Rhythmic auditory-motor entrainment improves hemiparetic arm kinematics during reaching movements: a pilot study.
OBJECTIVE
Recovery of skilled upper limb movement remains a critical focus of rehabilitation in individuals post stroke. Conventional treatments, however, have demonstrated limited capability to produce substantial improvements in poststroke quality of movement. Recently, rhythmic auditory stimulation (RAS) has emerged as efficacious in improving and normalizing limb movements in neurologically impaired populations. This pilot study examined changes in pre- to post-RAS reach kinematics and functional outcomes in survivors of stroke.


METHODS
Five individuals in the chronic poststroke phase participated in a 2-week program of RAS training. Kinematic reaching variables were trunk, shoulder, and elbow segment contribution; movement time; and reach velocity. Functional outcomes were the Wolf Motor Function Test, Motor Activity Log, and Fugl-Meyer Assessment.


RESULTS
Post-RAS assessment of reaching kinematics revealed a significant (p < .05) decrease in compensatory trunk movement, increase in shoulder flexion, and a slight increase in elbow extension. Movement time and velocity significantly improved post RAS. Significant gains were observed on all functional assessments.


CONCLUSIONS
Post RAS, participants demonstrated substantial decreases in compensatory reaching movements. These changes in motor control strategy were paralleled by gains in functional abilities, suggesting that reduced reliance on compensatory movements may translate to improved performance of daily activities.
Malcolm
Matthew P
MP
Department of Occupational Therapy, NeuroRehabilitation Research Laboratory, Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, Colorado, USA.
Massie
Crystal
C
Thaut
Michael
M
D000161:Acoustic Stimulation; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000502:physiology*; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D006801:Humans; D008297:Male; D009043:Motor Activity; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation