Effects of a Music-Based Rhythmic Auditory Stimulation on Gait and Balance in Subacute Stroke.

Samira Gonzalez-Hoelling,Rosa Suñer-Soler,Carme Bertran-Noguer,Gloria Reig-Garcia

doi:10.3390/ijerph18042032

Samira Gonzalez-Hoelling, Rosa Suñer-Soler + Show 2 more

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https://doi.org/10.3390/ijerph18042032

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Abstract

Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 (n = 27) were assigned as the historical control group whereas 2019 patients (n = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement (p = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains.

Highlights

Stroke is the main cause of disability in adults and the third cause of death in developed countries
The present study aimed to evaluate the effect of a music-based rhythmic auditory stimulation in combination with conventional physiotherapy on gait parameters and walking ability in people with stroke in a subacute phase, within the 21 days after stroke onset, and compare it to conventional physiotherapy alone
January to December 2018, 27 people were analyzed and included in the historical control group. from April to December 2019, we recruited 29 participants

Summary

Introduction

Stroke is the main cause of disability in adults and the third cause of death in developed countries. It can affect motor function, language, cognition, and perceptual-sensory processing. A close relationship has been found between the neural activity of the auditory and premotor cortex during rhythm processing, ratifying that rhythm perception is based on auditory and motor system interactions [4]. Since rhythm is processed in some of the same ways as timing, and timing is essential for many perceptual and motor functions, other music components are needed to process music-based rhythm across multiple brain areas, such as those related to pitch and timbre perception [4]

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