Page 33 - NAMAH-Jan-2023

Namah Effects of Musical Cueing in Gait Kinematics

phases in the gait cycle, one is called stance difficulty hearing the beat with music and
phase in which the foot is on the ground and therefore have problems synchronising her
the other is swing-phase where it is in the movements with it. So, listening to music
air. The stride begins when the foot hits the may demand some additional attentional
ground to start the stance phase and ends resources and, could potentially adversely
after the stance and swing phase have been affect her gait performance. But RAS, used
completed, when the same foot hits the ground in combination with gait training improves
again. During the gait cycle, when both feet her walking velocity and step length. Overall,
are on the ground, it is called ‘double support eight individual sessions of RAS with six
time’. So with any abnormal gait pattern, beats parameter improves her gait with good
there is usually an increase in the double stride length. Below, mentioned pointers for
support time with an effort by the body to Nilima are a good example for overall benefits
improve stability and decrease the risk of of a PD patient from the Rhythmic Auditory
falling. Stimulation.

ii. Step 1. Increasing stride length and taking bigger
A step is measured from the time when one steps.
foot hits the ground, until the time when the 2. Emphasise the heel strike, and with a heel-
other hits the ground. We count steps when to-toe gait pattern this will help to decrease
we calculate cadence or step per minute. toe walking
3. Improvement of posture and some balance
Nilima may subconsciously time her motor training to reduce their fall risk.
actions to an auditory rhythmic stimulus when 4. ‘Stop and Go’ rhythmic cueing can be used
she pays no attention to the music. Within to work on initiation and coordination.
music, the pitch and the rhythm combine 5. Slowly progress the duration to increase
to provide a melodic pattern whereas an functional endurance
electronic tabla app only provides a rhythm. 6. To improve the ability to walk through
When she dances to the music of Momo doorways, keeping to the beat.
chitte Niti nritya, written by Rabindranath
Tagore during a group dancing session, What Is RAS?
we as therapists can channelise her hands
movements to some basic daily living exercises Therapeutic Mechanisms - Rhythmic Auditory
like how to hold handles or how to comb Stimulation is based on four neurological
her hair. But on the other hand, to increase principles, namely rhythmic entrainment,
her walking stride length, we use Rhythmic priming, cueing of the movement period and
Auditory Stimulation based on six beats of stepwise limit cycle entrainment.
Taal - Dadra without music to do the six steps
exercise of RAS. The attraction of making Rhythmic entrainment is the ability of the motor
rhythmic movements to a rhythm is further system to couple with the auditory system
exemplified by the finding that she is having and drive movement patterns. Central pattern
more difficulty to tap in between the beats generators are local spinal cord circuits that
than on the beat. However, she may also have help to connect incoming sensory information

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