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Entrainment and the Motor System
Abstract
Entrainment is a universal phenomenon that can be observed in physical (e.g., pendulum clocks) and biological systems (e.g., fire flies) when one system's motion or signal frequency entrains the frequency of another system. The use of entrainment for therapeutic purposes was established for the first time in the early 1990s by Thaut and colleagues in several research studies, showing that the periodicity of auditory rhythmic patterns could entrain movement patterns in patients with movement disorders (Thaut, Kenyon, Schauer, & McIntosh, 1999). Physiological, kinematic and behavioral movement analysis showed very quickly that entrainment cues not only changed the timing of movement but also improved spatial and force parameters. We know now that anticipatory rhythmic templates are critical coordinative constraints in the brain for optimal motor planning and execution. Rhythmic entrainment is one of the most important underlying mechanisms for the successful application of rhythmic-musical stimuli in motor rehabilitation for movement disorders associated with stroke, Parkinson's disease, traumatic brain injury, cerebral palsy etc. Most importantly, temporal rhythmic entrainment has been successfully extended into applications in cognitive rehabilitation and speech and language rehabilitation, and thus become one of the major neurological mechanisms linking music and rhythm to brain rehabilitation. Multiple treatment techniques in Neurologic Music Therapy utilize entrainment concepts in sensorimotor, cognitive, and speech/language training.
... One suggestion for how auditory feedback improves movement execution is that it reduces the uncertainty related to target acquisition and frees up attentional resources for planning the subsequent movement (Hatfield et al., 2010). The incorporation of RAS has also been proposed to ready the motor system by entraining the neural firing of the motor system in preparation for movement initiation (Thaut, 2013). Consistent with the above predictions, the use of RAS was found to supplement RT in a goal-directed reaching task performed by neurotypical individuals, where RTs improved with sound presented before movement onset (Peters & Glazebrook, 2020). ...
... The RAS have been proposed to prepare the motor system for movement performance by engaging auditory neurons which then entrain motor neurons (Thaut, 2013). In the present study, RTs improved when the RAS were present before movement onset, and the temporal differences of the groups were clear as there were differences in RT variability between the two groups. ...
... Instructions facilitating this focus may supplement learning by releasing the attentional demand of the task (Chiviacowsky et al., 2013). Further to this, RAS has been found to prime the motor system in movement planning and regulate spatial characteristics of muscle activation patterns and movement control (Thaut, Kenyon, Schauer, & McIntosh, 1999;Thaut, 2013;Thaut & Kenyon, 2003). Temporal priming may optimize neuromotor mechanisms, resulting in improved response times and movement trajectories. ...
Improvements in functional reaching directly support improvements in independence. The addition of auditory inputs (e.g., music, rhythmic counting) may improve goal-directed reaching for individuals with cerebral palsy (CP). To effectively integrate auditory stimuli into adapted teaching and rehabilitation protocols, it is necessary to understand how auditory stimuli may enhance limb control. This study considered the influence of auditory stimuli during the planning or execution phases of goal-directed reaches. Adults (with CP = 10, without CP = 10) reached from a home switch to two targets. Three conditions were presented—no sound, sound before, and sound during—and three-dimensional movement trajectories were recorded. Reaction times were shorter for both groups in the sound before condition, while the group with CP also reached peak velocity relatively earlier in the sound before condition. The group with CP executed more consistent movements in both sound conditions. Sound presented before movement initiation improved both the planning and execution of reaching movements for adults with CP.
... Entrainment describes a process where neural firing will become entrained to the external auditory stimulus (Thaut, 2015;Thaut et al., 2015) and will also continue after stimulus cessation (Lakatos et al., 2013). The idea is that auditory neuron firing is entrained to the rhythmic auditory stimuli, which then entrain motor neurons to prime the motor system (Thaut, 2013). Entrainment effects have been proposed to underlie movement performance improvements in clinical populations (Thaut, 2013). ...
... The idea is that auditory neuron firing is entrained to the rhythmic auditory stimuli, which then entrain motor neurons to prime the motor system (Thaut, 2013). Entrainment effects have been proposed to underlie movement performance improvements in clinical populations (Thaut, 2013). We propose that this stable neural rhythm facilitates better movement planning through better scaling of movement parameters, particularly when visual feedback is unavailable, leading to improved movement execution (Peters & Glazebrook, 2020). ...
... The purpose of the present experiment was to explore possible explanations for the reported benefits of rhythmic auditory stimuli for improving features of goaldirected reaching movements. Our first hypothesis was grounded in models of entrainment (Thaut, 2013(Thaut, , 2015Thaut et al., 2015), and was that rhythmic auditory stimuli increase the temporal stability of the movement plan, leading to improved movement execution (Peters & Glazebrook, 2020). The present experiment tested this idea by manipulating rhythmic frequency, to see if more precise temporal information would lead to further Frequency and Source of Rhythmic Auditory Stimuli benefits for movement performance. ...
Music and metronomes differentially impact movement performance. The current experiment presented metronome and drum beats in simple and complex rhythms before goal-directed reaching movements, while also quantifying enjoyment. Auditory conditions were completed with and without visual feedback and were blocked and counterbalanced. There were no differences between simple and complex rhythms, indicating that rhythmic information alone is sufficient to benefit performance. The drum elicited shorter movement times and higher peak velocities, without an increase in spatial variability. Reaction times were moderately correlated with ratings of enjoyment. These data provide evidence that the source of an auditory stimulus impacts movement performance of a goal-directed reaching task. Results are contextualized within models of goal-directed reaching to elucidate mechanisms contributing to performance improvements.
... Technically, entrainment is a physical phenomenon, namely "the frequency locking of two oscillating bodies, that is bodies that can move in stable periodic or rhythmic cycles. They have different frequencies or movement periods when moving independently, but when interacting they assume a common period" (Thaut, 2013). It was reported that the effect of rhythmic entrainment on motor control is directly linked to the firing rates of auditory neurons that entrain the firing patterns of motor neurons, affecting the motor system frequency at different levels. ...
... One specific aspect of entrainment is its "executive function", which influences motor planning and motor execution. In particular, "rhythmic stimuli create stable anticipatory time scales or templates" (Thaut, 2013(Thaut, , 2015b which provide "time cues for the brain to plan ahead and be ready. Furthermore, successful movement anticipation is based on foreknowledge of the duration of the cue period" (Thaut, 2013(Thaut, , 2015b. ...
... In particular, "rhythmic stimuli create stable anticipatory time scales or templates" (Thaut, 2013(Thaut, , 2015b which provide "time cues for the brain to plan ahead and be ready. Furthermore, successful movement anticipation is based on foreknowledge of the duration of the cue period" (Thaut, 2013(Thaut, , 2015b. Sejdić et al. (2012), who described the effects of rhythmic sensory cues on healthy movement behavior, suggested that "rhythmic cues could be considered as an alternative cueing modality in rehabilitation". ...
In recent years, cognitive theories have increasingly influenced the approach to motor rehabilitation. The connection between different aspects of cognitive and motor function is increasingly documented, underlining the importance of developing rehabilitation projects that take cognitive aspects into account. The aim of this non-systematic review is to highlight the relationship between cognition and motion and, in the light of new rehabilitation technologies, to better define how aspects of cognition can affect motor rehabilitation.
... Yet, research on these predictive mechanisms has only unfolded over the last two decades, providing a lot of evidence on their existence, neuronal substrates and function. The accumulated data come from a wide range of experiments and paradigms that studied different sensory modalities in several species including humans and non-human primates (for example [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]). ...
... This evidence and its underlying principles are the focus of this review. We will first survey the empirical evidence for neuronal entrainment and outline its different flavors (for recent reviews on entrainment with different emphases see [26,32,[43][44][45][46][47][48][49][50][51]). Because of the diversity of the findings and the relevance of oscillatory entrainment to brain operations, we feel that it is time for devising a unifying theoretical framework of neuronal entrainment, which we lay out in the subsequent section. ...
... d Building block 1: entrainment exists. While there are certain methodological caveats in demonstrating entrainment [213][214][215][216], the electrophysiological and behavioral data amassed using a wide range of stimuli and stimulation parameters leaves no doubt that neuronal entrainment exists in the brain, and that it has behavioral consequences [2,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Of note, a recent study [217] demonstrated in a rare, direct comparison that an oscillatory model outperforms an evoked model in explaining neuronal responses to rhythmic input. ...
Rhythms are a fundamental and defining feature of neuronal activity in animals including humans. This rhythmic brain activity interacts in complex ways with rhythms in the internal and external environment through the phenomenon of 'neuronal entrainment', which is attracting increasing attention due to its suggested role in a multitude of sensory and cognitive processes. Some senses, such as touch and vision, sample the environment rhythmically, while others, like audition, are faced with mostly rhythmic inputs. Entrainment couples rhythmic brain activity to external and internal rhythmic events, serving fine-grained routing and modulation of external and internal signals across multiple spatial and temporal hierarchies. This interaction between a brain and its environment can be experimentally investigated and even modified by rhythmic sensory stimuli or invasive and non-invasive neuromodulation techniques. We provide a comprehensive overview of the topic and propose a theoretical framework of how neuronal entrainment dynamically structures information from incoming neuronal, bodily and environmental sources. We discuss the different types of neuronal entrainment, the conceptual advances in the field, and converging evidence for general principles.
... Most relevant to this study, rhythmic skills have a direct influence on motor control. The development of rhythmic templates acts as a coordinative constraint to automatize motor planning and programming (Thaut, 2013). When an auditory rhythm is presented, the motor system rapidly detects the temporal pattern and entrains to the rhythm (temporally locks into the frequency of the auditory stimulus; Thaut, 2013). ...
... The development of rhythmic templates acts as a coordinative constraint to automatize motor planning and programming (Thaut, 2013). When an auditory rhythm is presented, the motor system rapidly detects the temporal pattern and entrains to the rhythm (temporally locks into the frequency of the auditory stimulus; Thaut, 2013). This process optimizes the spatial and timing parameters produced by the motor system (Thaut et al., 2015). ...
Purpose:
Rhythm is one procedural mechanism that underlies language and motor skill acquisition and has been implicated in children with childhood apraxia of speech (CAS). The purpose of this study is to investigate manual rhythmic sequencing skills in children with a history of or current CAS (hx/CAS) compared to children with typical development (TD).
Method:
Thirty-eight children (18 with hx/CAS, 20 with TD), ages 5;0-12;8 (years;months), from across the United States participated in an online study. Participants imitated two rhythms in two different conditions, clapping and tapping. We assessed overall accuracy, mean number of beats, pause marking, and rhythmic sequence variability using the Mann-Whitney U test. Effect sizes were calculated to examine the influence of coordinative complexity on performance.
Results:
Compared to children with TD, children with hx/CAS marked fewer trials with a pause in both conditions of the easier rhythm and showed lower overall accuracy and more variable rhythmic sequences in both rhythms and conditions. The mean number of beats produced by children with hx/CAS and children with TD did not differ in three out of four rhythms/conditions. Unlike children with TD, children with hx/CAS showed little improvement from clapping to tapping across most dependent measures; reducing coordination demands did not improve performance in children with hx/CAS.
Conclusions:
We found that children with hx/CAS show manual rhythmic deficits that are similar to the deficits they display in speech. These findings provide support for a domain-general cognitive mechanisms account of the rhythmic deficits observed across linguistic and nonlinguistic tasks in children with hx/CAS.
Supplemental material:
https://doi.org/10.23641/asha.24052821.
... Neurological rehabilitation makes use of various treatment modalities, including techniques from neurologic music therapy, which has shown very positive impacts on learning and motor abilities of children with neurological deficits [1]. The link between auditory and motor systems is evident in the research, and its influences can be seen clearly when applying rhythmic entrainment to movement disorder rehabilitation [2]. Studies providing fixed rhythmic auditory stimulus (RAS) have shown improvements in gait patterns and stride parameters for patients with stroke, Parkinson's disorder, traumatic brain injury, and cerebral palsy [3][4][5][6]. ...
... Positive patterns will increase layers of the drum kit as the user takes successive steps, whereas unsuccessful steps will need to be tallied up to remove drum kit layers. Studies have shown the complexity of movement and locomotion [2,4], thus we propose a dual system of fixed RAS will stimulate pattern synchronization and then MMG-based biofeedback for stimulating temporal cues of movements to improve gait dynamics and neural reorganization in the long-term. ...
... Rhythm can entrain and prime neurons in the motor cortex via the rich neural connections between auditory and motor regions, [14][15][16][17][18][19][20][21] and numerous studies have evaluated the therapeutic effectiveness of Rhythmic Auditory Stimulation (RAS) and music-based therapies in various clinical populations, with growing evidence that RAS can improve motor outcomes in stroke survivors. [22][23][24][25][26][27][28][29][30][31] RAS, in addition to other benefits, can improve different gait parameters such as stride length and walking symmetry in stroke survivors. ...
Background
Stroke persists as an important cause of long-term disability world-wide with the need for rehabilitation strategies to facilitate plasticity and improve motor function in stroke survivors. Rhythm-based interventions can improve motor function in clinical populations. This study tested a novel music-motor software application ‘GotRhythm’ on motor function after stroke.
Methods
Participants were 22 stroke survivors undergoing inpatient rehabilitation in a subacute stroke ward. Participants were randomised to the GotRhythm intervention (combining individualised music and augmented auditory feedback along with wearable sensors to deliver a personalised rhythmic auditory stimulation training protocol) or usual care. Intervention group participants were offered 6-weeks of the GotRhythm intervention, consisting of a supervised 20-minute music-motor therapy session using GotRhythm conducted 3 times a week for 6 weeks. The primary feasibility outcomes were adherence to the intervention and physical function (change in the Fugl-Meyer Assessment of Motor Recovery score) measured at baseline, after 3-weeks and at end of the intervention period (6-weeks).
Results
Three of 10 participants randomised to the intervention did not receive any of the GotRhythym music-motor therapy. Of the remaining 7 intervention group participants, only 5 completed the 3-week mid-intervention assessment and only 2 completed the 6-week post-intervention assessment. Participants who used the intervention completed 5 (IQR 4,7) sessions with total ‘dose’ of the intervention of 70 (40, 201) minutes.
Conclusion
Overall, adherence to the intervention was poor, highlighting that application of technology assisted music-based interventions for stroke survivors in clinical environments is challenging along with usual care, recovery, and the additional clinical load.
... Self-generated oscillatory rhythms are thought to play a vital role in this . A number of authors have suggested that, instead of merely reflexively responding to external changes when they occur, we may instead, or as well, start to predict the future occurrence of external changes before they occur -by detecting periodicities in the external stimuli, and adjusting our own patterns of internal periodic activity to match them (Ding and Simon, 2014;Lakatos et al., 2019;Poeppel and Assaneo, 2020;Thaut, 2013). This process is known as oscillatory entrainment. ...
An individual’s early interactions with their environment are thought to be largely passive; through the early years, the capacity for volitional control develops. Here, we consider: how is the emergence of volitional control characterised by changes in the entrainment observed between internal activity (behaviour, physiology and brain activity) and the sights and sounds in our everyday environment (physical and social)? We differentiate between contingent responsiveness (entrainment driven by evoked responses to external events) and oscillatory entrainment (driven by internal oscillators becoming temporally aligned with external oscillators). We conclude that ample evidence suggests that children show behavioural, physiological and neural entrainment to their physical and social environment, irrespective of volitional attention control; however, evidence for oscillatory entrainment beyond contingent responsiveness is currently lacking. Evidence for how oscillatory entrainment changes over developmental time is also lacking. Finally, we suggest a mechanism through which periodic environmental rhythms might facilitate both sensory processing and the development of volitional control even in the absence of oscillatory entrainment.
... Thus, it may be presumed that performing and modulating the pace of upper-limb movements did not require additional cognitive resources. An alternative hypothesis is that whole-body motor behaviours benefited from higher entrainment (i.e., temporal locking process in which a signal frequency entrains the frequency of a system; Thaut, 2013). The entrainment process has indeed been shown to optimise motor planning and execution, possibly through spontaneous adjustments of neural dynamics (Nozaradan et al., 2011;Thaut et al., 2015). ...
Human beings constantly adapt the spontaneous pace of their actions in order to interact with their environment. Advances in timing research have shown that two processes (automatic vs. controlled) are involved in the processing of temporal information. There is, nonetheless, a dearth of knowledge regarding the cognitive mechanisms and brain areas underlying the temporal control of motor behaviours. The general aim of my thesis was to examine the cognitive and cerebral resources needed during the execution of actions performed under different time constraints. In Study 1, the involvement of cognitive control in motor timing was investigated using time series analysis and a dual-task paradigm. Results showed that moving fast and slow entailed distinct timing strategies, characterised by contrasting attentional demands. In Study 2, the fNIRS neuroimaging technique was used to examine the cerebral oxygenation of prefrontal and motor areas simultaneously during the execution of upper-limb motor tasks performed under different time constraint. Findings indicated that fast-paced movement relied on greater activity in the motor areas, whereas moving at a close-to-spontaneous pace exerted heavier load on the posterior prefrontal cortex. Study 3 was designed to investigate the ecological validity of motor-timing tasks by providing a direct comparison across the tasks of finger tapping, foot tapping, and stepping on the spot. The results showed that single-limb and whole-body movements entailed distinct timing strategies, and suggested that tapping-to-metronome paradigms might be too far removed from natural behaviours to facilitate translation of the results. Hence, in Study 4, the fNIRS technique was employed to examine prefrontal and motor activation during the execution of upper-limb and whole-body movements under distinct time constraints. Findings indicated that slow pacing led to increased prefrontal activations only during whole-body movements. Yet, a large variability in participants' haemodynamic responses was observed. Therefore, in Study 5, three case studies were conducted to assess the test–retest reliability and define the appropriate number of trials necessary for a block design procedure in fNIRS brain imaging during motor paradigms. The original contribution of the present research programme is that prefrontal cognitive control plays an essential role during the production of slow motor behaviours. Rather than a co-existence of two timing-processes, the present body of work supports an alternative view of motor timing insofar as the production of fast and slow movements relies on a similar motor mechanism. Cognitive monitoring would be additionally involved in the production of slow movements in order to slow the pace of motor execution. This view provides new insights into the cognitive and brain mechanisms underlying adaptative human behaviour.
... Self-generated oscillatory rhythms are thought to play a vital role in this . A number of authors have suggested that, instead of merely reflexively responding to external changes when they occur, we may instead, or as well, start to predict the future occurrence of external changes before they occur -by detecting periodicities in the external stimuli, and adjusting our own patterns of internal periodic activity to match them (Ding and Simon, 2014;Lakatos et al., 2019;Poeppel and Assaneo, 2020;Thaut, 2013). This process is known as oscillatory entrainment. ...
An individual’s early interactions with their environment are thought to be largely passive; through the early years, the capacity for volitional control develops. Here, we consider: how is the emergence of volitional control characterised by changes in the entrainment observed between internal activity (behaviour, physiology and brain activity) and the sights and sounds in our everyday environment (physical and social)? We differentiate between contingent responsiveness (entrainment driven by evoked responses to external events) and oscillatory entrainment (driven by internal oscillators becoming temporally aligned with external oscillators). We conclude that ample evidence suggests that children show behavioural, physiological and neural entrainment to their physical and social environment, irrespective of volitional attention control; however, evidence for oscillatory entrainment beyond contingently responsiveness is currently lacking. We also discuss environmental entrainment as a mechanism that might explain why periodic environment rhythms facilitate sensory processing, and explain the relationships observed between how periodic a child’s environment is and their long-term development of volitional control.
... The effects of sound on movement entrainment has been extensively researched [46]. Humans have the tendency to follow auditory rhythms with their bodily movements [4,10], also when it comes to respiratory movement [18]. ...
... Prior knowledge of the rhythmic period facilitates this mapping, allowing for greater control of the effector's movement in space, and modulating muscle activation patterns. 37 Studies have shown that neural oscillations from auditory stimuli drive auditory-motor entrainment, with even brief periods of rhythmic auditory priming enhancing subsequent neural efficiency. 38 Given the extensive connections between auditory and motor systems and rhythm processing in the brain, 39 it is conceivable that training to a predictable pulse at their preferred rate induced entrainment of neural oscillations to the attended beat, facilitating a reduction in neuromotor noise that may negatively affect motor execution and planning. ...
Objective
To investigate the potential benefits of three Therapeutic Instrumental Music Performance (TIMP)-based interventions in rehabilitation of the affected upper-extremity [UE] for adults with chronic post-stroke hemiparesis.
Design
Randomized-controlled pilot study
Setting
University research facility
Participants
Thirty community-dwelling volunteers [16 male/14 female; ages 33-76; mean age =55.9] began and completed the protocol. All participants had sustained a unilateral stroke > 6 months prior to enrollment [mean time post-stroke =66.9 months].
Interventions
Two baseline assessments, a minimum of one week apart; nine intervention sessions (3x/wk for 3 wks), in which rhythmically-cued, functional arm movements were mapped onto musical instruments; one post-test following the final intervention. Participants were block-randomized to one of three conditions: Group 1 - 45 minutes TIMP; Group 2 - 30 minutes TIMP, 15 minutes metronome-cued motor imagery (TIMP+cMI); Group 3 - 30 minutes TIMP, 15 minutes motor imagery without cues (TIMP+MI). Assessors and investigators were blinded to group assignment.
Main Outcome Measures
Fugl-Meyer Upper-Extremity (FM-UE); Wolf Motor Function Test- Functional Ability Scale (WMFT-FAS)
Secondary Measures
Motor Activity Log (MAL) – Amount of Use Scale; Trunk Impairment Scale.
Results
All groups made statistically significant gains on the FM-UE (TIMP, p=.005, r=.63; TIMP+cMI, p=.007, r=.63; TIMP+MI, p=.007, r=.61) and the WMFT-FAS (TIMP, p=.024, r=.53; TIMP+cMI, p=.008, r=.60; TIMP+MI, p=.008, r=.63). Comparing between-group percent change differences, on the FM-UE, TIMP scored significantly higher than TIMP+cMI (p=.032, r=.57), but not TIMP+MI. There were no differences in improvement on WMFT-FAS across conditions. On the MAL, gains were significant for TIMP (p=.030, r=.54) and TIMP+MI (p =.007, r=.63).
Conclusion
TIMP-based techniques, with and without motor imagery, led to significant improvements in paretic arm control on primary outcomes. Replacing a physical training segment with imagery-based training resulted in similar improvements; however, synchronizing internal and external cues during auditory-cued motor imagery may pose additional sensorimotor integration challenges.
... This idea is grounded in models of entrainment where the firing of auditory and motor neurons entrain to the RAS (Thaut, 2015;Thaut, McIntosh, & Hoemberg, 2015) and continue to fire after stimulus cessation (Lakatos et al., 2013). Entrainment is thought to underlie performance improvements in clinical populations in paradigms that include RAS (Thaut, 2013). Specifically, Thaut et al. (2015) propose that entrainment primes the motor system though stable anticipatory time scales which enable improved performance of the subsequent movement. ...
Rhythmic auditory stimuli presented before a goal-directed movement have been found to improve temporal and spatial movement outcomes. However, little is known about the mechanisms mediating these benefits. The present experiment used three types of auditory stimuli to probe how improved scaling of movement parameters, temporal preparation and an external focus of attention may contribute to changes in movement performance. Three types of auditory stimuli were presented for 1200 ms before movement initiation; three metronome beats (RAS), a tone that stayed the same (tone-same), a tone that increased in pitch (tone-change) and a no sound control, were presented with and without visual feedback for a total of eight experimental conditions. The sound was presented before a visual go-signal, and participants were instructed to reach quickly and accurately to one of two targets randomly identified in left and right hemispace. Twenty-two young adults completed 24 trials per blocked condition in a counterbalanced order. Movements were captured with an Optotrak 3D Investigator, and a 4(sound) by 2(vision) repeated measures ANOVA was used to analyze dependant variables. All auditory conditions had shorter reaction times than no sound. Tone-same and tone-change conditions had shorter movement times and higher peak velocities, with no change in trajectory variability or endpoint error. Therefore, rhythmic and non-rhythmic auditory stimuli impacted movement performance differently. Based on the pattern of results we propose multiple mechanisms impact movement planning processes when rhythmic auditory stimuli are present.
... Prior knowledge of the rhythmic period facilitates this mapping, allowing for greater control of the effector's movement in space, and modulating muscle activation patterns. 37 Studies have shown that neural oscillations from auditory stimuli drive auditory-motor entrainment, with even brief periods of rhythmic auditory priming enhancing subsequent neural efficiency. 38 Given the extensive connections between auditory and motor systems and rhythm processing in the brain, 39 it is conceivable that training to a predictable pulse at their preferred rate induced entrainment of neural oscillations to the attended beat, facilitating a reduction in neuromotor noise that may negatively affect motor execution and planning. ...
Background:
The burden of post-stroke cognitive impairment, as well as affective disorders, remains persistently high. With improved stroke survival rates and increasing life expectancy, there is a need for effective interventions to facilitate remediation of neurocognitive impairments and post-stroke mood disorders.
Objective:
To investigate the effects of Therapeutic Instrumental Music Performance (TIMP) training with and without Motor Imagery on cognitive functioning and affective responding in chronic post-stroke individuals.
Methods:
Thirty chronic post-stroke, community-dwelling participants were randomized to one of three experimental arms: (1) 45 minutes of active TIMP, (2) 30 minutes of active TIMP followed by 15 minutes of metronome-cued motor imagery (TIMP+cMI), (3) 30 minutes of active TIMP followed by 15 minutes of motor imagery without cues (TIMP+MI). Training took place three times a week for three weeks, using a selection of acoustic and electronic instruments. Assessments, administered at two baselines and post-training, included the Trail Making Test (TMT) - Part B to assess mental flexibility, the Digit Span Test (DST) to determine short-term memory capacity, the Multiple Affect Adjective Checklist - Revised (MAACL-R) to ascertain current affective state, and the General Self-Efficacy Scale (GSE) to assess perceived self-efficacy. The Self-Assessment Maniqin (SAM) was also administered prior to and following each training session.
Results:
Thirty participants completed the protocol, ten per arm [14 women; mean age = 55.9; mean time post-stroke = 66.9 months]. There were no statistically significant differences between pooled group baseline measures. The TIMP+MI group showed a statistically significant decrease in time from pre-test 2 to post-test on the TMT. The TIMP group showed a significant increase on MAACL sensation seeking scores, as well as on the Valence and Dominance portions of the SAM; TIMP+cMI showed respective increases and decreases in positive and negative affect on the MAACL, and increases on the Valence, Dominance, and Arousal portions of the SAM. No statistically significant association between cognitive and affective measures was obtained.
Conclusions:
The mental flexibility aspect of executive functioning appears to be enhanced by therapeutic instrumental music training in conjunction with motor imagery, possibly due to multisensory integration and consolidation of representations through motor imagery rehearsal following active practice. Active training using musical instruments appears to have a positive impact on affective responding; however, these changes occurred independently of improvements to cognition.
... The effects of SMT on sensorimotor synchronization abilities are in line with previous SMT studies, including i.e., various groups of clinical populations (Johansson et al., 2012) and adult golfers (Libkuman et al., 2002;Sommer and Rönnqvist, 2009;Sommer et al., 2014). SMT may fine-tune the way in which the firing rates of auditory neurons entrain the firing patterns of motor neurons (Thaut, 2013), consequently leading to a closer match between motor output and rhythmic input. Importantly, improved sensorimotor synchronization was transferable to improved soccer cross-pass performance, in terms of better accuracy and less variability. ...
Although trainers and athletes consider “good timing skills” critical for optimal sport
performance, little is known in regard to how sport-specific skills may benefit from timing
training. Accordingly, this study investigated the effects of timing training on soccer
skill performance and the associated changes in functional brain response in elite- and
sub-elite female soccer players. Twenty-five players (mean age 19.5 years; active in the
highest or second highest divisions in Sweden), were randomly assigned to either an
experimental- or a control group. The experimental group (n = 12) was subjected to a
4-week program (12 sessions) of synchronized metronome training (SMT). We evaluated
effects on accuracy and variability in a soccer cross-pass task. The associated brain
response was captured by functional magnetic resonance imaging (fMRI) while watching
videos with soccer-specific actions. SMT improved soccer cross-pass performance,
with a significant increase in outcome accuracy, combined with a decrease in outcome
variability. SMT further induced changes in the underlying brain response associated with
observing a highly familiar soccer-specific action, denoted as decreased activation in
the cerebellum post SMT. Finally, decreased cerebellar activation was associated with
improved cross-pass performance and sensorimotor synchronization. These findings
suggest a more efficient neural recruitment during action observation after SMT. To our
knowledge, this is the first controlled study providing behavioral and neurophysiological
evidence that timing training may positively influence soccer-skill, while strengthening
the action-perception coupling via enhanced sensorimotor synchronization abilities, and
thus influencing the underlying brain responses.
https://doi.org/10.3389/fnhum.2018.00311
... 492). In addition, research regarding rhythmic 298 entrainment in music therapy settings has shown critical successes in motor rehabil-299 itation with people who have motor-disorders such as Parkinson's disease, stroke, 300 and cerebral palsy, as well as in speech, language, and cognitive rehabilitation 301 processes (Thaut 2013;Thaut et al. 1999). ...
What influences personal and small group transformation for classical chamber musicians? In this chapter, I explore the context of classical chamber music ensembles and how embodied awareness and reflexivity contribute to personal and small group transformation, or collective virtuosity. According to Marotto, et al. (2007), collective virtuosity occurs when “individual virtuosity becomes collective in groups through a reflexive process in which group members are transformed by their own peak performance” (p. 395). During my research with classical chamber musicians, I observed personal transformation take place as individuals broadened and deepened their awareness by practicing a set of rehearsal techniques. Each technique helped musicians to expand and embody awareness, mirror gestures, and entrain energies, enter into a mutual tuning-in process, and to ultimately form a We Presence in which musicians experienced collective virtuosity. This chapter contains examples of several chamber music rehearsal techniques with explanations of how they contribute to personal and small group transformation. I provide a model that illustrates a transformation process which results in collective virtuosity.
Keywords: transformation, small groups, teams, music education, organizational development, human development, chamber music
References:
Marotto, M., Roos, J., & Victor, B. (2007). Collective virtuosity in organizations: A study of peak performance in an orchestra. Journal of Management Studies, 44(3), 388-413.
... Due to its effective application to oscillatory movement, a great number of related studies have been conducted with regard to gait (Thaut & Abiru, 2010); however, its effects on repetitive cyclical arm movement have been increasingly evidenced Whitall & McCombe-Waller, 2013). The regularly timed external cue provides temporal templates to be referenced for anticipation and execution of a movement and promotes efficient coordination of a movement by synchronizing the movement to the predictable referent (Malcolm, Massie, & Thaut, 2009;Thaut, 2013). In the feed-forward/feedback mechanism, rhythmic auditory cueing optimizes the priming effect on the motor system via auditory-motor interaction and entrainment by increasing muscle excitability and decreasing variability in the timing of muscle activation . ...
Background:
Given the increasing evidence demonstrating the effects of rhythmic auditory cueing for motor rehabilitation of stroke patients, this synthesized analysis is needed in order to improve rehabilitative practice and maximize clinical effectiveness.
Objective:
This study aimed to systematically analyze the literature on rhythmic auditory cueing for motor rehabilitation of stroke patients by highlighting the outcome variables, type of cueing, and stage of stroke.
Methods:
A systematic review with meta-analysis of randomized controlled or clinically controlled trials was conducted. Electronic databases and music therapy journals were searched for studies including stroke, the use of rhythmic auditory cueing, and motor outcomes, such as gait and upper-extremity function.
Results:
A total of 10 studies (RCT or CCT) with 356 individuals were included for meta-analysis. There were large effect sizes (Hedges's g = 0.984 for walking velocity; Hedges's g = 0.840 for cadence; Hedges's g = 0.760 for stride length; and Hedges's g = 0.456 for Fugl-Meyer test scores) in the use of rhythmic auditory cueing. Additional subgroup analysis demonstrated that although the type of rhythmic cueing and stage of stroke did not lead to statistically substantial group differences, the effect sizes and heterogeneity values in each subgroup implied possible differences in treatment effect.
Conclusions:
This study corroborates the beneficial effects of rhythmic auditory cueing, supporting its expanded application to broadened areas of rehabilitation for stroke patients. Also, it suggests the future investigation of the differential outcomes depending on how rhythmic auditory cueing is provided in terms of type and intensity implemented.
... The initial discoveries established the effect of music and rhythm in motor therapies, most comprehensively in stroke and Parkinson's disease (DeDreu et al., 2012;Thaut et al., 2007;Thaut et al., 1997;Thaut et al., 1996). Physiological priming (Rossignol and Melvill Jones, 1976), anticipatory perceptual cue timing, and neural auditory motor entrainment (Grahn and Watson, 2013;Thaut, 2013) have been proposed among the most prevalent underlying mechanisms. Music and rhythm intervention techniques (c.f., Rhythmic Auditory Stimulation RAS) are now considered evidence based and are widely used within neurologic rehabilitation (Hoemberg, 2013). ...
Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions. To further elucidate this question specifically for memory, we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis (MS) and if music-assisted learning will also influence short-term, system-level brain plasticity. We measured systems-level brain activity with oscillatory network synchronization during music-assisted learning. Specifically, we measured the spectral power of 128-channel electroencephalogram (EEG) in alpha and beta frequency bands in 54 patients with MS. The study sample was randomly divided into two groups, either hearing a spoken or a musical (sung) presentation of Rey's auditory verbal learning test. We defined the "learning-related synchronization" (LRS) as the percent change in EEG spectral power from the first time the word was presented to the average of the subsequent word encoding trials. LRS differed significantly between the music and the spoken conditions in low alpha and upper beta bands. Patients in the music condition showed overall better word memory and better word order memory and stronger bilateral frontal alpha LRS than patients in the spoken condition. The evidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization in prefrontal areas in MS patients during word learning. It is suggested that the temporal structure implicit in musical stimuli enhances "deep encoding" during verbal learning and sharpens the timing of neural dynamics in brain networks degraded by demyelination in MS.
Advances in timing research advocate for the existence of two timing mechanisms (automatic vs. controlled) that are related to the level of cognitive control intervening for motor behavior regulation. In the present study, we used the functional near‐infrared spectroscopy (fNIRS) cutting‐edge technique to examine the hypothesis that prefrontal inhibitory control is needed to perform slow motor activities. Participants were asked to perform a sensorimotor‐synchronization task at various paces (i.e., slow, close‐to‐spontaneous, fast). We contrasted upper‐limb circle drawing to a more naturalistic behavior that required whole‐body movements (i.e., steady‐state walking). Results indicated that whole‐body movements led to greater brain oxygenation over the motor regions when compared with upper‐limb activities. The effect of motor pace was found in the walking task only, with more bilateral orbitofrontal and left dorsolateral activation at slow versus fast pace. Exploratory analyses revealed a positive correlation between the activation of the orbitofrontal and motor areas for the close‐to‐spontaneous pace in both tasks. Overall, results support the key role of prefrontal cognitive control in the production of slow whole‐body movements. In addition, our findings confirm that upper‐limb (laboratory‐based) tasks might not be representative of those engaged during everyday‐life motor behaviors. The fNIRS technique may be a valuable tool to decipher the neurocognitive mechanisms underlying naturalistic, adaptive motor behaviors. Collectively, our findings argue against the existence of a fast vs. slow movement dichotomy in terms of brain mechanisms. Rather, they extend Buonomano's population‐clocks model by suggesting that motor timing is embedded within the motor cortex regardless of the time interval being performed. The prefrontal cortex may support the key role of motor inhibition to move slower than the spontaneous tempo.
The benefits of active music participation and training for cognitive development has been evidenced in multiple studies, with this link leveraged in music therapy approaches with clinical populations. Although music, rhythm, and movement activities are widely integrated into children's play and early education, few studies have systematically translated music therapy-based approaches to a non-clinical population to support early cognitive development. This study reports the follow-up effects of the RAMSR program delivered by preschool teachers in low socioeconomic communities. This randomized control trial involved 213 children across eight preschools in disadvantaged communities in Queensland, Australia. The intervention group received 16 to 20 sessions of RAMSR over eight weeks, while the control group undertook usual preschool programs. Primary outcome measures included executive function (child assessment of shifting, working memory, and inhibition) and self-regulation (teacher report), with secondary outcomes of school readiness and visual motor integration. Data was collected pre and post intervention, and again six months later once children had transitioned into school. Results demonstrated significant intervention effects across the three time points for school readiness (p = .038, ηp 2 = .09), self-regulation (p <.001, ηp 2 = .08) and inhibition (p = .002 ηp 2 = .23). Additionally, the feasibility of building capacity in teachers without any music background to successfully deliver the program was evidenced. These findings are important given that children from low socioeconomic backgrounds are both more likely to need support for cognitive development yet have inequitable access to quality music and movement programs. This article is protected by copyright. All rights reserved.
Children with hearing loss (HL) who use listening and spoken language as their methods of communication are now being integrated into classrooms with typically hearing peers upon school entry due to the development of sophisticated hearing technology. However, areas in overall development may lag as the delay in accessibility to speech and language makes it difficult to reach age-appropriate levels in time for kindergarten. Supporting development in these areas of the challenge requires explicit teaching of, and experience with, listening, language, social and executive function, literacy and balance. Participating in a group music and movement class with a focus on areas of challenge for children with HL using neurologic music therapy techniques allows for goal-directed therapy and practice, along with the opportunity to interact with peers in a supportive environment. An overview of the specific techniques for each area of interest and how they can be used is discussed along with a sample curriculum.
In motor skill learning, the influence of instruction on the outcome has been widely studied, but little attention has been paid to the content of the message. In aquatic skills teaching processes, spatial features are commonly emphasized, whereas other aspects such as rhythmic structure are left aside, even though rhythmic structure is known to be a feature that distinguishes one motor skill from the other, and crucial for effective performance. Rhythm is an overall organizing principle that is structured in three levels: pulse, meter and rhythmic variation. It is intuitively communicated and connects individuals and groups through several perceptive channels, but its potential in teaching has not yet been explored. This study investigates the effects of visual and auditory instructions that depict different meters on learning the breaststroke kick, and looks into correlations with other factors like previous experience and instruction access frequency. The sample consisted of 52 college students, divided into four groups, each of which received group specific instruction: auditory or visual, depicting either the typical or an alternative meter. Participants were further grouped according to their previous experience with rhythmic activities (i.e. dancing, gymnastics, playing music), swimming lessons and/or playing in water during childhood, which were assessed by a yes/no questionnaire. The breaststroke kick learning process was determined using three outcome measures: stroke index, rhythmic configuration index and spatial configuration index. All participants performed 400 trials of the breaststroke kick in prone position during the acquisition phase over two days, plus 50 retention trials and 50 transfer trials on a third day, the latter in supine position. Before each set of ten trials, participants were allowed to access their group specific instruction. The outcome measures were evaluated based on video recordings of the trials and submitted to descriptive, variance and effect size analysis. All participants increased their stroke index and spatial configuration index, but not their rhythmic configuration index, although both indices were highly correlated during the whole learning process. The typical meter instruction groups outperformed the alternative meter instruction groups in the retention test as measured by stroke index in (p=0,075; r=0,258), and in the transfer test as measured by spatial configuration index (p=0,045, r=0,289). No difference was
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found between auditory and visual instruction or relating to the instruction access frequencies. Participants who reported childhood play in water showed better stroke indices (p=0,035; r=0,541) than other experience groups, whereas swimming lesson experience hampered learning. Experience in rhythmic activities did not correlate with outcome differences. This puts into perspective the role of instruction in aquatic skills learning, and stresses the impact of previous perceptive-motor experience. In a combined consideration, our results show that information about the typical metric structure helps to learn the breaststroke kick and suggest that under certain circumstances auditory instruction may improve learning more than visual instruction. Emphasizing the spatial configuration of the skill, as is common practice in aquatic skill teaching, does not promote the learning process; instead, the rhythmic configuration deserves more attention. Furthermore, teaching should go beyond merely transmitting predetermined motor patterns and instead focus on fostering diverse perceptual-motor experiences.
Human musicality is a complex problem because it involves the coupling of multiple exogenous and endogenous signals with different physical properties. The synchronization of these signals translates into specific behaviors. The study of this synchronization, based on the physical properties of two oscillatory bodies, is the first step in understanding the behaviors associated with rhythmic auditory stimuli. In recent years, different neurorehabilitation therapies have emerged for motor pathologies involving music. However, the neurophysiological bases that describe the coupling phenomenon are not yet fully understood. In this article, two theories are addressed that attempt to explain the convergence of the auditory system and the motor system according to new neuroanatomical, neurophysiological and artificial neural network findings. It also reflects on the different approaches to a complex problem in cognitive neuroscience and the need for a study model for the different motor behaviors evoked by auditory stimuli.
Background: Stroke can result in disabling impairments, affecting functional mobility, balance, and gait. Individualized in-patient rehabilitation interventions improve balance and gait in patients with stroke. Rhythmic pairing of personally-selected music with rehabilitation interventions can be a practical form of personalized therapy that could improve functional outcomes.
Objective: To describe an in-patient rehabilitation intervention that rhythmically paired patient-selected music with rehabilitative interventions for a patient with acute stroke.
Case Description: The patient was a 48-year old male who sustained a right thalamic hemorrhagic stroke eight days prior to admittance to the in-patient rehabilitation facility. The Berg Balance Scale (BBS) (Balance), Performance Oriented Mobility Assessment-Gait portion (POMA-G) (Gait), and Functional Independence Measure® (FIM) Motor were completed on Day 1, Day 4, and Day 16 (Discharge) during the patient’s in-patient rehabilitation stay.
Outcomes: From intake to discharge, balance, gait and functional mobility significantly increased by 35, 9, and 31 points, respectively. Likewise, the patient reported positive attitudes toward the novel intervention.
Conclusion: Incorporating patient-selected music with in-patient physical rehabilitation may be a feasible intervention for patients with acute stroke. Further research with an adequate sample size that randomly assigns patients to music and control conditions is necessary to confirm the promising findings from this case report.
A neuroscience-informed approach to music therapy may not appear to have many similarities to a humanistic one. However, a closer look at both reveals some commonalities, as well as some divergences, particularly in the conceptualization of common aspects to music therapy practice. Thus, the purpose of this article is to explore such similarities and differences and examine how ideas inherent in humanistic-leaning music therapy practice may inform and strengthen neuroscience-informed music therapy practice. After describing characteristics of the neuroscience-informed music therapy approach, we review current publications from this area of practice to see where humanistic principles are suggested. We then outline where standards of selfhood, agency, relationality, and aestheticality in particular can be infused in the clinical practice and research of the neuroscience-informed music therapist as a way to enhance client outcomes by allowing them input in realizing their own health and wellness.
Rhythmic finger tapping was examined during synchronization to metronome sequences whose base intervals were slightly perturbed by a cosine-wave function with the period of four samples. Data were collected under perturbation levels of 1%, 3%, 5% and 7% in conjunction with base intervals of 400, 500, and 600 ms. Statistical analysis examined the relationship between the inter-response interval (IRI), inter-stimulus interval (ISI) and synchronization error (SE). It was observed that IRI and SE entrain to the periodicity of the ISI patterns even at perturbation levels close to and below the conscious auditory perception threshold. Furthermore, the similarity between the IRI and ISI increased in proportion to the perturbation level. It was also found that the relative perturbation level had more influence on the synchronization behavior than the absolute level. Finally, the observed rhythmic tracking data were modeled mathematically to examine the likelihood of three possible synchronization strategies.PsycINFO classification: 2330
The superior paraolivary nucleus (SPON) is a prominent structure in the auditory brainstem. In contrast to the principal superior olivary nuclei with identified roles in processing binaural sound localization cues, the role of the SPON in hearing is not well understood. A combined in vitro and in vivo approach was used to investigate the cellular properties of SPON neurons in the mouse. Patch-clamp recordings in brain slices revealed that brief and well timed postinhibitory rebound spiking, generated by the interaction of two subthreshold-activated ion currents, is a hallmark of SPON neurons. The I(h) current determines the timing of the rebound, whereas the T-type Ca(2+) current boosts the rebound to spike threshold. This precisely timed rebound spiking provides a physiological explanation for the sensitivity of SPON neurons to sinusoidally amplitude-modulated (SAM) tones in vivo, where peaks in the sound envelope drive inhibitory inputs and SPON neurons fire action potentials during the waveform troughs. Consistent with this notion, SPON neurons display intrinsic tuning to frequency-modulated sinusoidal currents (1-15Hz) in vitro and discharge with strong synchrony to SAMs with modulation frequencies between 1 and 20 Hz in vivo. The results of this study suggest that the SPON is particularly well suited to encode rhythmic sound patterns. Such temporal periodicity information is likely important for detection of communication cues, such as the acoustic envelopes of animal vocalizations and speech signals.
Recovery of skilled upper limb movement remains a critical focus of rehabilitation in individuals post stroke. Conventional treatments, however, have demonstrated limited capability to produce substantial improvements in poststroke quality of movement. Recently, rhythmic auditory stimulation (RAS) has emerged as efficacious in improving and normalizing limb movements in neurologically impaired populations. This pilot study examined changes in pre- to post-RAS reach kinematics and functional outcomes in survivors of stroke.
Five individuals in the chronic poststroke phase participated in a 2-week program of RAS training. Kinematic reaching variables were trunk, shoulder, and elbow segment contribution; movement time; and reach velocity. Functional outcomes were the Wolf Motor Function Test, Motor Activity Log, and Fugl-Meyer Assessment.
Post-RAS assessment of reaching kinematics revealed a significant (p < .05) decrease in compensatory trunk movement, increase in shoulder flexion, and a slight increase in elbow extension. Movement time and velocity significantly improved post RAS. Significant gains were observed on all functional assessments.
Post RAS, participants demonstrated substantial decreases in compensatory reaching movements. These changes in motor control strategy were paralleled by gains in functional abilities, suggesting that reduced reliance on compensatory movements may translate to improved performance of daily activities.
The effect of rhythmic auditory stimulation (RAS) on gait velocity, cadence, stride length, and symmetry was studied in 31 patients with idiopathic Parkinson's disease, 21 of them on (ON) and 10 off medication (OFF), and 10 healthy elderly subjects.
Patients walked under four conditions: (1) their own maximal speed without external rhythm; (2) with the RAS beat frequency matching the baseline cadence; (3) with RAS 10% faster than the baseline cadence; (4) without rhythm to check for carry over from RAS. Gait data were recorded via a computerised foot switch system. The RAS was delivered via a 50 ms square wave tone embedded in instrumental music (Renaissance style) in 2/4 metre prerecorded digitally on a sequencer for variable tempo reproduction. Patients on medication were tested in the morning 60-90 minutes after medication. Patients off medication were tested at the same time of day 24 hours after the last dose. Healthy elderly subjects were tested during the same time of day.
Faster RAS produced significant improvement (P < 0.05) in mean gait velocity, cadence, and stride length in all groups. Close synchronisation between rhythm and step frequency in the controls and both Parkinson's disease groups suggest evidence for rhythmic entrainment mechanisms even in the presence of basal ganglia dysfunction.
The results are consistent with and extend prior reports of rhythmic auditory facilitation in Parkinson's disease gait when there is mild to moderate impairment, and suggest a technique for gait rehabilitation in Parkinson's disease.
The purpose of this study was to investigate the influence of auditory rhythm on muscle activity as measured by changes in electromyographic (EMG) patterns of two antagonist muscles (biceps vs. triceps). Subjects ( N = 24) performed a gross motor task under pre/post test conditions with bipolar surface EMG electrodes attached to the head of the medial triceps and the belly of the biceps brachii. The task consisted of repeated down- and upswings of the arm by flexing and extending the elbow from 130–145 degrees to 0–10 degrees, and hitting a target pad on completion of the downswing with the ulnar side of the hand, clenched in a fist, and the wrist remaining in a neutral position. During the pretest, all subjects performed the task following their internal (personal) tempo. During the posttest, subjects were randomly assigned to one of three conditions: (a) repeat task as in pretest (control group: (b) perform task with auditory rhythm matched to internal tempo; and (c) perform task with auditory rhythm slower than internal tempo. Dependent measures analyzed were: (a) duration of EMG in biceps and triceps before and after target contact; (b) variation of EMG (standard deviations of duration measures); and (c) co-contraction (overlapping EMG activity of biceps and triceps before and after target contact). Statistical analysis revealed a significant decrease ( p < .05) in variation of triceps EMG before target contact for the matched rhythm group. Co-contraction of biceps and triceps EMG increased significantly before target contact for the slower and matched rhythm groups vs. the control group. Duration of triceps activity increased significantly before target contact under both rhythmic conditions. In the slower rhythm group, biceps activity after target contact increased significantly compared to the other two experimental conditions.
This research investigated the effect of auditory (musical) rhythm on temporal parameters of the stride cycle and electromyographic (EMG) activity in normal gait at three different walking cadences. Sixteen normal subjects were studied. For each walking cadence, a baseline walk without rhythm and a walk with rhythmic cuing, matched to the baseline tempo, were measured. Surface EMG and a dual walkway, consisting of pressure-sensitive switch mats, were used to record data. Results showed several significant (p < 0.05) changes with rhythmic cuing: a) improved stride rhythmicity between right and left lower limbs; b) delayed onset of gastrocnemius EMG; c) shortened duration of gastrocnemius EMG; d) decreased variation in timing of gastrocnemius EMG; e) increased integrated amplitude ratios for gastrocnemius EMG. Data suggest that auditory rhythm as peripheral timing signal improved stride rhythmicity and effected muscle activity by producing more focused motor unit recruitment patterns.
This study investigated the effect of auditory (musical) rhythm on temporal parameters of the stride cycle and electromyographic (EMG) activity in gait of stroke patients. Ten subjects were studied over three trials. Each trial consisted of a baseline walk without rhythm and a walk with rhythm as pacemaker, marched to the step cadence of the baseline walk. Surface EMG on the gastrocnemius muscle and a dual walkway, consisting of pressure-sensitive voltage coded switch mats, were used to record data. Percentage change scores from no-rhythm to rhythm conditions were calculated for statistical analysis. Results showed several significant (p < .05) changes: (a) weight-bearing stance time on the paretic side and stride symmetry improved with rhythmic cuing; (b) magnitude of muscle activation during midstance/pushoff increased on the affected side and decreased on the nonaffected side; (c) variability of integrated amplitude ratios decreased during the midstance/pushoff phase on the affected side; (d) EMG activity during the swing phase also decreased on the affected side; (e) decrease in EMG variability and decrease in muscle activity during the swing phase were positively correlated with improvement in stride symmetry. Specificity of changes in muscle activation and improvement in temporal gait parameters suggest a strong entrainment effect of auditory rhythmic cues on temporal gait control in stroke patients.
Acoustic rhythms are frequently used in gait rehabilitation, with positive instantaneous and prolonged transfer effects on various gait characteristics. The gait modifying ability of acoustic rhythms depends on how well gait is tied to the beat, which can be assessed with measures of relative timing of auditory-motor coordination. We examined auditory-motor coordination in 20 healthy elderly individuals walking to metronome beats with pacing frequencies slower than, equal to, and faster than their preferred cadence. We found that more steps were required to adjust gait to the beat, the more the metronome rate deviated from the preferred cadence. Furthermore, participants anticipated the beat with their footfalls to various degrees, depending on the metronome rate; the faster the tempo, the smaller the phase advance or phase lead. Finally, the variability in the relative timing between footfalls and the beat was smaller for metronome rates closer to the preferred cadence, reflecting superior auditory-motor coordination. These observations have three practical implications. First, instantaneous effects of acoustic stimuli on gait characteristics may typically be underestimated given the considerable number of steps required to attune gait to the beat in combination with the usual short walkways. Second, a systematic phase lead of footfalls to the beat does not necessarily reflect a reduced ability to couple gait to the metronome. Third, the efficacy of acoustic rhythms to modify gait depends on metronome rate. Gait is coupled best to the beat for metronome rates near the preferred cadence.
The effects of patterned sensory enhancement (PSE) music on muscle power and movement control in children with spastic diplegia (SD) during loaded sit-to-stand (LSTS) were investigated. Twenty-three children with SD aged 5 to 12 years were recruited. Individualized PSE was composed by a music therapist based on each subject's sit-to-stand (STS) movement with 50% 1-repetition maximum load. Each subject performed LSTS continuously for eight repetitions under randomly assigned music or no-music (Control) conditions while the kinematic and kinetic data were measured simultaneously. For the music condition, PSE music was played only during the first five repetitions (PSE condition), and the following three repetitions were referred to as the Continuation condition. Paired t- or Wilcoxon signed rank tests were used to compare the variables between the PSE and Control conditions, and between the Continuation and Control conditions. Compared to the Control condition, greater peak knee extensor power (P=0.009), greater total extensor power (P=0.015), and better center-of-mass smoothness (P=0.01), but less movement time (P=0.003) were found in the PSE condition. Significant effects of the PSE music on the above variables were also found for Continuation condition. The current results showed that individualized PSE music helped improve the performance of LSTS in children with SD. The associated biomechanical features also continued to exist in subsequent movement cycles after the music had ceased. These findings suggest that therapy using LSTS combined with PSE music may be beneficial for rehabilitating children with SD.
To determine changes in kinematic variables and compensatory movement patterns of survivors of stroke completing constraint-induced therapy (CIT).
Pre-post, case series.
Clinical rehabilitation research laboratory.
Men (n=7) and women (n=3) with unilateral stroke occurring at least 9 months prior to study entry with moderate, stable motor deficits.
Participants completed 10 consecutive weekdays of CIT for 6 hours a day comprised of trainer-supervised, functionally based activities using massed practice.
Kinematic measures included movement time, average velocity, trajectory stability, shoulder abduction, and segmental contribution. Functional measures included Wolf Motor Function Test (WMFT) performance time and functional ability scores and Motor Activity Log (MAL) "how-well" scores. All measures were administered before and after the 2-week CIT intervention.
Movement time, average velocity, and trajectory stability significantly improved after CIT. Participants used more shoulder flexion to reach after CIT, but also demonstrated increased compensatory shoulder abduction. Functional scores also significantly improved, including WMFT performance time and functional ability and MAL scores. There was no change in trunk movement or amount of elbow extension.
CIT improved motor capacities in the hemiparetic arm as reflected in the functional outcomes and in some kinematic measures. Participants' reliance on common compensatory movements was not beneficially affected by CIT. The results of this study demonstrate that while functional capacity and some movement strategies in the hemiparetic arm improve after CIT, participants may not overcome their reliance on common compensatory movement patterns. Based on these findings, this study suggests that CIT may encourage subjects to generate movement through compensatory and/or synergy-dominated movement rather than promote the normalization of motor control. This outcome highlights the need to develop CIT further as an intervention that improves functional capacity and more normative movement strategies.
An investigation was made of the time course of audio-spinal influences in man using the H-reflex technique and non-startling sounds. It was found that in all subjects the sound potentiated the H-reflex at a central latency of 80 msec, the peak facilitation (185%) being attained at 110--130 msec. The mean duration of this facilitation was 200 msec ranging from 120 to 460 msec. No inhibition was seen to follow the excitatory period. An habituation study showed a significant drop in peak facilitation after exposure to ten conditioning stimuli but a constant increase of the H-reflex above control level even after 60 presentations. The time course of this audiospinal facilitation was superposed over the EMG events during hopping to a simplified musical stimulus. In this situation, landing occurred some 50 msec prior to the ON beat or strong beat of the music. With this mode of synchronization, the timing of the ON and OFF beats of the musical stimulus would be suitable to potentiate the EMG events related respectively to the peak upwards acceleration determining the take-off and to the landing. It is inferred that during synchronized stereotyped movements to repetitive auditory stimuli, the motor events are timed to make best use of a potential audio-spinal facilitation.
Variability and bilateral symmetry of EMG gait-cycle profiles were studied in parkinsonian and healthy elderly subjects in the gastrocnemius, tibialis anterior, and vastus lateralis muscles. Components reflecting shape and timing were defined by the magnitude and phase of the cross-correlation function between individual stride profiles and the latency corrected ensemble average (LCEA) (variability), and between bilateral LCEAs (symmetry). Statistical significance was set at a confidence level of 0.01 reflecting a Bonferroni adjustment due to multiple measures. Parkinsonian gait was significantly different from the healthy elderly in several measures: increased shape variability and asymmetry in the gastrocnemius and tibialis anterior muscles, and reduced timing variability in the gastrocnemius. A portion of the parkinsonian group participated in a 3 week therapy program where they walked to rhythmic auditory stimulation. Gait parameters shifted toward healthy elderly values in each measure where population differences were found. Significant changes were observed in decreased tibialis anterior shape variability and asymmetry, and gastrocnemius shape variability. Strong trends were also observed in increased gastrocnemius timing variability and reduced bilateral asymmetry. In addition to the expected decreased in variability and asymmetry of healthy elderly, increased timing variability in the gastrocnemius was associated with a more normal gait, possibly reflecting feedback adaptability of muscle activity which may be useful in generating stable locomotion.
To characterize synchronisation strategies in the tracking of auditory rhythm with rhythmic finger tapping, the adaptation process after unexpected step changes of an interstimulus interval (ISI) of 500 ms was investigated. Step changes of 2% (10 ms), 4% (20 ms), and 10% (50 ms) of ISI were applied to the stimulus sequence. Synchronisation patterns of 5 subjects were analyzed based on synchronisation error (SE) and interresponse intervals (IRI). A strategy shift contigent upon the size of the introduced step change was detected. After small ISI changes, rapid IRI matching to the new ISI was accompanied by temporarily enlarged SE values, which slowly returned to preferred SE values before the step change. Large ISI changes showed quick SE adaptations accompanied by a temporary overcorrection of IRI. Response asymmetry between ISI decreases and increases emerged, showing a stronger adaptation during ISI increases. A two-dimensional difference equation was formulated to simulate the time series of intertap intervals and explain the control process during IRI and SE adjustments. The system constants were optimized to minimalize the deviations between the computed and the observed response trajectories, consisting of the time series of SE and IRI. It was shown that a successful model fit using a linear two-dimensional difference equation was based on the size and direction of the ISI changes. MANOVA procedures showed that differences in equation parameters during small and large step changes were statistically significant (P < 0.05). It is therefore suggested that a uniform model accounting for synchronization responses to all step changes would require the introduction of nonlinear system properties.
The synchronization of rhythmic arm movements to a syncopated metronome cue was studied in a step-change design whereby small tempo shifts were inserted at fixed time points into the metronome frequency. The cueing sequence involved three stimulus types: (1) target contact in synchrony with the metronome beats, (2) syncopated target contact midway in time between audible beats, and (3) syncopated target contact following either a +2% or -2% change in stimulus frequency. Analysis of normalized and aggregated data revealed that (1) during the syncopation condition the response period showed a rapid adaptation to the frequency-incremented stimulus period, (2) response period was less variable during syncopated movement, (3) mean synchronization error and variability, calculated during syncopation relative to the mathematical midpoint of the stimulus cycle, were reduced during syncopated movements, and (4) synchronization error following the frequency increment showed trends to return linearly to pre-increment values which was fully achieved in the -2% change condition only. The results suggest that frequency entrainment to stimulus period was possible during syncopated movement with the response and stimulus onsets 180 degrees out of phase. Most remarkably, 70-80% of the adaptation of the response period to the new stimulus period was immediately attained during the second half cycle of the syncopated movement. Finally, a mathematical model, based on recursion, was introduced that accurately modeled actual data as a function of the previous stimulus and response intervals and a weighted response of period error and synchronization error, which showed dominance of frequency entrainment over phase entrainment during rhythmic synchronization.
The study of rhythmicity provides insights into the understanding of temporal coding of music and temporal information processing in the human brain. Auditory rhythms rapidly entrain motor responses into stable steady synchronization states below and above conscious perception thresholds. Studying the neural dynamics of entrainment by measuring brain wave responses (MEG) we found nonlinear scaling of M100 amplitudes generated in primary auditory cortex relative to changes in the period of the rhythmic interval during subliminal and supraliminal tempo modulations. In recent brain imaging studies we have described the neural networks involved in motor synchronization to auditory rhythm. Activated regions include primary sensorimotor and cingulate areas, bilateral opercular premotor areas, bilateral SII, ventral prefrontal cortex, and, subcortically, anterior insula, putamen, and thalamus. Within the cerebellum, vermal regions and anterior hemispheres ipsilateral to the movement became significantly activated. Tracking temporal modulations additionally activated predominantly right prefrontal, anterior cingulate, and intraparietal regions as well as posterior cerebellar hemispheres. Furthermore, strong evidence exists for the substantial benefits of rhythmic stimuli in rehabilitation training with motor disorders.
The objective was to investigate the effects of auditory rhythms and arm movement on inter-segmental coordination during walking in persons who have suffered a stroke. Eleven subjects walked on a treadmill: (1) during systematic increases in velocity (0.22-1.52 m/s), (2) with instructions to 'step to the beat' during systematic increases in metronome frequency (1-2.2 Hz), and (3) with instructions: 'move the arms and legs to the beat' during systematic increases in metronome frequency (1-2.2 Hz). Movement amplitude of upper and lower body segments, frequency coordination between arm and leg movements, phase relation between upper and lower body segments were measured. Moving the arms and legs to the beat resulted in increased arm swing along with 1:1 frequency coordination between the arm and leg, and a more out-of-phase relation between transverse pelvic and thoracic rotation was observed with larger pelvic and thoracic rotations. Verbal instructions to move the arms to the beat of a metronome leads to increased arm swing, increased stride length, but further study is needed to examine the dynamics of the changes in arm movement, to enhance understanding of how upper extremity movement dysfunction affects inter-segmental coordination during walking.