Sonification for Personalised Gait Intervention

Abstract

Mobility challenges threaten physical independence and good quality of life. Often, mobility can be improved through gait rehabilitation and specifically the use of cueing through prescribed auditory, visual, and/or tactile cues. Each has shown use to rectify abnormal gait patterns, improving mobility. Yet, a limitation remains, i.e., long-term engagement with cueing modalities. A paradigm shift towards personalised cueing approaches, considering an individual’s unique physiological condition, may bring a contemporary approach to ensure longitudinal and continuous engagement. Sonification could be a useful auditory cueing technique when integrated within personalised approaches to gait rehabilitation systems. Previously, sonification demonstrated encouraging results, notably in reducing freezing-of-gait, mitigating spatial variability, and bolstering gait consistency in people with Parkinson’s disease (PD). Specifically, sonification through the manipulation of acoustic features paired with the application of advanced audio processing techniques (e.g., time-stretching) enable auditory cueing interventions to be tailored and enhanced. These methods used in conjunction optimize gait characteristics and subsequently improve mobility, enhancing the effectiveness of the intervention. The aim of this narrative review is to further understand and unlock the potential of sonification as a pivotal tool in auditory cueing for gait rehabilitation, while highlighting that continued clinical research is needed to ensure comfort and desirability of use.

Concurrent Supra-Postural Auditory–Hand Coordination Task Affects Postural Control: Using Sonification to Explore Environmental Unpredictability in Factors Affecting Fall Risk

“…Several applications use sonification of biomechanical variables, whereby real-time biofeedback as to, for instance, the angle of a joint, is given through sound. Examples include sonified feedback for postural stabilization during challenged standing [ 42 ], knee-angle feedback during walking [ 43 ], gait improvement in Parkinson’s disease [ 44 ], and sensory substitution for visual impairment [ 45 , 46 ]. From the present results, we can add that sonifying movements not only holds promise as a form of real-time biofeedback, but also holds promise for investigating how multi-tasking affects the cognitive and motor resources needed for safe real-world mobility.…”

A Wearable Sonification System to Improve Movement Awareness: A Feasibility Study

“…Auditory feedback in wearable technology, especially in the form of sonification, has demonstrated its potential to enhance motor coordination and gait rehabilitation [17,[30][31][32]. Sonification signals generated according to different types and magnitudes of body motions can provide crucial feedback, especially during a gait cycle and other time-related activities, to assist a person in the perception of their movements [34,35].…”

“…An increasing number of commercially available low-cost, off-the-shelf devices and open-source software have created opportunities for manufacturers, designers, engineers, technologists, and researchers to design and develop devices that can be worn and enhance interactions between them and their users. When deployed in motion-aware applications, these wearables can improve awareness of the limb's position, movement, and gait activities [5,[14][15][16][17]. Wearable technologies for accurate gait event detection have come in many different forms, such as inertial measurement units (IMUs) [5,[17][18][19][20] with embedded sensors, including accelerometers [21][22][23][24][25] and gyroscopes [26][27][28].…”

“…When deployed in motion-aware applications, these wearables can improve awareness of the limb's position, movement, and gait activities [5,[14][15][16][17]. Wearable technologies for accurate gait event detection have come in many different forms, such as inertial measurement units (IMUs) [5,[17][18][19][20] with embedded sensors, including accelerometers [21][22][23][24][25] and gyroscopes [26][27][28].…”

“…Sonification is a process of using non-speech audio to convey information to users [29]. The application of sonification in gait and rehabilitation is a growing area of interest [17,[30][31][32][33]. It involves translating gait characteristics captured by wearable technology into auditory feedback, aiding in establishing rhythmic and harmonious gait or movement patterns.…”