Rhythm Perception and Production Abilities and Their Relationship to Gait After Stroke

Arch Phys Med Rehabil. 2018 May;99(5):945-951. doi: 10.1016/j.apmr.2018.01.009. Epub 2018 Feb 8.


Objectives: To assess rhythm abilities, to describe their relation to clinical presentation, and to determine if rhythm production independently contributes to temporal gait asymmetry (TGA) poststroke.

Design: Cross-sectional.

Setting: Large urban rehabilitation hospital and university.

Participants: Individuals (N=60) with subacute and chronic stroke (n=39) and data for healthy adults extracted from a preexisting database (n=21).

Interventions: Not applicable.

Main outcome measures: Stroke group: National Institutes of Health Stroke Scale (NIHSS), Chedoke-McMaster Stroke Assessment (CMSA) leg and foot scales, Montreal Cognitive Assessment (MoCA), rhythm perception and production (Beat Alignment Test [BAT]), and spatiotemporal gait parameters were assessed. TGA was quantified with the swing time symmetry ratio. Healthy group: age and beat perception scores assessed by the BAT. Rhythm perception of the stroke group and healthy adults was compared with analysis of variance. Spearman correlations quantified the relation between rhythm perception and production abilities and clinical measures. Multiple linear regression assessed the contribution of rhythm production along with motor impairment and time poststroke to TGA.

Results: Rhythm perception in the stroke group was worse than healthy adults (F1,56=17.5, P=.0001) Within the stroke group, rhythm perception was significantly correlated with CMSA leg (Spearman ρ=.33, P=.04), and foot (Spearman ρ=.49, P=.002) scores but not NIHSS or MoCA scores. The model for TGA was significant (F3,35=12.8, P<.0001) with CMSA leg scores, time poststroke, and asynchrony of rhythm production explaining 52% of the variance.

Conclusions: Rhythm perception is impaired after stroke, and temporal gait asymmetry relates to impairments in producing rhythmic movement. These results may have implications for the use of auditory rhythmic stimuli to cue motor responses poststroke. Future work will explore brain responses to rhythm processing poststroke.

Keywords: Gait; Perception; Rehabilitation; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Cross-Sectional Studies
  • Female
  • Foot / physiopathology
  • Gait / physiology
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology*
  • Gait Disorders, Neurologic / psychology
  • Humans
  • Leg / physiopathology
  • Linear Models
  • Male
  • Middle Aged
  • Periodicity*
  • Statistics, Nonparametric
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke / psychology
  • Time Perception / physiology*