Evaluation of the Effectiveness of Stepping in Place with Rhythmic Auditory Stimulation on Improving Gait in a Community Dwelling Stroke Population

Abstract

Stroke survivors often exhibit asymmetric walking patterns associated with one-sided weakness, or hemiparesis, resulting in a reduced walking ability and lower levels of independence. Rhythmic Auditory Stimulation (RAS) is an emerging strategy that uses music with a strong beat to help cue walking. RAS has successfully improved walking ability and symmetry in stroke survivors, yet the use of RAS while stepping in place has been only minimally explored. Due to limited mobility in this population, stepping in place may be a more feasible method of practicing walking patterns. The purpose of this study is two-fold: 1) to determine the immediate effects of stepping in place with RAS on kinematic walking parameters, and 2)to evaluate whether any changes in gait parameters translate to walking following a RAS session. The study is currently underway, with an objective of testing 8 to 10 participants who have experienced a stroke resulting in hemiparesis and reduced walking ability. The testing protocol is divided into two parts; part one involves an initial walking assessment to determine stepping cadence. In part two, participants complete a gait analysis and functional assessment before and after the stepping in place with RAS session. Two-dimensional analysis using a motion capture system and force plates allows for multiple spatiotemporal and kinematic outcome measures to be collected such as walking speed, step length, and joint angles. Ultimately, findings from this study will help to determine if and how stepping in place with RAS can improve gait in stroke survivors.