Effects of Rhythmic Auditory Cueing in Gait Rehabilitation for Multiple Sclerosis: A Mini Systematic Review and Meta-Analysis

Abstract

Rhythmic auditory cueing has been shown to enhance gait performance in several movement disorders. The “entrainment effect” generated by the stimulations can enhance auditory motor coupling and instigate plasticity. However, a consensus as to its influence over gait training among patients with multiple sclerosis is still warranted. A systematic review and meta-analysis was carried out to analyze the effects of rhythmic auditory cueing in studies gait performance in patients with multiple sclerosis. This systematic identification of published literature was performed according to PRISMA guidelines, from inception until Dec 2017, on online databases: Web of science, PEDro, EBSCO, MEDLINE, Cochrane, EMBASE, and PROQUEST. Studies were critically appraised using PEDro scale. Of 602 records, five studies (PEDro score: 5.7 ± 1.3) involving 188 participants (144 females/40 males) met our inclusion criteria. The meta-analysis revealed enhancements in spatiotemporal parameters of gait i.e., velocity (Hedge's g: 0.67), stride length (0.70), and cadence (1.0), and reduction in timed 25 feet walking test (−0.17). Underlying neurophysiological mechanisms, and clinical implications are discussed. This present review bridges the gaps in literature by suggesting application of rhythmic auditory cueing in conventional rehabilitation approaches to enhance gait performance in the multiple sclerosis community.

Training proprioception with sound: effects of real‐time auditory feedback on intermodal learning

“…Several of the systematic reviews and meta-analyses have also suggested a similar temporal course for auditory-motor training regimens to allow enhancements in motor performance. [29][30][31][32][33][34] In the present research, we aim to address the limitations of the experimental design used, and also to elucidate the influence of auditory feedback on motor learning. An expanded intermodal auditoryproprioceptive training protocol has been developed to investigate the efficacy of real-time auditory information on proprioceptive motor learning.…”

“…reported functional neuroplastic changes (higher positive peak (P2) activity and β‐band oscillation) with a prolonged auditory–motor training session (30 min). Several of the systematic reviews and meta‐analyses have also suggested a similar temporal course for auditory–motor training regimens to allow enhancements in motor performance …”

Virtual reality training enhances gait poststroke: a systematic review and meta‐analysis

“…The authors mentioned that this increased activation in the ipsilesional somatosensory cortex could have also resulted in unmasking of preexisting inactive motor representations, which then could have allowed enhancements in gait performance. [101][102][103][104][105][106] Conventionally, faster gait speed in stroke patients has been associated with improved kinematics and patterns of muscle activation. Lamontagne and Fung 107 reported that an increase in gait speed is attributable to larger STpLs and shorter cycle durations on the paretic and nonparetic sides, regardless of the functioning level.…”

Role of Sonification and Rhythmic Auditory Cueing for Enhancing Gait Associated Deficits Induced by Neurotoxic Cancer Therapies: A Perspective on Auditory Neuroprosthetics

“…Such type of an intervention involves mapping of movement parameters on the sound components, such as pitch, amplitude with a very minimal or no latency (72) [for differential effects of auditory cueing and sonification please see (82)]. Recent systematic reviews and meta-analyses have conclusively demonstrated the benefits of these auditory stimulations on gait and postural stability with aging (77), in neurological disorders such as stroke (82, 83, 86), parkinsonism (78), cerebral palsy (80), and multiple sclerosis (81). Findings from these reviews can have widespread implications for counteracting neurotoxicity related motor deficits in cancer patients.…”

“…Additionally, we also presume that damage induced by white matter deficits, which are a prominent manifestation of neurotoxicity can also be supplemented by the application of auditory stimulations (32, 87). Ghai and Ghai (81) recently demonstrated the beneficial effects of auditory cueing on patients with multiple sclerosis (a multifocal white matter disease). The authors stated evidence which supports the possibility of white matter re-organization with auditory-motor training [see (88)].…”