Autonomous Control of Music to Retrain Walking After Stroke.
Ashley N Collimore, Anna V Roto Cataldo, Ashlyn J Aiello and 5 others
PMID 37272500WHAT IT FOUND
One 30-minute session of automated, music-based gait training improved walking symmetry and reduced energy cost in 10 stroke survivors.
The system adjusted music tempo and beat salience in real time based on foot sensors, offering a potential way to deliver skilled gait rehab without a therapist present.
Key findings
01Participants showed significant reductions in step time, stance time, and swing time asymmetries after training, with 9 out of 10 improving on these temporal metrics.
02The energetic cost of walking decreased significantly from a median of 0.229 to 0.196 ml O2/kg/m, with the largest benefits seen in those who had a high baseline energetic impairment.
03No significant changes were found in step length asymmetry, cadence, or gait variability, possibly because walking speed was experimentally controlled during the treadmill evaluations.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so it is impossible to determine if the improvements were due to the specific closed-loop algorithm, the music itself, or simply the act of walking for 30 minutes. The sample size was very small (n=10) and single-session, meaning the results reflect immediate, short-term changes rather than long-term rehabilitation outcomes or retention. Evaluations were conducted on a treadmill with speed controlled, which may not reflect how patients walk overground in the community and may have masked changes in spatial parameters like step length. Participants were not screened for amusia (inability to perceive rhythm) or anhedonia (inability to feel pleasure), which could affect response to music-based therapy. The training was supervised in a lab, not in the unsupervised home or community settings the technology is designed for.
Declared interests
The study was supported by MedRhythms, Inc. One author is a paid advisor to the company, and another is the co-founder and CEO. The company also developed the technology used in the study.
The easy way to misread this
Do not assume this technology is proven effective for long-term rehabilitation. This was a single-session pilot with no control group, funded by the company that makes the device. The improvements were immediate and may not persist, and the lack of a control group means we do not know if the specific music algorithm caused the change or if it was just the exercise.