Step to the beat: Auditory-motor coupling during walking to higher and lower tempi with music and metronomes in progressive multiple sclerosis: An observational study

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-11-01 DOI:10.1016/j.msard.2024.106152

Nele Vanbilsen , Lousin Moumdjian , Fenne Kinnaert , Birte Degens , Bart Moens , Mieke Goetschalckx , Daphne Kos , Bart Van Wijmeersch , Marc Leman , Peter Feys

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引用次数: 0

Abstract

Background

Many persons with multiple sclerosis (MS) are confronted with fatigue and difficulties with walking and even more so in persons with progressive subtypes of MS. Task-oriented training, and more specifically in the form of auditory-motor coupling, where persons are asked to synchronise their steps to beats in music and metronomes, is promising. However, it is currently not known whether persons with progressive MS (PwPMS) can synchronise their steps to beats in music and metronomes and if they can adapt their gait to slower and higher tempi.

Methods

The study is a case control study where participants with progressive MS (PwPMS) and healthy controls (HCs) were asked to synchronise their steps during overground walking to beats in music and metronomes at five different tempi, ranging from slow (-8%, -4%), baseline (0%) and high (4%, 8%) while synchronisation, spatiotemporal parameters and gait dynamics were recorded. Mixed model analyses were performed on synchronisation outcome measures and spatiotemporal gait parameters. Additionally, a regression analysis was performed to identify clinical factors such as cognition and motor function influencing synchronisation consistency.

Results

In total, 18 PwPMS (mean age = 52.4, median EDSS = 4.24) and 16 healthy controls (HCs) (mean age = 56.5) were included in the study. Results show that both groups were able to synchronise their steps to beats in music and metronomes, but highest synchronisation consistency was reached for metronome conditions compared to music conditions and for HCs compared to persons with progressive MS. Highest synchronisation consistency for persons with progressive MS was found at -4% and 0%. Additionally, more variability in inter-step-intervals and thus a more anti-persistent gait pattern was found for metronome compared to music conditions. Last, lower performance on the Timed Up & Go Test negatively impacted synchronisation consistency.

Conclusion

PwPMS are able to synchronise steps to beats in music and metronomes. Overall, more consistent synchronisation is seen for metronome conditions. All participants are able to adapt their cadence to all tempi, yet, PwPMS struggle to adapt gait speed to high tempi. Noteworthy, participants walk with more random inter-step-interval fluctuations when walking to metronome compared to music conditions. Last, dynamic balance significantly impacted synchronisation consistency. These results show the potential of using auditory-motor coupling for walking related rehabilitation for PwPMS, however, tempo and auditory stimulation should be carefully considered.

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跟着节拍走进行性多发性硬化症患者在音乐和节拍器的伴奏下按照较高和较低的节拍行走时的听觉-运动耦合：一项观察性研究。

背景：许多多发性硬化症（MS）患者都面临着疲劳和行走困难的问题，对于进展性亚型多发性硬化症患者来说更是如此。以任务为导向的训练，更具体地说是听觉-运动耦合形式的训练，即要求患者根据音乐和节拍器中的节拍同步迈步，是很有前景的。然而，目前尚不清楚进行性多发性硬化症患者（PwPMS）能否根据音乐和节拍器中的节拍同步步伐，以及他们能否根据较慢和较快的节奏调整步态：该研究是一项病例对照研究，要求患有进行性多发性硬化症（PwPMS）的参与者和健康对照组（HCs）在地面行走时，根据音乐和节拍器中的节拍，在慢速（-8%，-4%）、基线（0%）和高速（4%，8%）等五种不同的节拍下同步他们的步伐，同时记录同步、时空参数和步态动态。对同步结果测量和时空步态参数进行了混合模型分析。此外，还进行了回归分析，以确定影响同步一致性的认知和运动功能等临床因素：研究共纳入了 18 名 PwPMS（平均年龄 = 52.4 岁，EDSS 中位数 = 4.24）和 16 名健康对照组（HCs）（平均年龄 = 56.5 岁）。结果显示，两组人都能根据音乐和节拍器中的节拍同步迈步，但节拍器条件下的同步一致性比音乐条件下的最高，而健康对照组比进行性多发性硬化症患者的同步一致性最高。进行性多发性硬化症患者的最高同步一致性为-4%和0%。此外，与音乐条件相比，节拍器条件下的步间间隔变异性更大，因此步态更不稳定。最后，在 "定时起立与前进测试 "中表现较差也对同步一致性产生了负面影响：结论：PwPMS 能够根据音乐和节拍器中的节拍同步步态。总体而言，节拍器条件下的同步一致性更高。所有参与者都能根据所有节拍调整步调，但 PwPMS 在根据高节拍调整步速方面却很吃力。值得注意的是，与音乐条件相比，在节拍器条件下行走时，参与者的步间间隔波动更为随机。最后，动态平衡对同步一致性有很大影响。这些结果表明，使用听觉-运动耦合进行与 PwPMS 步行相关的康复训练具有潜力，但应仔细考虑节奏和听觉刺激。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.