Department of Music Therapy, Ewha Music and Rehabilitation Center, Ewha Womans University, Korea.
Clin Rehabil. 2012 Oct;26(10):904-14. doi: 10.1177/0269215511434648. Epub 2012 Feb 3.
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.
A repeated-measures analysis between the pretreatment and posttreatment tests and a comparison study between groups.
Human gait analysis laboratory.
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).
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.
Temporal data, kinematic parameters and gait deviation index as a measure of overall gait pathology were assessed.
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).
Gait training with rhythmic auditory stimulation or neurodevelopmental treatment elicited differential effects on gait patterns in adults with cerebral palsy.
研究节律性听觉刺激（RAS）对成年人脑瘫步态模式的影响，并与神经发育治疗（NDT/Bobath）后的变化进行比较。
治疗前后测试的重复测量分析和组间比较研究。
人体步态分析实验室。
28 名双侧痉挛性脑瘫患者参加了本研究。受试者被随机分配到神经发育治疗组（n=13）或节律性听觉刺激组（n=15）。
每周进行 3 次节律性听觉刺激或神经发育治疗，共 3 周。在干预前后分析了时间和运动学数据。节律性听觉刺激采用个人步频的节拍器节拍与来自现场键盘的节奏提示相结合的方式提供，而神经发育治疗则按照传统方法进行。
评估时间数据、运动学参数和步态偏差指数作为整体步态病理的衡量标准。
时间步态测量结果表明，节律性听觉刺激显著增加了步频、步行速度、步长和跨步长（P<0.05）。运动学数据显示，节律性听觉刺激后骨盆前倾斜和髋关节在步态周期中的屈曲明显改善（P<0.05）。步态偏差指数也显示节律性听觉刺激治疗的脑瘫患者有适度改善（P<0.05）。然而，神经发育治疗显示髋关节的内旋和外旋明显改善，而节律性听觉刺激显示在横平面上的最大内旋加剧（P<0.05）。
节律性听觉刺激或神经发育治疗对脑瘫成年人的步态模式产生了不同的影响。
