Prolonged walking to beats in music and metronomes with and without assistive adaptations in persons with progressive MS

Abstract

Introduction

Acoustic rhythms are frequently employed in gait rehabilitation for individuals with neurological conditions, more specifically in persons with MS (PwMS), leading to both immediate and sustained improvements in various aspects of gait. Research showed that the use of an adaptive music player, to optimize synchronization, by aligning beats by manipulating the timing difference between beats and footfalls, has been shown to provide additional benefits to gait in other neurological disorders. This work expands this to progressive MS, characterized by higher disability, investigating the effect of an adaptive music player on prolonged walking.

Methods

Participants walked to beats in music and metronomes with and without assistive adaptations, aligning the beats with the footfall, in order to maintain synchronization, at preferred walking cadence for eight minutes while synchronization (Resultant Vector Length; RVL), spatiotemporal gait parameters and gait dynamics (fractal scaling exponent using Detrended Fluctuation Analysis) were measured.

Results

17 HCs (median Speed=1.13m/s) and 20 PwPMS (median EDSS=4, median Speed=0.85m/s) were included in the study. Higher synchronization consistency was seen a) in the first minute compared to all minutes in all participation, and b) between groups, higher for HCs compared to PwPMS, c) between stimuli, higher for metronome compared to music and d) higher for adaptive compared to non-adaptive conditions. Compared to walking in silence, gait speed was lower for adaptive-metronome (mean=-4.08) compared to non-adaptive-metronome (mean=-1.83) (t=-3.11, p=0.011). Overall, the fractal scaling component was higher in the adaptive compared to the non-adaptive conditions (F(1,103)=22.60, p<0.001), as well as when walking to music compared to metronome (F(1,103)=9.96, p<0.01).

Conclusion

PwPMS were able to synchronize their steps to beats in music and metronomes during eight minutes of walking with higher synchronization consistency for adaptive conditions. Gait speed was significantly lower when walking with assistive adaptions compared to a steady rhythm and adaptive conditions increased the fractal scaling component.