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Musical motor feedback (MMF) in walking hemiparetic stroke patients: randomized trials of gait improvement
Michael Schauer1, Karl-Heinz Mauritz
1Max-Planck-Institute of Cognitive Neuroscience, Leipzig, Germany. schauer@cns.mpg.de
Objective:
To demonstrate the effect of rhythmical auditory stimulation in a musical context for gait therapy in hemiparetic stroke patients, when the stimulation is played back measure by measure initiated by the patient's heel-strikes (musical motor feedback). Does this type of musical feedback improve walking more than a less specific gait therapy?
Design:
The randomized controlled trial considered 23 registered stroke patients. Two groups were created by randomization: the control group received 15 sessions of conventional gait therapy and the test group received 15 therapy sessions with musical motor feedback.
Setting:
Inpatient rehabilitation hospital.
Subjects:
Median post-stroke interval was 44 days and the patients were able to walk without technical aids with a speed of approximately 0.71 m/s.
Main Outcome Measures:
Gait velocity, step duration, gait symmetry, stride length and foot rollover path length (heel-on-toe-off distance).
Result:
The test group showed more mean improvement than the control group: stride length increased by 18% versus 0%, symmetry deviation decreased by 58% versus 20%, walking speed increased by 27% versus 4% and rollover path length increased by 28% versus 11%.
Conclusion:
Musical motor feedback improves the stroke patient's walk in selected parameters more than conventional gait therapy. A fixed memory in the patient's mind about the song and its timing may stimulate the improvement of gait even without the presence of an external pacemaker.
