Differential effects of rhythmic auditory stimulation and neurodevelopmental treatment/Bobath on gait patterns in adults with cerebral palsy: a randomized controlled trial.
OBJECTIVE
To investigate the effects of rhythmic auditory stimulation (RAS) on gait patterns in comparison with changes after neurodevelopmental treatment (NDT/Bobath) in adults with cerebral palsy.


METHODS
A repeated-measures analysis between the pretreatment and posttreatment tests and a comparison study between groups.


METHODS
Human gait analysis laboratory.


METHODS
Twenty-eight cerebral palsy patients with bilateral spasticity participated in this study. The subjects were randomly allocated to either neurodevelopmental treatment (n = 13) or rhythmic auditory stimulation (n = 15).


METHODS
Gait training with rhythmic auditory stimulation or neurodevelopmental treatment was performed three sessions per week for three weeks. Temporal and kinematic data were analysed before and after the intervention. Rhythmic auditory stimulation was provided using a combination of a metronome beat set to the individual's cadence and rhythmic cueing from a live keyboard, while neurodevelopmental treatment was implemented following the traditional method.


METHODS
Temporal data, kinematic parameters and gait deviation index as a measure of overall gait pathology were assessed.


RESULTS
Temporal gait measures revealed that rhythmic auditory stimulation significantly increased cadence, walking velocity, stride length, and step length (P < 0.05). Kinematic data demonstrated that anterior tilt of the pelvis and hip flexion during a gait cycle was significantly ameliorated after rhythmic auditory stimulation (P < 0.05). Gait deviation index also showed modest improvement in cerebral palsy patients treated with rhythmic auditory stimulation (P < 0.05). However, neurodevelopmental treatment showed that internal and external rotations of hip joints were significantly improved, whereas rhythmic auditory stimulation showed aggravated maximal internal rotation in the transverse plane (P < 0.05).


CONCLUSIONS
Gait training with rhythmic auditory stimulation or neurodevelopmental treatment elicited differential effects on gait patterns in adults with cerebral palsy.
Department of Music Therapy, Ewha Music and Rehabilitation Center, Ewha Womans University, Korea.
Soo Ji
SJ
Kim
Eunmi E
EE
Kwak
Eun Sook
ES
Park
Sung-Rae
SR
Cho
D000161:Acoustic Stimulation / Q000379:methods*; D000328:Adult; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome