Neurorehabilitation Department, Hospital Sociosanitari Mutuam Girona, 17007 Girona, Spain.
Health and Health Care Research Group, University of Girona, 17003 Girona, Spain.
Int J Environ Res Public Health. 2021 Feb 19;18(4):2032. doi: 10.3390/ijerph18042032.
Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 ( = 27) were assigned as the historical control group whereas 2019 patients ( = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement ( = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains.
步态和平衡障碍在中风后很常见。本研究旨在评估基于音乐的节奏听觉刺激（RAS）与常规物理治疗相结合对亚急性中风患者步态参数和行走能力的影响。这是一项单盲、历史对照试验，纳入了 55 名在入组前 3 周内发生中风的患者。2018 年的患者（n = 27）被分配为历史对照组，而 2019 年的患者（n = 28）接受每周三次基于音乐的 RAS。两组患者在住院期间每周接受 11 小时的常规物理治疗。主要结局为步态和平衡参数（Tinetti 测试和计时起立行走测试）和行走能力（功能性步行分类量表）。次要结局为躯干控制、辅助器具、功能独立性（功能独立性测量量表、巴氏指数）以及中风严重程度和残疾（改良 Rankin 量表、国立卫生研究院中风量表）。结果：在步态和平衡参数以及次要结局方面，两组之间没有差异。功能性步行分类量表显示，干预组（Δmean ± SD；3.43 ± 1.17）的改善程度显著大于对照组（Δmean ± SD；2.48 ± 1.09）（ = 0.002）。与单独常规物理治疗相比，我们的结果表明，基于音乐的 RAS 联合常规物理治疗可能会改善亚急性中风患者的行走能力，但这种治疗在获得步态和平衡改善方面并不优于常规物理治疗。
