Sonification Techniques for Gait Training: a Pilot Multicentric Randomized Controlled Trial
Music therapy is widely used in relational and rehabilitation settings. In addition to Neurologic Music Therapy and other music-based techniques, sonification approaches were recently introduced in the field of rehabilitation. The sonification can be defined as a properly selected set of sonorous-music stimuli are associated with patient movements mapping. In fact, the auditory-motor feedback can replace damaged proprioceptive circuits with a consequent improvement of the rehabilitation process. Interventions with sonification facilitate sensorimotor learning, proprioception and movements planning and execution improving global motor parameters. This study proposes the use of musical auditory cues which includes the melodic-harmonic component of the music. This kind of sonification makes the feedback pleasant and predictable as well as potentially effective. The investigators propose to apply and assess the effectiveness of this kind of sonification on gait training and other secondary outcomes in stroke, Parkinson's disease and multiple sclerosis population. Also, the investigators will assess the impact of sonification on the level of fatigue perceived during the rehabilitation process and on the quality of life. The study is a multicenter randomized controlled trial and will involve 120 patients that will undergo standard motor rehabilitation or the same rehabilitation but with the sonification support. The interventions will be evaluated at the baseline, after 10 sessions, after 20 sessions and at follow-up (one month after the end of the treatment). The assessment will include functional, motor, fatigue and quality of life evaluations. The collected data will be statistically processed.
• Age \< 80
• Mini Mental State Examination \> 24
• Modified Rankin Scale: 1-3
• Single hemisphere lesion
• Stabilized disease (\> 6 months after the acute event)
• Impairment in gait parameters (e.g. velocity, perceived fatigue etc)
• Motor independence during walking (without orthotic devices and aids) but with pathological pattern (spasticity level: Ashworth \< 2)
• Age \< 80
• Mini Mental State Examination \> 24
• Unified Parkinson Disease Rating Scale score (Parte III): \< 28
• Stabilized disease and drug therapy
• Altered gait patterns
• Motor independence during walking (without orthotic devices and aids) but with pathological pattern
• Age \< 60
• Mini Mental State Examination \> 24
• Expanded Disability Status Scale score: 3-5
• Stabilized disease in the last 6 months (without relapse or disability progression)
• Altered gait patterns (i.e., careening, slowing down, spasticity: Ashworth \< 2, etc.)
• Motor independence during walking