Background: Stroke patients show abnormal walking patterns due to brain injury. In order to have the desired walking pattern, appropriate stimulation is required to activate the central pattern generator. For this reason, our study performed treadmill ambulatory training with rhythmic auditory stimulation. However we did not consider the influence of visual feedback. Objects: The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation and visual feedback (TRASVF) or treadmill walking training with rhythmic auditory stimulation (TRAS) alone. Methods: Twenty-one stroke patients were divided into two groups: A TRASVF group (10 subjects) and a TRAS group (11 subjects). They received 30 minutes of neuro-developmental therapy (NDT) and walking training for 30 minutes, five times a week for three weeks. Temporal and spatial gait parameters were measured before and after the training period. The Biodex gait trainer treadmill system measured gait parameters. Results: After the training periods, the TRASVF group showed a significant improvement in walking speed, the step length of the affected limb, and time on each foot of the affected limb when compared to the TRAS group (p<.05). Conclusion: The results of this study showed that the treadmill walking training with rhythmic auditory stimulation and visual feedback improved individual gait ability more than the treadmill walking training with rhythmic auditory stimulation alone. Therefore, visual feedback should be considered along with rhythmic auditory stimulation training.

This study aimed to determine the effects of Rhythmic Auditory Stimulation (RAS) using music and a metronome on the gait of stroke patients. 13 female and 15 male volunteers were randomly allocated to two groups: namely a group to receive RAS using music and a metronome group (the experimental group; n1=14) and a group to receive RAS using a metronome only (the control group; n2=14). The affected side was the left side in 15 subjects and the right side in 13 subjects. The mean age of the subjects was 56.6 years, and the mean onset duration of stroke was 8.6 months. Intervention was applied for 30 minutes per session, once a day, 5 times a week for 4 weeks. To measure the patients’ gait improvement, we measured gait velocity, cadence, stride length, double limb support using GAITRite, body center sway angle using an accelerometer, and Timed Up-and-Go test. Functional Gait Assessment were conducted before and after the experiment. The paired t-test was used for comparisons before and after the interventions in each group. Analysis of covariance was used for comparisons between the groups after the interventions. Statistical significance was set at α=.05. Within each of the two groups, significant differences in all of the dependent variables before and after the experiment (p<.05) were observed. However, in the comparison between the two groups, the experimental group showed more significant improvements in all dependent variables than the control group (p<.05). Our results also suggest that in applying RAS in stroke patients, the combination of music and a metronome is more effective than using a metronome alone in improving patients’ gait.

본 연구는 평균 10년 경력의 무용전공 여자 대학생 33명과 일반 여자 대학생 33명을 대상으로 시각 및 청각적 자극에 따른 이미지 상상 동안의 뇌 영역별 뇌파 활성도와 기분상태를 알아보고자 하였다. 뇌파 측정은 총 4차례에 걸쳐 각각 5분간씩 기록하였다. 1차 측정은 자극제시 전 안정시, 2차는 시청각적인 무용 동영상 감상 동안, 3차는 청각적인 음악 감상 및 이미지 상상 동안, 4차는 자극이 끝난 안정시에 각각 측정하였다. 측정 부위는 10/20 국제 전극배치법에 의해 차례로 Fp1, Fp2, F3, F4, C3, C4, P3, P4 위치에 전극을 부착하였고, 각 채널별 상대파워를 구하였다. 분석결과, 각 주파수 영역별 상대파워는 쎄타파에서만 집단간 유의한 차이를 보였다. 기분상태 검사는 총 4차례의 뇌파측정 전과 후의 기분상태를 알아보기 위해 한국어판 기분상태 질문지(K-POMS)를 사용하였다. 쎄타파 상대파워의 반복측정 이원분산분석 결과, 8채널 모두에서 집단간 유의한 차이를 보였다. 특히, 8채널에 대한 집단별 평균값에 있어서 무용수 집단은 총 4차례의 실시간 뇌파 변화에서 일관성 있는 쎄타파의 증가를 보였다. 그러나 일반집단에서는 무용집단처럼 일관적이지 않고 쎄타파의 증가도 미미하게 나타났다. 기분상태의 하위 요인에 대한 반복측정 이원분산분석 결과, 긴장, 우울, 혼란에서 집단간 유의한 차이를 보였다. 집단별 평균값을 비교해 볼 때, 자극제시 전 안정시에 무용집단이 일반집단에 비해 부정적 정서가 낮은 값을 나타내 평소의 정신건강 상태가 안정적임을 보여주었다. 그러나 자극제시 후에는 두 집단 모두 유사한 부정적 정서의 감소를 보였다.