Effect of Rhythmic Auditory Cuing on Temporal Stride Parameters and EMG. Patterns in Hemiparetic Gait of Stroke Patients

This study investigated the effect of auditory (musical) rhythm on temporal parameters of the stride cycle and electromyographic (EMG) activity in gait of stroke patients. Ten subjects were studied over three trials. Each trial consisted of a baseline walk without rhythm and a walk with rhythm as pacemaker, marched to the step cadence of the baseline walk. Surface EMG on the gastrocnemius muscle and a dual walkway, consisting of pressure-sensitive voltage coded switch mats, were used to record data. Percentage change scores from no-rhythm to rhythm conditions were calculated for statistical analysis. Results showed several significant (p < .05) changes: (a) weight-bearing stance time on the paretic side and stride symmetry improved with rhythmic cuing; (b) magnitude of muscle activation during midstance/pushoff increased on the affected side and decreased on the nonaffected side; (c) variability of integrated amplitude ratios decreased during the midstance/pushoff phase on the affected side; (d) EMG activity during the swing phase also decreased on the affected side; (e) decrease in EMG variability and decrease in muscle activity during the swing phase were positively correlated with improvement in stride symmetry. Specificity of changes in muscle activation and improvement in temporal gait parameters suggest a strong entrainment effect of auditory rhythmic cues on temporal gait control in stroke patients.