Effects of Real-time Auditory Stimulation Feedback on Balance and Gait after Stroke: a Randomized Controlled Trial

Background: The aim of this study was to examine the effects of Real-time Auditory stimulation Feedback (RAF) on balance and gait in stroke patients and to suggest a more effective method of gait training. Methods: This was a hospital-based, randomized controlled trial with a blinded assessor. Twenty four chronic stroke patients who were more than six months post-stroke participated in this study. They were randomly allocated to 1 of 2 groups: Real-time Auditory stimulation Feedback (RAF) group (n= 12) and treadmill group (n=12). Patients in the RAF group received three 30-minute sessions of treadmill gait training combined with RAF per week over a period of four weeks. Patients in the treadmill group received general treadmill training under the same experimental condition without RAF. The following clinical measures were used for assessment of static balance and gait abilities: Balancia, Timed Up and Go Test. Spatiotemporal gait parameters were also collected using the GAITRite system. Results: Significant differences in outcomes for average perturbation velocity and total perturbation distance in closed eyes condition were observed in the RAF group compared with the control group. In addition, measurements for the TUG test indicated significant differences in the RAF group. Results for gait speed, step length and stride length, single limb support percentage of the affected side, and gait asymmetry showed a more significant difference in the RAF group compared with the control group. Conclusion: Gait training using RAF is effective for restoration of balance and gait ability, and it improves the existing problem of rhythmic auditory stimulation gait training.