The Effect of Rhythmic Auditory Cue on the Lower Limb Muscle Activity during Cycling in the Elderly Subjects

Abstract

Rhythmic auditory cue is one of the accepted techniques for the rehabilitation and improvement of motor control in the healthy elderly and who with movement disorders. The aim of this study was to determine the effects of auditory cue on the EMG activity of the elderly subjects during cycling. 10 healthy elderly males participated in this study. The EMG activity of rectus femoris (RF), biceps femoris (BF) and tibialis anterior (TA) muscles were recorded using an EMG-USB2+ multichannel system (Bioelettronica Italy) (sampling frequency of 1000 Hz) and bipolar surface electrodes. Using OT BioLab software the signals were processed and the RMS of signals was obtained. For the tests, the subjects were asked to pedal with preferred speed with and without rhythmic auditory cue. Each condition was repeated for three times, and each test lasts for one minute. There was 3-minutes rest between repetitions. Data was analyzed using SPSS software (version 24) and repeated measure analysis of variance and paired sample t-tests with significance level of 0.05. The results showed that, the normalized muscle activity in pedaling with auditory cue was significantly higher than that of pedaling without an auditory cue (P=0.05). During pedaling with auditory cue, the normalized EMG activity of right RF and left TA muscles were approximately 1.25 (p=0.03) and 1.22 (p=0.04) significantly greater than un-cued condition, respectively. In conclusion, rhythmic auditory cue increased the EMG activity of the lower extremity muscles among the elderly. So, in designing an appropriate training and rehabilitation program for the lower extremity muscles in the elderly, the use of auditory cue while pedaling as an easy and low-cost training method can be recommended.

Keywords

Main Subjects


  1. Bayatloo, A., Salavati, M., & Akhbari, B. The ability to selectively allocateattentional demands on walking during secondary cognitive and motor tasks in elderly people with and without a history of falls. Iranian Journal of Ageing, 2011. 5(4): p. 0-0.
  2. Noroozian, M. The elderly population in iran: an ever growing concern in the health system. Iranian journal of psychiatry and behavioral sciences, 2012. 6(2): p. 1.
  3. 3Barak, Y., Wagenaar, R. C., & Holt, K. G. Gait characteristics of elderly people with a history of falls: a dynamic approach. Physical therapy, 2006. 86(11): p. 1501-1510.
  4. Tinetti, M. E., Speechley, M., & Ginter, S. F. Risk factors for falls among elderly persons living in the community. New England journal of medicine, 1988. 319(26): p. 1701-1707.
  5. Ellmers, T. J., Paraskevopoulos, I. T., Williams, A. M., & Young, W. R. Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention. Journal of neuro engineering and rehabilitation, 2018.15(1): p. 26.
  6. James B. Robinson, Julie Loebach Wetherell. An Interdisciplinary Intervention for Fear of Falling: Lessons Learned from Two Case Studies. Clinical Gerontologist, 2018. 41(4): p. 366-373.
  7. Jafarnezhadgero A, Madadi-Shad M, Alavi-Mehr SM, Granacher U. The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet. 2018
  1. Wong, S. L., Gilmour, H. L., & Ramage-Morin, P. L. Parkinson's disease: Prevalence, diagnosis and impact. Statistics Canada. 2014
  2. Ford, M. P., Malone, L. A., Nyikos, I., Yelisetty, R., & Bickel, C. S. Gait training with progressive external auditory cueing in persons with Parkinson's disease. Archives of Phys Medicine and Rehabilitation, 2010. 91(8): p. 1255-1261.
  3. Willems, A. M., Nieuwboer, A., Chavret, F., Desloovere, K., Dom, R., Rochester, L., … Van Wegen, E. The use of rhythmic auditory cues to influence gait in patients with Parkinson’s disease, the differential effect for freezers and non-freezers, an explorative study. Disability & Rehabilitation, 2006. 28(11): p. 721–728.
  4. Zijlstra, W., Rutgers, A. W. F., & Van Weerden, T. W. Voluntary and involuntary adaptation of gait in Parkinson's disease. Gait & Posture, 1988. 7(1): p. 53-63.
  5. Zhao Y, Nonnekes J, Storcken EJ, Janssen S, Wegen EE, Bloem BR, et al. Feasibility of external rhythmic cueing with the Google Glass for improving gait in people with Parkinson’s disease. J Neurol, 2016. 263: p. 1156-1165.
  6. Espay AJ, Baram Y, Dwivedi AK, Shukla R, Gartner M, Gaines L, et al. At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease. J Rehabil Res Dev, 2010. P. 47: 573
  7. Pau M, Corona F, Pili R, Casula C, Sors F, Agostini T, et al. effects of Physical rehabilitation integrated with rhythmic auditory stimulation on spatioTemporal and Kinematic Parameters of gait in Parkinson’s Disease. Front Neurol, 2016. P. 7
  8. Chen, J.L., Penhue, V.B., & Zatorre, R.J. The role of auditory and premotor cortex in sensorimotor transformations.  The Neurosciences and Music III- Disorders and Plasticity, 2009. 1169: p. 15-34.  
  9. Ghai, S., Ghai, I., & Effenberg, A. O. Effect of rhythmic auditory cueing on aging gait: a systematic review and meta-analysis. Aging and disease, 2018. 9(5): p. 901.
  10. Hausdorff, J. M., Lowenthal, J., Herman, T., Gruendlinger, L., Peretz, C., & Giladi, N. Rhythmic auditory stimulation modulates gait variability in Parkinson’s disease. European Journal of Neuroscience, 2007. 26(8): p. 2369–2375.
  11. McIntosh, G. B., S., & Rice, R., Thaut, M. Rhythmic auditor-motor facilitation of gait patterns in patients with Parkinson’s disease. J of Neurology, Neurosurgery, and Psychiatry, (Journal Article), 1997. 62: p. 22–26.
  12. Rochester, L., Baker, K., Hetherington, V., Jones, D., Willems, A. M., Kwakkel, G., ... & Nieuwboer, A. Evidence for motor learning in Parkinson's disease: acquisition, automaticity and retention of cued gait performance after training with external rhythmical cues. Brain Research, 2010. 1319: p. 103-111.
  13. Baker, K., Rochester, L., & Nieuwboer, A. The effect of cues on gait variability-reducing the attentional cost of walking in people with Parkinson’s disease. Parkinsonism & Related Disorders, 2008. 14(4): p. 314–320
  14. Thaut M, McIntosh G, Prassas S, Rice R. Effect of Rhythmic Auditory Cuing on Temporal Stride Parameters and EMG. Patterns in Hemi paretic Gait of Stroke Patients. J Neuro Rehab 1993. 7: p. 9-16
  15.  Kotz, S. A. & Schwartze, M. Differential input of the supplementary motor area to a dedicated temporal processing network: functional and clinical implications. Front Integr Neurosci 2011. 5: p. 86.
  16.  Schwartze, M. & Kotz, S. A. A dual-pathway neural architecture for specific temporal prediction. Neurosci Biobehav Rev 2013. 37: p. 2587–2596.
  17. Rinaldi, N. M., Pereira, M. P., Formaggio, P. M., Morais, L. C., & Gobbi, L. T. B. Positive effects of auditory cue in locomotor pattern of people with Parkinson’s disease (off and on medication). Revista Brasileira de Educação Física e Esporte, 2014. 28(4): p. 561-570.
  18. Paltsev, E. I. change in the functional state of the segmental apparatus of the spinal cord under the influence of acoustic stimuli and its role in bringing about an arbitrary movement. Biofizika. 1967.
  19. Rossignol, S., & Jones, G. M. Audio-spinal influence in man studied by the H-reflex and its possible role on rhythmic movements synchronized to sound. Electroencephalography and clinical neurophysiology, 1946. 41(1): p. 83-92.
  20.  Ridgel, A. L., Phillips, R. S., Walter, B. L., Discenzo, F. M., & Loparo, K. A. Dynamic high-cadence cycling improves motor symptoms in Parkinson’s disease. Frontiers in neurology, 2015. 6: p. 194.
  21. de Aguiar Greca JP, Ryan J, Baltzopoulos V, Korff T. Biomechanical evaluation of walking and cycling in children. Journal of biomechanics. 2019 Apr 18; 87:13-8.

 

  1. Jafarnezhadgero AA, Majlesi M, Etemadi H, Robertson D. Rehabilitation improves walking kinematics in children with a knee varus: Randomized controlled trial. Annals of physical and rehabilitation medicine. 2018;61(3):125-34.
  1.  Gallagher, R., Damodaran, H., Werner, W. G., Powell, W., & Deutsch, J. E. Auditory and visual cueing modulate cycling speed of older adults and persons with Parkinson’s disease in a Virtual Cycling (V-Cycle) system. Journal of neuroengineering and rehabilitation, 2016. 13(1): p. 77.
  2. Contreras, B., Vigotsky, A. D., Schoenfeld, B. J., Beardsley, C., & Cronin, J. A comparison of gluteus maximus, biceps femoris, and vastus lateralis electromyography amplitude in the parallel, full, and front squat variations in resistance-trained females. Journal of applied biomechanics, 2016. 32(1): p. 16-22.
  3. Merletti, R., Rainoldi, A., & Farina, D. Surface electromyography for noninvasive characterization of muscle. Exercise and sport sciences reviews, 2001. 29(1), p. 20-25.
  4. Lin, H. T., Hsu, A. T., Chang, J. H., Chien, C. S., & Chang, G. L. Comparison of EMG activity between maximal manual muscle testing and cybex maximal isometric testing of the quadriceps femoris. Journal of the Formosan Medical Association, 2008. 107(2) p. 175-180.
  5. Lee, S. Y., & Jo, M. E. Comparison of maximum voluntary isometric contraction of the biceps on various posture and respiration conditions for normalization of electromyography data. Journal of physical therapy science, 2016. 28(11), p. 3007-3010.
  6. Tabard-Fougère, A., Rose-Dulcina, K., Pittet, V., Dayer, R., Vuillerme, N., & Armand, S. EMG normalization method based on grade 3 of manual muscle testing: Within-and between-day reliability of normalization tasks and application to gait analysis. Gait & posture, 2018. 60, p. 6-12.
  7. Zadeh, M. A., & Moghadam, J. B. The effects of balance training on depression and quality of life in Parkinson's patients.
  8. Fernández-del-Olmo, M., & Cudeiro Mazaira, F. J. A simple procedure using auditory stimuli to improve movement in Parkinson s disease: a pilot study. 2003.
  9. Azadian, E., Taheri, H. R., Saberi Kakhki, A., & Farahpour, N. Effects of dual-tasks on spatial-temporal parameters of gait in older adults with impaired balance. Iranian Journal of Ageing, 2016. 11(4): p. 100-109.
  10. Snijders A, Verstappen C, Munneke M, Bloem B. Assessing the interplay between cognition and gait in the clinical setting. J Neural Transm, 2007. 114: p. 13151321.
  11. Muir-Hunter SW, Wittwer JE. Dual-task testing to predict falls in community-dwelling older adults: a systematic review. Physiotherapy, 2016. 102: p. 29-40
  12. Ghai S, Ghai I, Effenberg AO Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis. Clin Interv Aging, 2017. 12: p. 557-577.
  13. Freedland, R. L., Festa, C., Sealy, M., McBean, A., Elghazaly, P., Capan, A., ... & Rothman, J. The effects of pulsed auditory stimulation on various gait measurements in persons with Parkinson's disease. NeuroRehabilitation, 2002. 17(1) p. 81-87.
  14. Arias P, Cudeiro J Effects of rhythmic sensory stimulation (auditory, visual) on gait in Parkinson’s disease patients. Exp Brain Res, 2008.186: p. 589-601
  15. Arias, P., & Cudeiro, J. Effect of rhythmic auditory stimulation on gait in Parkinsonian patients with and without freezing of gait. PloS one, 2010. 5(3).