Wind-like sonification of footsteps for walking rehabilitation in chronic stroke survivors: a multiple case study

Gait impairments following stroke are prevalent and persistent, often affecting walking ability, body perception, and quality of life. Movement sonification-mapping body motion to sound-has shown promise for modulating sensorimotor function and body movements. This multiple-case experimental study investigated the effects of movement sonification using metaphorical sound on gait, body perception, emotional and cognitive state in three chronic stroke survivors. Using an ABA'C case study design, participants walked with real-time auditory feedback delivered via an interactive walking-interface system (SoniBand) across four periods: baseline (A), "Wind" sound (B or C), return to baseline (A'), and "Mechanical" sound (B or C), presented in a counterbalanced order, each phase lasted 3 weeks. Gait symmetry and walking velocity and ability were assessed as a primary outcome. Further, self-reported body perception, emotional and cognitive state were assessed as a secondary outcome. Exposure to the "Wind" sound condition led to improvements in gait symmetry and walking velocity. Further, showed enhanced perceptions of body lightness, speed, flexibility, mood improvements and sense of pleasure compared to the "Mechanical" sound and baseline periods. The "Mechanical" sound exposure induced a decrease in both gait speed and endurance in one out of the three patients. This multiple-case study provides some preliminary results to support the potential of metaphorical sound sonification to influence movement and body representation for walking rehabilitation in stroke survivors. The results from this case study pave the way to conduct future pilot studies including bigger samples, with a control arm, of chronic stroke survivors presenting walking impairments.