Musical stairs: the impact of audio feedback during stair-climbing physical therapies for children

Abstract

Purpose: Enhanced biofeedback during rehabilitation therapies has the potential to provide a therapeutic environment optimally designed for neuroplasticity. This study investigates the impact of audio feedback on the achievement of a targeted therapeutic goal, namely, use of reciprocal steps. Methods: Stair-climbing therapy sessions conducted with and without audio feedback were compared in a randomized AB/BA cross-over study design. Seventeen children, aged 4–7 years, with various diagnoses participated. Reports from the participants, therapists, and a blinded observer were collected to evaluate achievement of the therapeutic goal, motivation and enjoyment during the therapy sessions. Results: Audio feedback resulted in a 5.7% increase (p = 0.007) in reciprocal steps. Levels of participant enjoyment increased significantly (p = 0.031) and motivation was reported by child participants and therapists to be greater when audio feedback was provided. Discussion: These positive results indicate that audio feedback may influence the achievement of therapeutic goals and promote enjoyment and motivation in young patients engaged in rehabilitation therapies. This study lays the groundwork for future research to determine the long term effects of audio feedback on functional outcomes of therapy.

Implications for Rehabilitation

• Stair-climbing is an important mobility skill for promoting independence and activities of daily life and is a key component of rehabilitation therapies for physically disabled children.

• Provision of audio feedback during stair-climbing therapies for young children may increase their achievement of a targeted therapeutic goal (i.e. use of reciprocal steps).

• Children’s motivation and enjoyment of the stair-climbing therapy was enhanced when audio feedback was provided.

• Biofeedback
• enjoyment
• motivation
• motor rehabilitation
• neuroplasticity

Acknowledgements

We would like to thank the Integrated Education Therapy team at Holland Bloorview Kids Rehabilitation Hospital and their patients for their participation in this study. The authors would like to thank the physical therapists who provided feedback on the study design; Claire Mackenzie for participant recruitment; Zuzana Firment, Lori Goldlust and Alan Wu for their help in data collection; Chandrashekhar Yaduvanshi for assistance in data analysis; and Tom Chau and Virginia Wright for their guidance and feedback during the project.

Declaration of interest

This research was supported in part by the Holland Bloorview Kids Rehabilitation Hospital Foundation and the Natural Sciences and Engineering Council of Canada. The authors report no conflicts of interest.