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Open Access 01-03-2011 | Research Article

Comparing the efficacy of metronome beeps and stepping stones to adjust gait: steps to follow!

Authors: Paulina J. M. Bank, Melvyn Roerdink, C. E. Peper

Published in: Experimental Brain Research | Issue 2/2011

Abstract

Acoustic metronomes and visual targets have been used in rehabilitation practice to improve pathological gait. In addition, they may be instrumental in evaluating and training instantaneous gait adjustments. The aim of this study was to compare the efficacy of two cue types in inducing gait adjustments, viz. acoustic temporal cues in the form of metronome beeps and visual spatial cues in the form of projected stepping stones. Twenty healthy elderly (aged 63.2 ± 3.6 years) were recruited to walk on an instrumented treadmill at preferred speed and cadence, paced by either metronome beeps or projected stepping stones. Gait adaptations were induced using two manipulations: by perturbing the sequence of cues and by imposing switches from one cueing type to the other. Responses to these manipulations were quantified in terms of step-length and step-time adjustments, the percentage correction achieved over subsequent steps, and the number of steps required to restore the relation between gait and the beeps or stepping stones. The results showed that perturbations in a sequence of stepping stones were overcome faster than those in a sequence of metronome beeps. In switching trials, switching from metronome beeps to stepping stones was achieved faster than vice versa, indicating that gait was influenced more strongly by the stepping stones than the metronome beeps. Together these results revealed that, in healthy elderly, the stepping stones induced gait adjustments more effectively than did the metronome beeps. Potential implications for the use of metronome beeps and stepping stones in gait rehabilitation practice are discussed.

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In addition, some significant differences were obtained at higher step numbers for both T _step and Y _step. However, these differences varied in sign and were all smaller than 2.5% of the prescribed step time and length, respectively. Therefore, these additional post hoc results were considered immaterial for the interpretation of the three-way interaction.

In this context, in particular the differences in %Corr between the cueing conditions over the first 6 steps are noteworthy, because the differences obtained for S ₇–S ₁₃ seemed to be due to an overcorrection in the visual cueing condition, which was gradually absorbed in subsequent steps.

Note that this difficulty to accelerate the steps was also discernable in the switching trials. More trials were excluded when a shorter-step response was required to establish synchronization with the new, phase-shifted cues (i.e., for the −90° shift; Table 1).

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Title: Comparing the efficacy of metronome beeps and stepping stones to adjust gait: steps to follow!
Authors: Paulina J. M. Bank
Melvyn Roerdink
C. E. Peper
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: Experimental Brain Research / Issue 2/2011
Print ISSN: 0014-4819
Electronic ISSN: 1432-1106
DOI: https://doi.org/10.1007/s00221-010-2531-9

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Comparing the efficacy of metronome beeps and stepping stones to adjust gait: steps to follow!

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