Rhythmic Sensory Stimulation on Gait in Patients With Chronic Stroke

Abstract

Background: Patients with stroke suffer from impaired locomotion which exhibit unstable walking with increased gait variability. Rhythmic sensory stimulation is one approach for improving the gait of persons with stroke, Parkinson’s disease, or the elderly. However, the effects of this approach on the gait of patients with chronic stroke are unclear. This study was conducted to identify the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Methods: Twenty 20 older adults with stroke (mean age ± SD, 72.10 ± 7.15 years; female/male, 8/12) and twenty age- and gender-matched healthy controls (mean age ± SD, 72.65 ± 6.93 years; female/male, 8/12) walked 60 m under four conditions: (1) normal walking with no stimulation, (2) walking with rhythmic auditory stimulation (RAS), (3) walking with rhythmic somatosensory stimulation (RSS), and (4) walking with rhythmic combined stimulation (RCS: RAS + RSS). RAS was applied through an earphone in the ear of each participant, while RSS was applied through a haptic device on the wrist of the participant. RCS was applied simultaneously via an earphone and haptic device. The gait performance (i.e., mean gait speed, stride length, gait cycle, cadence, stance ratio, swing ratio, and double support ratio) and gait variability (i.e., coefficient of variation (CV) value of stride length, gait cycle, stance ratio, swing ratio, and double support ratio) were evaluated. Results: Gait performance in the stroke group was significantly improved in walking with RAS, RSS, and RCS compared to normal walking with no stimulation (P < 0.008). Gait variability was significantly decreased in the RAS, RSS, and RCS conditions compared to that during normal walking (P < 0.008). The gait performance and variability in the healthy control group were not significantly different under the RAS, RSS, or RCS conditions compared to those under normal walking (P > 0.008). Conclusions: Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. Trial registration: This study was approved by the Bioethics Committee (IRB-2019-04-003-001), and all participants provided written informed consent.