed the six supervised sessions and 10/12 completed the 12 self-managed sessions. Provider and participant session written records and feedback questionnaires confirmed programme deliverability and acceptability.ConclusionAn ARC gait and balance training programme refined by key stakeholders was feasible to deliver and acceptable to participants and providers.Trial registrationISCTRN 12/03/2018.
Highlights
Laboratory studies demonstrate that training programmes using auditory rhythmical cueing (ARC) may improve gait post-stroke, few studies have evaluated this intervention in the home and outdoors where deployment may be more appropriate
Nine physiotherapists working in inpatient and community stroke services attended the first workshop and four stroke survivors attended the second
Discussion on ease of use focused on the size of the metronome screen and buttons, potential confusion if there were a number of buttons and practicalities of set up if the stroke survivor could only use one arm
Summary
Laboratory studies demonstrate that training programmes using auditory rhythmical cueing (ARC) may improve gait post-stroke, few studies have evaluated this intervention in the home and outdoors where deployment may be more appropriate. This manuscript reports stakeholder refinement of an ARC gait and balance training programme for use at home and outdoors, and a study which assessed acceptability and deliverability of this programme. The ability to walk safely and unsupervised around the home and outdoors is fundamental to independent living and as such is an important topic in stroke rehabilitation [7]. The efficacy of ARC has been well established in Parkinson’s disease over the last 20 years [11], and this intervention has more recently been utilised in stroke
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