Article

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.

Langue : ANGLAIS