본문 바로가기
KERD
논문KCI 등재

Effect of Rhythmic Auditory Stimulation on Hemiplegic Gait Patterns

1

조회

0

다운로드

5

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose: The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. Materials and Methods: Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatialdata were collected and analyzed using a three-dimensional motion analysis system. Results: Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. Conclusion: Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia,providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.

Abstract

Purpose: The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. Materials and Methods: Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatialdata were collected and analyzed using a three-dimensional motion analysis system. Results: Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. Conclusion: Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia,providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.

참고문헌 (46)

  1. Galli M, "Gait patterns in hemiplegic children with Cerebral Palsy: comparison of right and left hemiplegia", Res Dev Disabil, 31, pp.1340~1345 (2010)
  2. Hillier SL, "Outcomes 5 years post-traumatic brain injury (with further reference to neurophysical impairment and disability)", Brain Inj, 11, pp.661~675 (1997)
  3. Rodda J, "Classification of gait patterns in spastic hemiplegia and spastic diplegia : a basis for a management algorithm", Eur J Neurol ;8 Suppl, 8(Suppl 5), pp.98~108 (2001)
  4. Böhm H, "Gait asymmetries in children with cerebral palsy: do they deteriorate with running?", Gait Posture, 35, pp.322~327 (2012)
  5. Hsu AL, "Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke", Arch Phys Med Rehabil, 84, pp.1185~1193 (2003)
  6. Patterson KK, "Gait asymmetry in community-ambulating stroke survivors", Arch Phys Med Rehabil, 89, pp.304~310 (2008)
  7. Salazar-Torres JJ, "Pelvic kinematics and their relationship to gait type in hemiplegic cerebral palsy", Gait Posture, 33, pp.620~624 (2011)
  8. Chen CL, "Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery", Am J Phys Med Rehabil, 82, pp.925~935 (2003)
  9. Voigt M, "Kinematic and kinetic analysis of the walking pattern in hemiplegic patients with foot-drop using a peroneal nerve stimulator", Clin Biomech (Bristol, Avon), 15, pp.340~351 (2000)
  10. Embrey DG, "Functional electrical stimulation to dorsiflexors and plantar flexors during gait to improve walking in adults with chronic hemiplegia", Arch Phys Med Rehabil, 91, pp.687~696 (2010)
  11. Jonkers I, "Capacity to increase walking speed is limited by impaired hip and ankle power generation in lower functioning persons post-stroke", Gait Posture, 29, pp.129~137 (2009)
  12. Roerdink M, "Understanding inconsistent step-length asymmetries across hemiplegic stroke patients: impairments and compensatory gait", Neurorehabil Neural Repair, 25, pp.253~258 (2011)
  13. Balasubramanian CK, "Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis", Arch Phys Med Rehabil, 88, pp.43~49 (2007)
  14. Pohl M, "Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: a randomized controlled trial", Stroke, 33, pp.553~558 (2002)
  15. Yang YR, "Cortical reorganization induced by body weight-supported treadmill training in patients with hemiparesis of different stroke durations", Arch Phys Med Rehabil, 91, pp.513~518 (2010)
  16. Patritti BL, "Robotic gait training in an adult with cerebral palsy: a case report", PM R, 2, pp.71~75 (2010)
  17. 박은숙, "Effects of Hippotherapy on Gross Motor Function and Functional Performance of Children with Cerebral Palsy", Yonsei Medical Journal, 55(6), pp.1736~1742 (2014), 연세대학교의과대학[DOI]
  18. Mauritz KH, "Gait training in hemiplegia", Eur J Neurol;9 Suppl, 9(Suppl 1), pp.23~29 (2002)
  19. Thaut MH, "Rhythmic auditory stimulation improves gait more than NDT", Bobath training in near-ambulatory patients early poststroke:a single-blind, randomized trial, 2007, pp.21, 455~459
  20. Cha Y, "Immediate effects of rhythmic auditory stimulation with tempo changes on gait in stroke patients", J Phys Ther Sci, 26, pp.479~482 (2014)
  21. Kim SJ, "Changes in gait patterns with rhythmic auditory stimulation in adults with cerebral palsy", NeuroRehabilitation, 29, pp.233~241 (2011)
  22. Kim SJ, "Differential effects of rhythmic auditory stimulation and neurodevelopmental treatment", Bobath on gait patterns in adults with cerebral palsy: a randomized controlled trial, 2012, pp.26, 904~914
  23. Arias P, "Effects of rhythmic sensory stimulation (auditory, visual) on gait in Parkinson’s disease patients", Exp Brain Res, 186, pp.589~601 (2008)
  24. Arias P, "Effect of rhythmic auditory stimulation on gait in Parkinsonian patients with and without freezing of gait", PLoS One, 5, pp.e9675~ (2010)
  25. Kadivar Z, "Effect of step training and rhythmic auditory stimulation on functional performance in Parkinson patients", Neurorehabil Neural Repair, 25, pp.626~635 (2011)
  26. Thaut MH, "Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation", Ann N Y Acad Sci, 1169, pp.406~416 (2009)
  27. de l’Etoile SK, "The effect of rhythmic auditory stimulation on the gait parameters of patients with incomplete spinal cord injury: an exploratory pilot study.", Int J Rehabil Res, 31, pp.155~157 (2008)
  28. Kim SJ, "Case Study of Gait Training Using Rhythmic Auditory Stimulation (RAS) for a Pediatric Patient with Cerebellar Astrocytomas", J Music Hum Behav, 7, pp.65~81 (2010)
  29. 한수정, "패턴화된 감각 증진(PSE)이 뇌졸중 환자의 상지 기능에 미치는 즉각적 영향", 인간행동과 음악연구, 11(1), pp.1~19 (2014), 한국음악치료교육학회
  30. Kwak EE, "Effect of rhythmic auditory stimulation on gait performance in children with spastic cerebral palsy", J Music Ther, 44, pp.198~216 (2007)
  31. Thaut MH, "Neural basis of rhythmic timing networks in the human brain", Ann N Y Acad Sci, 999, pp.364~373 (2003)
  32. Thaut MH, "Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation", J Neurol Sci, 151, pp.207~212 (1997)
  33. McIntosh GC, "Rhythmic auditorymotor facilitation of gait patterns in patients with Parkinson’s disease", J Neurol Neurosurg Psychiatry, 62, pp.22~26 (1997)
  34. Hausdorff JM, "Rhythmic auditory stimulation modulates gait variability in Parkinson’s disease", Eur J Neurosci, 26, pp.2369~2375 (2007)
  35. Suh JH, "Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients", NeuroRehabilitation, 34, pp.193~199 (2014)
  36. Hashiguchi Y, "Effect of rhythmic auditory stimulation on gait parameters and gait emg in patients with hemiplegia after stroke more less", Gait Posture, 39, pp.S139~ (2014)
  37. Perry J, "Classification of walking handicap in the stroke population", Stroke, 26, pp.982~989 (1995)
  38. Schwartz MH, "The Gait Deviation Index: a new comprehensive index of gait pathology", Gait Posture, 28, pp.351~357 (2008)
  39. Krakauer JW, "Motor learning: its relevance to stroke recovery and neurorehabilitation", Curr Opin Neurol, 19, pp.84~90 (2006)
  40. Perry J, "The mechanics of walking in hemiplegia", Clin Orthop Relat Res, 63, pp.23~31 (1969)
  41. Lennon S, "Gait re-education based on the Bobath concept in two patients with hemiplegia following stroke", Phys Ther, 81, pp.924~935 (2001)
  42. Kuan TS, "Hemiplegic gait of stroke patients: the effect of using a cane", Arch Phys Med Rehabil, 80, pp.777~784 (1999)
  43. Chen G, "Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds", Gait Posture, 22, pp.51~56 (2006)
  44. Siegel KL, "Joint moment control of mechanical energy flow during normal gait", Gait Posture, 19, pp.69~75 (2004)
  45. Bobath K, "The facilitation of normal postural reactions and movements in the treatment od cerebral palsy", Physiotherapy, 50, pp.246~262 (1964)
  46. Woolley SM, "Characteristics of gait in hemiplegia", Top Stroke Rehabil, 7, pp.1~18 (2001)

관련 논문AI추천

이 간행물의 다른 논문 (22건)