Department of Therapy, Takarazuka Rehabilitation Hospital, Medical Corporation SHOWAKAI, 22-2 tsuru-no-so, Takarazuka-shi, Hyogo 665-0833, Japan.
Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, 26-2 Higashihaemi-cho, Handa, Aichi 475-0012, Japan; Neurorehabilitation Research Center, Kio University, 4-2-2 Umaminaka, Koryo, Kitakatsuragi-gun, Nara 635-0832, Japan.
Hum Mov Sci. 2022 Oct;85:102995. doi: 10.1016/j.humov.2022.102995. Epub 2022 Sep 7.
Temporal gait variability is strongly associated with motor function and falls in the context of numerous diseases. Rhythmic auditory cueing (RAC) can influence stride-to-stride time, although its effects on temporal gait variability remain unclear. Therefore, the aim of the present cross-disease study was to examine the effects of RAC on stride time variability (STV), as well as the factors affecting changes in STV during walking with RAC. Participants with post-stroke (n = 12) and orthopedic disease (n = 23) performed a random block design under four conditions: comfortable walking speed (CWS) and walking with RAC (RAC 0%, RAC +10%, RAC -10%). STV was measured along with co-contraction and inter-muscular coherence of the shank muscles during walking for each condition. The contributions of the muscle activity pattern and voluntary control to the change in STV between the CWS and RAC 0% conditions were examined using hierarchical multiple regression analysis. STV was significantly lower in the RAC 0% condition than in the CWS condition (p = 0.03). Hierarchical multiple regression analysis revealed that the change in STV was explained by STV in the CWS condition (β = -0.36) and by changes in co-contraction (β = 0.43) and inter-muscular coherence (β = 0.38) during the stance phase between the CWS and RAC 0% conditions (R = 0.56, p < 0.001). These findings indicate that walking training with RAC is effective in reducing gait variability and immediately improves muscle activity patterns and excessive corticospinal activity.
时间步态变异性与多种疾病中的运动功能和跌倒密切相关。节奏性听觉提示（RAC）可以影响步长时间，但它对时间步态变异性的影响尚不清楚。因此，本跨疾病研究旨在研究 RAC 对步长时间变异性（STV）的影响，以及在有 RAC 辅助行走时影响 STV 变化的因素。脑卒中后（n=12）和骨科疾病（n=23）患者在 4 种条件下进行随机块设计：舒适步行速度（CWS）和 RAC 辅助行走（RAC 0%、RAC +10%、RAC -10%）。在每种条件下行走时，测量 STV 以及小腿肌肉的共收缩和肌肉间相干性。使用层次多重回归分析检查肌肉活动模式和自愿控制对 CWS 和 RAC 0%条件之间 STV 变化的贡献。与 CWS 条件相比，RAC 0%条件下的 STV 显著降低（p=0.03）。层次多重回归分析表明，STV 的变化可以通过 CWS 条件下的 STV（β=-0.36）以及 CWS 和 RAC 0%条件之间站立阶段的共收缩（β=0.43）和肌肉间相干性（β=0.38）的变化来解释（R=0.56，p<0.001）。这些发现表明，带有 RAC 的步行训练可有效降低步态变异性，并立即改善肌肉活动模式和过度皮质脊髓活动。
