Gait training with auditory feedback improves trunk control, muscle activation and dynamic balance in patients with hemiparetic stroke: A randomized controlled pilot study

BACKGROUND: Auditory feedback enables an individual to identify and modify the differences between actual and intended movement during the motor learning process. OBJECTIVE: We investigated the effects of gait training with auditory feedback on trunk control, muscle activation, and dynamic balance in patients with hemiparetic stroke. METHODS: Twenty participants with hemiparetic stroke were recruited in this study and randomly assigned to the experimental (n = 10) or control (n = 10) group. The subjects in the experimental group participated in gait training with auditory feedback for 30 minutes, 5 times a week, for 4 weeks, whereas those in the control group received conventional gait training for 30 minutes, 5 times a week, for 4 weeks. During auditory feedback training, a beeping sound is produced every time a patient loaded weight that was higher than the preset threshold on the cane. Activation of the erector spinae muscle was measured using surface electromyography, and trunk control was evaluated using the Trunk Impairment Scale (TIS). Dynamic balance was measured using the Timed Up and Go (TUG) test. RESULTS: Muscle activation was significantly higher in the experimental group than in the control group (6.6 +/- 9.2% vs 1.4 +/- 5.4% nonparetic peak activity). No significant difference was found in the TIS score between the experimental and control groups. Based on the TUG test, a significant improvement was observed in the experimental group compared to the control group (12.1 +/- 11.4 vs 3.8 +/- 4.7 s). CONCLUSION: Our findings indicate that gait training with auditory feedback was beneficial for improving trunk control and muscle activation in patients with hemiparetic stroke.