Title | A Music-Based Digital Therapeutic: Proof-of-Concept Automation of a Progressive and Individualized Rhythm-Based Walking Training Program After Stroke. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Hutchinson K, Sloutsky R, Collimore A, Adams B, Harris B, Ellis TD, Awad LN |
Journal | Neurorehabil Neural Repair |
Volume | 34 |
Issue | 11 |
Pagination | 986-996 |
Date Published | 2020 Nov |
ISSN | 1552-6844 |
Keywords | Adult, Aged, Female, Humans, Male, Middle Aged, Music Therapy, Physical Therapy Modalities, Stroke Rehabilitation, Treatment Outcome, Walking, Walking Speed, Wearable Electronic Devices |
Abstract | BACKGROUND: The rhythm of music can entrain neurons in motor cortex by way of direct connections between auditory and motor brain regions. OBJECTIVE: We sought to automate an individualized and progressive music-based, walking rehabilitation program using real-time sensor data in combination with decision algorithms. METHODS: A music-based digital therapeutic was developed to maintain high sound quality while modulating, in real-time, the tempo (ie, beats per minute, or bpm) of music based on a user's ability to entrain to the tempo and progress to faster walking cadences in-sync with the progression of the tempo. Eleven individuals with chronic hemiparesis completed one automated 30-minute training visit. Seven returned for 2 additional visits. Safety, feasibility, and rehabilitative potential (ie, changes in walking speed relative to clinically meaningful change scores) were evaluated. RESULTS: A single, fully automated training visit resulted in increased usual (∆ 0.085 ± 0.027 m/s, = .011) and fast (∆ 0.093 ± 0.032 m/s, = .016) walking speeds. The 7 participants who completed additional training visits increased their usual walking speed by 0.12 ± 0.03 m/s after only 3 days of training. Changes in walking speed were highly related to changes in walking cadence ( > 0.70). No trips or falls were noted during training, all users reported that the device helped them walk faster, and 70% indicated that they would use it most or all of the time at home. CONCLUSIONS: In this proof-of-concept study, we show that a sensor-automated, progressive, and individualized rhythmic locomotor training program can be implemented safely and effectively to train walking speed after stroke. Music-based digital therapeutics have the potential to facilitate salient, community-based rehabilitation. |
DOI | 10.1177/1545968320961114 |
Alternate Journal | Neurorehabil Neural Repair |
PubMed ID | 33040685 |
Grant List | KL2 TR001411 / TR / NCATS NIH HHS / United States |