Advertisement

Rhythm Perception and Production Abilities and Their Relationship to Gait After Stroke

Published:February 07, 2018DOI:https://doi.org/10.1016/j.apmr.2018.01.009

      Abstract

      Objectives

      To assess rhythm abilities, to describe their relation to clinical presentation, and to determine if rhythm production independently contributes to temporal gait asymmetry (TGA) poststroke.

      Design

      Cross-sectional.

      Setting

      Large urban rehabilitation hospital and university.

      Participants

      Individuals (N=60) with subacute and chronic stroke (n=39) and data for healthy adults extracted from a preexisting database (n=21).

      Interventions

      Not applicable.

      Main Outcome Measures

      Stroke group: National Institutes of Health Stroke Scale (NIHSS), Chedoke-McMaster Stroke Assessment (CMSA) leg and foot scales, Montreal Cognitive Assessment (MoCA), rhythm perception and production (Beat Alignment Test [BAT]), and spatiotemporal gait parameters were assessed. TGA was quantified with the swing time symmetry ratio. Healthy group: age and beat perception scores assessed by the BAT. Rhythm perception of the stroke group and healthy adults was compared with analysis of variance. Spearman correlations quantified the relation between rhythm perception and production abilities and clinical measures. Multiple linear regression assessed the contribution of rhythm production along with motor impairment and time poststroke to TGA.

      Results

      Rhythm perception in the stroke group was worse than healthy adults (F1,56=17.5, P=.0001) Within the stroke group, rhythm perception was significantly correlated with CMSA leg (Spearman ρ=.33, P=.04), and foot (Spearman ρ=.49, P=.002) scores but not NIHSS or MoCA scores. The model for TGA was significant (F3,35=12.8, P<.0001) with CMSA leg scores, time poststroke, and asynchrony of rhythm production explaining 52% of the variance.

      Conclusions

      Rhythm perception is impaired after stroke, and temporal gait asymmetry relates to impairments in producing rhythmic movement. These results may have implications for the use of auditory rhythmic stimuli to cue motor responses poststroke. Future work will explore brain responses to rhythm processing poststroke.

      Keywords

      List of abbreviations:

      ANOVA (analysis of variance), BAT (Beat Alignment Test), CMSA (Chedoke-McMaster Stroke Assessment), MoCA (Montreal Cognitive Assessment), NIHSS (National Institutes of Health Stroke Scale), RAS (rhythmic auditory stimulation), TGA (temporal gait asymmetry)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Grahn J.A.
        • Brett M.
        Rhythm and beat perception in motor areas of the brain.
        J Cogn Neurosci. 2007; 19: 893-906
        • Mullensiefen D.
        • Gingras B.
        • Musil J.
        • Stewart L.
        The musicality of non-musicians: an index for assessing musical sophistication in the general population.
        PLoS One. 2014; 9: e89642
        • Thaut M.H.
        • McIntosh G.C.
        • Rice R.R.
        Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation.
        J Neurol Sci. 1997; 151: 207-212
        • Thaut M.H.
        • Abiru M.
        Rhythmic auditory stimulation in rehabilitation of movement disorders: a review of current research.
        Music Perception: An Interdisciplinary Journal. 2010; 27: 263-269
        • Chen J.L.
        • Zatorre R.J.
        • Penhune V.B.
        Interactions between auditory and dorsal premotor cortex during synchronization to musical rhythms.
        Neuroimage. 2006; 32: 1771-1781
        • Zatorre R.J.
        • Chen J.L.
        • Penhune V.B.
        When the brain plays music: auditory-motor interactions in music perception and production.
        Nat Rev Neurosci. 2007; 8: 547-558
        • Chen J.L.
        • Penhune V.B.
        • Zatorre R.J.
        Moving on time: brain network for auditory-motor synchronization is modulated by rhythm complexity and musical training.
        J Cogn Neurosci. 2008; 20: 226-239
        • Grahn J.A.
        • Rowe J.B.
        Feeling the beat: premotor and striatal interactions in musicians and nonmusicians during beat perception.
        J Neurosci. 2009; 29: 7540-7548
        • Yoo G.E.
        • Kim S.J.
        Rhythmic auditory cueing in motor rehabilitation for stroke patients: systematic review and meta-analysis.
        J Music Ther. 2016; 53: 149-177
        • Shin Y.K.
        • Chong H.J.
        • Kim S.J.
        • Cho S.R.
        Effect of rhythmic auditory stimulation on hemiplegic gait patterns.
        Yonsei Med J. 2015; 56: 1703-1713
        • Thaut M.H.
        • Leins A.K.
        • Rice R.R.
        • et al.
        Rhythmic auditory stimulation improves gait more than NDT/Bobath training in near-ambulatory patients early poststroke: a single-blind randomized trial.
        Neurorehabil Neural Repair. 2007; 21: 455-459
        • Bowden M.G.
        • Behrman A.L.
        • Neptune R.R.
        • Gregory C.M.
        • Kautz S.A.
        Locomotor rehabilitation of individuals with chronic stroke: difference between responders and nonresponders.
        Arch Phys Med Rehabil. 2013; 94: 856-862
        • Mulroy S.J.
        • Klassen T.
        • Gronley J.K.
        • Eberly V.J.
        • Brown D.A.
        • Sullivan K.J.
        Gait parameters associated with responsiveness to treadmill training with body-weight support after stroke: an exploratory study.
        Phys Ther. 2010; 90: 209-223
        • McIntosh G.C.
        • Brown S.H.
        • Rice R.R.
        • Thaut M.H.
        Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson's disease.
        J Neurol Neurosurg Psychiatry. 1997; 62: 22-26
        • Grahn J.A.
        • McAuley J.D.
        Neural bases of individual differences in beat perception.
        Neuroimage. 2009; 47: 1894-1903
        • Leow L.A.
        • Parrott T.
        • Grahn J.A.
        Individual differences in beat perception affect gait responses to low-and high-groove music.
        Front Hum Neurosci. 2014; 8: 811
        • Patterson K.K.
        • Parafianowicz I.
        • Danells C.J.
        • et al.
        Gait asymmetry in community-ambulating stroke survivors.
        Arch Phys Med Rehabil. 2008; 89: 304-310
        • Patterson K.K.
        • Gage W.H.
        • Brooks D.
        • Black S.E.
        • McIlroy W.E.
        Evaluation of gait symmetry after stroke: a comparison of current methods and recommendations for standardization.
        Gait Posture. 2010; 31: 241-246
        • Patterson K.K.
        • Mansfield A.
        • Biasin L.
        • Brunton K.
        • Inness E.L.
        • McIlroy W.E.
        Longitudinal changes in post-stroke spatiotemporal gait asymmetry over inpatient rehabilitation.
        Neurorehabil Neural Repair. 2015; 29: 153-162
        • Teasell R.W.
        • Bhogal S.K.
        • Foley N.C.
        • Speechley M.R.
        Gait retraining post stroke.
        Top Stroke Rehabil. 2003; 10: 34-65
        • Lewek M.D.
        • Bradley C.E.
        • Wutzke C.J.
        • Zinder S.M.
        The relationship between spatiotemporal gait asymmetry and balance in individuals with chronic stroke.
        J Appl Biomech. 2013; 30: 31-36
        • Jorgensen L.
        • Crabtree N.J.
        • Reeve J.
        • Jacobsen B.K.
        Ambulatory level and asymmetrical weight bearing after stroke affects bone loss in the upper and lower part of the femoral neck differently: bone adaptation after decreased mechanical loading.
        Bone. 2000; 27: 701-707
        • Ellis R.G.
        • Howard K.C.
        • Kram R.
        The metabolic and mechanical costs of step time asymmetry in walking.
        Proc Biol Sci. 2013; 280: 20122784
        • Patterson S.L.
        • Rodgers M.M.
        • Macko R.F.
        • Forrester L.W.
        Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke: a preliminary report.
        J Rehabil Res Dev. 2008; 45: 221-228
        • Prajapati S.K.
        • Gage W.H.
        • Brooks D.
        • Black S.E.
        • McIlroy W.E.
        A novel approach to ambulatory monitoring: investigation into the quantity and control of everyday walking in patients with subacute stroke.
        Neurorehabil Neural Repair. 2011; 25: 6-14
        • Turnbull G.I.
        • Wall J.C.
        Long-term changes in hemiplegic gait.
        Gait Posture. 1995; 3: 258-261
        • Patterson K.K.
        • Gage W.H.
        • Brooks D.
        • Black S.E.
        • McIlroy W.E.
        Changes in gait symmetry and velocity after stroke: a cross-sectional study from weeks to years after stroke.
        Neurorehabil Neural Repair. 2010; 24: 783-790
        • Alexander L.D.
        • Black S.E.
        • Patterson K.K.
        • Gao F.
        • Danells C.J.
        • McIlroy W.E.
        Association between gait asymmetry and brain lesion location in stroke patients.
        Stroke. 2009; 40: 537-544
        • Fries W.
        • Swihart A.A.
        Disturbance of rhythm sense following right hemisphere damage.
        Neuropsychologia. 1990; 28: 1317-1323
        • Cameron D.J.
        • Pickett K.A.
        • Earhart G.M.
        • Grahn J.A.
        The effect of dopaminergic medication on beat-based auditory timing in Parkinson's disease.
        Front Neurol. 2016; 7: 19
        • Brott T.
        • Adams Jr., H.P.
        • Olinger C.P.
        • et al.
        Measurements of acute cerebral infarction: a clinical examination scale.
        Stroke. 1989; 20: 864-870
        • Gowland C.
        • VanHullenaar S.
        • Torresin W.
        Chedoke-McMaster Stroke Assessment: development, validation and administration manual.
        McMaster University, Hamilton1995
        • Nasreddine Z.S.
        • Phillips N.A.
        • Bedirian V.
        • et al.
        The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.
        J Am Geriatr Soc. 2005; 53: 695-699
        • Wong J.S.
        • Jasani H.
        • Poon V.
        • Inness E.L.
        • McIlroy W.E.
        • Mansfield A.
        Inter-and intra-rater reliability of the GAITRite system among individuals with sub-acute stroke.
        Gait Posture. 2014; 40: 259-261
        • Shaw R.G.
        • Mitchell-Olds T.
        ANOVA for unbalanced data: an overview.
        Ecology. 1993; 74: 1638-1645
        • McDonald J.H.
        Handbook of biological statistics. Vol 2. Sparky House Publishing, Baltimore2009
        • Grahn J.A.
        • Schuit D.
        Individual differences in rhythmic ability: behavioral and neuroimaging investigations.
        Psychomusicology: Music, Mind, and Brain. 2012; 22: 105-121
        • Cameron D.J.
        • Grahn J.A.
        Enhanced timing abilities in percussionists generalize to rhythms without a musical beat.
        Front Hum Neurosci. 2014; 8: 1003
        • Sowiński J.
        • Dalla Bella S.
        Poor synchronization to the beat may result from deficient auditory-motor mapping.
        Neuropsychologia. 2013; 51: 1952-1963
        • Nombela C.
        • Hughes L.E.
        • Owen A.M.
        • Grahn J.A.
        Into the groove: can rhythm influence Parkinson's disease?.
        Neurosci Biobehav Rev. 2013; 37: 2564-2570
        • Patterson K.K.
        • Nadkarni N.K.
        • Black S.E.
        • McIlroy W.E.
        Gait symmetry and velocity differ in their relationship to age.
        Gait Posture. 2012; 35: 590-594