Technology-Assisted Solutions to Enhance Auditory-Motor Synchronization During Walking in Progressive Multiple...

Area of Science:

• Neurorehabilitation
• Biomechanics
• Human-Computer Interaction

Background:

• Beat-based cues (music, metronomes) aid short-distance walking in people with progressive multiple sclerosis (PwPMS).
• Prolonged walking assessment is crucial for real-world functional evaluation.
• Adaptive beat-alignment algorithms' effects on PwPMS gait dynamics are unknown.

Purpose of the Study:

• Investigate adaptive beat-alignment's impact on synchronization consistency and gait dynamics during prolonged walking in PwPMS.
• Compare adaptive vs. non-adaptive beat-alignment with music and metronomes.
• Examine cognitive and dynamic balance influences on synchronization.

Main Methods:

• Healthy controls (HCs) and PwPMS completed 8-minute walks under five conditions: silence, music, and metronome, with or without adaptive beat alignment.
• An algorithm adjusted phase and tempo in real-time to maintain baseline cadence.
• Measured synchronization, gait parameters, dynamics, and clinical outcomes.

Main Results:

• Adaptive beat-alignment enhanced synchronization consistency and gait dynamics compared to fixed-tempo cues.
• Cognitive flexibility and working memory accounted for 6-10% of synchronization variance.
• Dynamic balance significantly impaired synchronization (40%) across both adaptive and non-adaptive conditions.
• Auditory cues led to slower walking and shorter strides than silence.

Conclusions:

• Adaptive beat-alignment strategies are feasible for improving PwPMS synchronization consistency and gait dynamics.
• Cognitive flexibility, working memory, and dynamic balance are key factors influencing synchronization performance in PwPMS.
• Further research into adaptive cueing for gait rehabilitation in PwPMS is warranted.