Music-Based Digital Therapeutic

Project Background

A key characteristic of healthy bipedal locomotion is a walking frequency optimized for fast, efficient, and stable walking. In contrast, individuals with poststroke hemiparesis have a characteristically slow, inefficient, and unstable gait. Previous work has shown that rhythmic auditory stimulation leads to an increase in walking speed and cadence and may lead to improvements in walking efficiency.

The objective of this study was to evaluate the immediate and short-term effects on poststroke locomotion of gait training centered on entrainment to music-based, rhythmic auditory cueing for progressively faster stepping. More specifically, we used a wearable sensor platform designed to manipulate the rhythm and beat characteristics for any musical composition based on a real-time assessment of (i) a user’s baseline walking frequency and (ii) their ability to entrain to a faster walking frequency.

We evaluated changes in gait speed, spatiotemporal measures, and metabolic cost following a single 30 minute training session. For a subset of individuals, we also analyzed speed progression across 4 visits.

I am currently leading an effort to publish changes in metabolic cost and relation to spatiotemporal parameters after a single day of training.

The system is safe and leads to improvements in walking speed...

...as well as metabolic cost and temporal asymmetries.

Check out our presentation at ASB 2021 starting at 18:27.

Please view our publications for full results!

Publications

Peer Reviewed Journal Articles

Under Review:

Collimore AN*, Roto Cataldo AV*, Aiello AJ, Sloutsky R, Hutchinson K, Harris B, Ellis T, Awad LN. (2022)
Automated gait training by closed-loop control of music reduces the energy cost of walking and gait asymmetry after stroke.
*co-first authors

Hutchinson K, Sloutsky R, Collimore A, Adams B, Harris B, Ellis T, Awad LN. (2020) Automating a progressive and individualized rhythm-based walking training program after stroke: A music-based digital therapeutic. Neurorehabilitation and Neural Repair. 2020. View the paper. or email me for a full version of the text.

National Conference Presentations

Collimore AN, Roto AV, Hutchinson K, Harris B, Awad LN. Rhythmic Auditory Stimulation Improves Cost of Transportand Asymmetry After Stroke.*co-first authors. (LIGHTNING TALK) American Society of Biomechanics Annual Meeting.Virtual. 2021

O’Connor MV, Collimore AN, Roto AV, Aiello AJ, Sloutsky R, Harris B, Awad LN. Targeting Rhythm to Improve Economy: One Session of Music-Based Rhythmic Locomotor Training Improves Post-Stroke Economy. (POSTER) Combined Sections Meeting of the American Physical Therapy Association. Denver, CO. 2020.

In the News

https://www.neurologylive.com/clinical-focus/digital-therapeutic-for-poststroke-walking-deficits-gets-breakthrough-designation

Related Work

1. Holt, KG, Jeng, SF, Ratcliffe, R, and Hamill, J. Energetic Cost and Stability during Human Walking at the Preferred Stride Frequency. Journal of Motor Behavior, 27(2):164–178, jun 1995.

2. Kobinata, N, Ueno, M, Imanishi, Y, and Yoshikawa, H. Immediate effects of rhythmic auditory stimulation on gait in stroke patients in relation to the lesion site. Journal of Physical Therapy Science, 28(9):2441–2444, 2016.

3. Patterson, KK, Wong JS, Knorr, S, and Grahn, JA. Rhythm Perception and Production Abilities and Their Relationship to Gait After Stroke. Archives of Physical Medicine and Rehabilitation, 99(5):945–951, may 2018. PMID: 29427575.

4. Reisman, DS, Rudolph, KS, and Farquhar, WB. Influence of speed on walking economy poststroke. Neurorehabilitation and neural repair, 23(6):529–34, 2009. PMID: 19126838.