Search Results (11)

In the current landscape of hearing rehabilitation, ear mold manufacturing typically involves the injection of silicone into the external ear canal (EEC) of each patient. This invasive procedure poses several risks, including the potential for silicone residue retention and tympanic membrane perforation, which may necessitate surgical intervention. To mitigate these risks, we present the design of a video otoscope that integrates a scanner capable of capturing high-precision, real-time images of the EEC’s geometry. The developed device allows (i) the generation of a 3D CAD model leading to the direct, quick, and low-cost production of customized hearing aids using 3D printing and (ii) the establishment of medical protocols for carrying out diagnoses and monitoring of hearing pathology evolution using methodologies based on Artificial Intelligence. Furthermore, the use of customized hearing aids that allow the application of Rhythmic Auditory Stimulation (RAS) and music therapy enhances audiology as an alternative and innovative way to treat cognitive and degenerative diseases, as well as pathological disorders. Full article

Temporal gait asymmetry (TGA) is commonly observed in individuals facing mobility challenges. Rhythmic auditory stimulation (RAS) can improve temporal gait parameters by promoting synchronization with external cues. While biofeedback for gait training, providing real-time feedback based on specific gait parameters measured, has been proven to successfully elicit changes in gait patterns, RAS-based biofeedback as a treatment for TGA has not been explored. In this study, a wearable RAS-based biofeedback gait training system was developed to measure temporal gait symmetry in real time and deliver RAS accordingly. Three different RAS-based biofeedback strategies were compared: open- and closed-loop RAS at constant and variable target levels. The main objective was to assess the ability of the system to induce TGA with able-bodied (AB) participants and evaluate and compare each strategy. With all three strategies, temporal symmetry was significantly altered compared to the baseline, with the closed-loop strategy yielding the most significant changes when comparing at different target levels. Speed and cadence remained largely unchanged during RAS-based biofeedback gait training. Setting the metronome to a target beyond the intended target may potentially bring the individual closer to their symmetry target. These findings hold promise for developing personalized and effective gait training interventions to address TGA in patient populations with mobility limitations using RAS. Full article

(1) Background: Even though music therapy is acknowledged to have positive benefits in neurology, there is still a lack of knowledge in the literature about the applicability of music treatments in clinical practice with a neurological population using wearable devices. (2) Methods: a systematic review was conducted following PRISMA 2020 guidelines on the 29 October 2022, searching in five databases: PubMed, PEDro, Medline, Web of Science, and Science Direct. (3) Results: A total of 2964 articles were found, including 413 from PubMed, 248 from Web of Science, 2110 from Science Direct, 163 from Medline, and none from PEDro. Duplicate entries, of which there were 1262, were eliminated. In the first screening phase, 1702 papers were screened for title and abstract. Subsequently, 1667 papers were removed, based on population, duplicate, outcome, and poor study design. Only 15 studies were considered after 35 papers had their full texts verified. Results showed significant values of spatiotemporal gait parameters in music-based therapy rhythmic auditory stimulation (RAS), including speed, stride length, cadence, and ROM. (4) Conclusions: The current findings confirm the value of music-based therapy RAS as a favorable and effective tool to implement in the health care system for the rehabilitation of patients with movement disorders. Full article

This study aims to create an all-around insight into the evolutions, status, and global trends of rhythmic auditory stimulation (RAS) research via enhanced bibliometric methods for the 2001–2020 time period. Articles concerning RAS were extracted from the Web of Science database. CiteSpace, Bibliometrix, VOSviewer, and Graphpad Prism were employed to analyze publication patterns and research trends. A total of 586 publications related to RAS between 2001 and 2020 were retrieved from the Web of Science database. The researcher Goswami U. made the greatest contribution to this field. The University of Toronto was the institution that published the most articles. Motor dysfunction, sensory perception, and cognition are the three major domains of RAS research. Neural tracking, working memory, and neural basis may be the latest research frontiers. This study reveals the publication patterns and topic trends of RAS based on the records published between 2001 and 2020. The insights obtained provided useful references for the future research and applications of RAS. Full article

(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson’s disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients. Full article

Purpose: the purpose of this paper was to evaluate the effects of music-based rhythmic auditory stimulation on balance and motor function after stroke and whether there are differences depending on the affected hemisphere, lesion site and age. Materials and Methods: This study was an observational and longitudinal study. Adult stroke survivors (n = 28), starting no later than 3 weeks after a stroke, conducted 90 min sessions of music-based rhythmic auditory stimulation 3 days a week, in addition to 60 min a day of conventional physiotherapy. Balance ability was evaluated using the Mini Best Test and the Tinetti Test; motor function was evaluated using the Motor Assessment Scale. Results: All of the participants significantly improved their balance ability and motor function variables upon comparing scores at discharge and admission. Intragroup differences were observed upon comparing subgroups of patients by lesion site and by the degree of motor impairment. Age, stroke type and affected hemisphere seemed not to be directly related to the amount of improvement. Conclusions: This study suggests that the effects of music-based rhythmic auditory stimulation (RAS) on balance ability and motor function varies depending on the scale or test used for evaluation and on the variables that the tests measure. Patients with hemiparesis seemed to improve more than those with hemiplegia. Full article

Patients with stroke suffer from impaired locomotion, exhibiting unstable walking with increased gait variability. Effects of rhythmic sensory stimulation on unstable gait of patients with chronic stroke are unclear. This study aims to determine the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Twenty older adults with stroke and twenty age- and gender-matched healthy controls walked 60 m under four conditions: normal walking with no stimulation, walking with rhythmic auditory stimulation (RAS) through an earphone in the ear, walking with rhythmic somatosensory stimulation (RSS) through a haptic device on the wrist of each participant, and walking with rhythmic combined stimulation (RCS: RAS + RSS). Gait performance in the stroke group significantly improved during walking with RAS, RSS, and RCS compared to that during normal walking (p < 0.008). Gait variability significantly decreased under the RAS, RSS, and RCS conditions compared to that during normal walking (p < 0.008). Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. The effect was greater in patients with reduced mobility, assessed by the Rivermead Mobility Index (RMI). Full article

Freezing of Gait (FOG) is an impairment that affects the majority of patients in the advanced stages of Parkinson’s Disease (PD). FOG can lead to sudden falls and injuries, negatively impacting the quality of life for the patients and their families. Rhythmic Auditory Stimulation (RAS) can be used to help patients recover from FOG and resume normal gait. RAS might be ineffective due to the latency between the start of a FOG event, its detection and initialization of RAS. We propose a system capable of both FOG prediction and detection using signals from tri-axial accelerometer sensors that will be useful in initializing RAS with minimal latency. We compared the performance of several time frequency analysis techniques, including moving windows extracted from the signals, handcrafted features, Recurrence Plots (RP), Short Time Fourier Transform (STFT), Discreet Wavelet Transform (DWT) and Pseudo Wigner Ville Distribution (PWVD) with Deep Learning (DL) based Long Short Term Memory (LSTM) and Convolutional Neural Networks (CNN). We also propose three Ensemble Network Architectures that combine all the time frequency representations and DL architectures. Experimental results show that our ensemble architectures significantly improve the performance compared with existing techniques. We also present the results of applying our method trained on a publicly available dataset to data collected from patients using wearable sensors in collaboration with A.T. Still University. Full article

Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 (n = 27) were assigned as the historical control group whereas 2019 patients (n = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement (p = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains. Full article

The aim of the study was to define the effect of different short-term metro-rhythmic stimulations on the time and spatial parameters of gait. The secondary goal was to test whether prior instructions on how to respond to stimulations played a significant role in the stimulation by sound stimuli. Experimental tests of gait were conducted on a group of 36 healthy participants: group 1—subjects who were not informed how to react after hearing sound stimuli, group 2—subjects who received a clear instruction before the test to adjust the frequency of taking steps to the rhythm of the music. The gait research was carried out on a Zebris FDM-S (zebris Medical Gmbh, Isny, Germany) treadmill for various sound stimuli (arrhythmic stimulus, rhythmic stimuli at different rate). It was shown that a short-term influence of metro-rhythmic stimulations changes the time and spatial parameters of gait, i.e., gait frequency, length and duration of the gait cycle. The greatest impact on the modification of the time–space parameters of walking is exerted by rhythmic stimuli at a pace different from the frequency of gait at a preferred velocity. Providing information on how to respond to sounds heard may be important in gait therapy with RAS (rhythmic auditory stimulation). Full article

The aim of this study was to investigate the effect of gait training with bilateral rhythmic auditory stimulation (RAS) on lower extremity rehabilitation in stroke patients. Forty-four participants (<6 months after stroke) were randomly allocated to the gait training with bilateral rhythmic auditory stimulation (GTBR) group (n = 23) and the control group (n = 21). The GTBR group had gait training with bilateral RAS for 30 min a day, 5 days a week, in a 6-week period, in addition to conventional therapy. The control group had gait training without RAS, and conventional therapy. Outcome measures included gait symmetry, gait ability, balance ability, and lower extremity function. Gait symmetry on step time showed significant improvements compared to baseline (p < 0.05) in the GTBR group, but not in the control group. Gait ability was significantly improved in both groups relative to baseline values (p < 0.05), and the GTBR group showed significantly greater improvement in comparison to the control group (p < 0.05). Both groups showed significant improvements in the Timed Up and Go test (TUG), Berg Balance Scale (BBS), and Fugl–Meyer Assessment (FMA) compared to baseline (p < 0.05). GTBR is an effective therapeutic method of improving symmetric gait in stroke rehabilitation. Moreover, we found that GTBR beat frequency matching fast step time might be even more beneficial in improving gait symmetry. Future studies may develop a method of applying RAS on step time and length for improvement of gait symmetry in stroke patients. Full article