Patterns of enhancement in paretic shoulder kinematics after stroke with musical cueing

Shinil Kang, Joon-Ho Shin, In Young Kim, Jongshill Lee, Ji-Yeoung Lee, Eunju Jeong, Shinil Kang, Joon-Ho Shin, In Young Kim, Jongshill Lee, Ji-Yeoung Lee, Eunju Jeong

Abstract

Musical cueing has been widely utilised in post-stroke motor rehabilitation; however, the kinematic evidence on the effects of musical cueing is sparse. Further, the element-specific effects of musical cueing on upper-limb movements have rarely been investigated. This study aimed to kinematically quantify the effects of no auditory, rhythmic auditory, and melodic auditory cueing on shoulder abduction, holding, and adduction in patients who had experienced hemiparetic stroke. Kinematic data were obtained using inertial measurement units embedded in wearable bands. During the holding phase, melodic auditory cueing significantly increased the minimum Euler angle and decreased the range of motion compared with the other types of cueing. Further, the root mean square error in the angle measurements was significantly smaller and the duration of movement execution was significantly shorter during the holding phase when melodic auditory cueing was provided than when the other types of cueing were used. These findings indicated the important role of melodic auditory cueing for enhancing movement positioning, variability, and endurance. This study provides the first kinematic evidence on the effects of melodic auditory cueing on kinematic enhancement, thus suggesting the potential use of pitch-related elements in psychomotor rehabilitation.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Significant differences of kinematic parameters of movement. The graphs show means with standard errors. (A) ROM during the holding phase. (B) MIN during the holding phase. (C) Duration during the holding phase. (D) RMSE during the holding phase. P values are provided for significant differences (p < 0.0167).
Figure 2
Figure 2
Comparison of Euler angle data of shoulder movement. (A) Data obtained from severely affected patients’ shoulders. (B) Data obtained from moderately affected patients’ shoulders.
Figure 3
Figure 3
Movement variability profile using Euler angle data. Representative RMSE profiles of the magnitudes of the Euler angle of 16 patients during the shoulder movement holding phase are shown. The x-axis displays 100% of the movement cycle: 0% and 100% are the shoulder movement holding times. The y-axis displays the normalised Euler angle values. Normalised Euler angle values were used to enhance the comparison among patients. The left column shows the NAC condition; the middle column shows the RAC condition; and the right column shows the MAC condition.
Figure 4
Figure 4
An example of auditory cueing. (A) Rhythmic auditory cueing. (B) Melodic auditory cueing.
Figure 5
Figure 5
In-house-built H-IMU. (A) Cover closed. (B) Cover opened.
Figure 6
Figure 6
An individual demonstrating shoulder abduction with the H-IMUs attached. (A) Arm at the side. (B) Raising one arm halfway. (C) Reaching the arm towards the head.
Figure 7
Figure 7
Kinematic recording of hemiparetic shoulder abduction, holding, and adduction movements across three types of cueing.
Figure 8
Figure 8
Sample raw Euler angle data obtained from one trial of shoulder abduction, holding, and adduction. SP start point, EP end point, FP fiducial point.

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