Real-time auditory feedback may reduce abnormal movements in patients with chronic stroke

Abstract

Purpose

The current pilot study assesses the use of real-time auditory feedback to help reduce abnormal movements during an active reaching task in patients with chronic stroke.

Materials and methods

20 patients with chronic stroke completed the study with full datasets (age: M = 53 SD = 14; sex: male = 75%; time since stroke in months: M = 34, SD = 33). Patients undertook 100 repetitions of an active reaching task while listening to self-selected music which automatically muted when abnormal movement was detected, determined by thresholds set by clinical therapists. A within-subject design with two conditions (with auditory feedback vs. without auditory feedback) presented in a randomised counterbalanced order was used. The dependent variable was the duration of abnormal movement as a proportion of trial duration.

Results

A significant reduction in the duration of abnormal movement was observed when patients received auditory feedback, F(1,18) = 9.424, p = 0.007, with a large effect size (partial ${\eta }^2$ = 0.344).

Conclusions

Patients with chronic stroke can make use of real-time auditory feedback to increase the proportion of time they spend in optimal movement patterns. The approach provides a motivating framework that encourages high dose with a key focus on quality of movement.

Trial Registration: ISRCTN12969079 https://www.isrctn.com/ISRCTN12969079

ISRTCN trial registration REF: ISRCTN12969079

IMPLICATIONS FOR REHABILITATION

• Movement quality during upper limb rehabilitation should be targeted as part of a well-balanced rehabilitation programme.

• Auditory feedback is a useful tool to help patients with chronic stroke reduce compensatory movements.

Keywords:

• Rehabilitation
• compensation
• movement
• machine learning
• kinematics

Acknowledgments

The authors would like to thank all the patients who participated in the study as well as the physiotherapists and occupational therapists from the QSUL programme who helped to recruit and setup the patients for the study: Shauna Feeney, Matthew Pountain, Conor Carville, Rachel Higgins, Fred Baron and Rebecca Wells.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The first author disclosed receipt of the following financial support for the research: This work was supported by the Economic and Social Research Council: grant number ES/J500124/1.