Effects of Rhythmic Auditory Stimulation during Hemiplegic Arm Reaching in Individuals with Stroke: An Exploratory Study

Abstract

Objective/Background This study investigated the effects of rhythmic auditory stimulation (RAS) on muscle activity and elbow motion during arm reaching with hemiplegic arm in participants with stroke. Methods Sixteen adults with stroke who resided in a community were recruited in this study. The RAS consisted of sound emitted from a digital metronome. While sitting upright in a chair, participants reached their arms towards a target (a switch on a table) both with and without RAS. The three-dimensional motion analysis system and surface electromyography system were used for measurements during the reaching tasks. Results We found that RAS elicited better performance in reaching movements than those movements performed without RAS. RAS shortened the movement time (p = .002), reduced the change in acceleration (p = .001), increased the elbow extension range of motion (p = .001), increased muscle activation of the triceps brachii (p = .024), and reduced the co-contraction ratio (p = .015) of the affected arm. Conclusion RAS might be a useful technique to facilitate improvements in motor function of the affected arm in patients with stroke.

Effects of Real-Time (Sonification) and Rhythmic Auditory Stimuli on Recovering Arm Function Post Stroke: A Systematic Review and Meta-Analysis

“…Further, a sub-group analysis for only rhythmic auditory cueing revealed a similar positive medium effect size with negligible heterogeneity (g: 0.37, 95% C.I: 0.01–0.72, I 2 : 0%, p > 0.05). Further sub-group analysis was not performed because two studies did not include a training regime ( 112 , 124 ), and one study analyzed the effects of real-time auditory feedback ( 118 ).…”

Rhythmic Auditory Stimulation as an Adjuvant Therapy Improved Post-stroke Motor Functions of the Upper Extremity: A Randomized Controlled Pilot Study

“…The sEMG signals were recorded through disposable AgCl electrodes by the 8-channel wireless sEMG system (Myo MUSCLE, Noraxon, USA Inc., Scottsdale, AZ, United States) (Mackala et al, 2013;Kim et al, 2014). The electrodes were placed on the affected biceps and the triceps.…”

“…The proposed theory on RAS's therapeutic effects include the regulation of spatiotemporal and force parameters with specification of the dynamics of a movement and reduction Abbreviations: ADL, activities of daily living; BI, Barthel Index; CID, clinical important difference; FMA-UE, Fugl-Meyer Assessment-Upper Extremity; MMSE, Mini-Mental State Examination; RAS, rhythmic auditory stimulation; RMS, root mean square; RS, reticulospinal; sEMG, surface electromyography; WMFT, Wolf Motor Function Test. of variability via the rhythmic cues, thus achieving the optimal movement pattern with repetitive exercise (Thaut et al, 2002;Thaut et al, 2009;Kim et al, 2014). Also, the rhythmic auditory cues may help with motor priming, facilitate movement anticipation and preparation, and potentially bypass damaged areas through the activation of alternative pathways (Yoo and Kim, 2016).…”

The Effects of Therapeutic Listening on Bilateral Coordination

“…Results displayed that reaching significantly improved more in the RAS group. The researchers documented that the RAS participants scored a shorter movement time, reduced change in acceleration, increased elbow extension range of motion, exhibited more muscle activation of the triceps, and reduced co-contraction ratio of affected arm (Kim et al, 2014). In short, the RAS group demonstrated more efficient reaches than the control group.…”

“…In another context, a study found that rhythmic sound enhanced upper extremity reaching in clients with hemiplegia (Kim et al, 2014). Researchers stated that rhythmic auditory stimulation (RAS) activates the cerebral cortex, basal ganglia, and cerebellum, and travels through the autonomic nervous system through the brainstem and spinal cord (Kim et al, 2014). Consequently, muscles activate and coordinate as the body syncs with the auditory rhythm.…”