Hyun Ju Chong

Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients

BACKGROUND Rhythmic auditory stimulation (RAS) improves gait velocity, cadence, and stride length in hemiplegic stroke patients, yet little is known about the effectiveness of RAS on standing balance. OBJECTIVES To examine and compare the effectiveness on standing balance and gait parameter of two different types of gait trainings, gait training with RAS versus gait training without RAS, was compared in two groups of hemiplegic stroke patients over a three-week period (RAS group, n = 8; control group = 8). METHODS Sixteen hemiplegic stroke patients were included in the study. Standing balance was measured by using Biosway®. Stride length, gait velocity, and cadence were calculated from the number of steps and required time for a 10 m-walk. RESULTS Pre- to post-test measures showed a significant improvement in RAS group for overall stability index (p = 0.043), mediolateral index (p = 0.006), anteroposterior index (p = 0.016), gait velocity (p = 0.012), stride length (p = 0.03) and cadence (p = 0.012) over the control group. CONCLUSIONS The results of this study showed that RAS was an effective therapeutic method to improve gait velocity, stride length, cadence, and standing balance in hemiplegic stroke patients.

Finger exercise with keyboard playing in adults with cerebral palsy: A preliminary study

The purpose of this study is to examine the effects of Therapeutic Instrument Music Performance (TIMP) for fine motor exercises in adults with cerebral palsy (CP). Individuals with CP (n = 5) received a total of twelve, 30-min TIMP sessions, two days per week for six to nine weeks. Pre- and post-Music Instrument Digital Interface (MIDI) data were used as a measure of hand function. Pre-velocity was significantly different from the normative data obtained from typical adults (n = 20); however, post-velocity did not yield significance, specifically in the second and fifth fingers, indicating improvement in hand function for the adults with cerebral palsy. The finding implies that TIMP using keyboard playing may effectively improve manual dexterity and velocity of finger movement. Based on these results, future program development of instrumental playing for adults with CP is called for to enhance both their independent living skills and quality of life.

Effect of Rhythmic Auditory Stimulation on Hemiplegic Gait Patterns.

Purpose The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. Materials and Methods Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatial data were collected and analyzed using a three-dimensional motion analysis system. Results Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. Conclusion Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia, providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.

Analysis of surface EMG activation in hand percussion playing depending on the grasping type and the tempo

Although instrument playing-based training has been repeatedly reported to improve functional hand movements including grasping, the attempts to present quantitative information on physiological mechanism of grasping have been relatively insufficient to determine the type and the intensity of the exercises involved. This study aimed to examine the muscle activation during hand percussion playing depending on the grasping type and the playing tempo. A total of twelve healthy older adults with a mean age of 71.5 years participated in this study. Surface electrodes were placed on three grasping-related muscles: Flexor digitorum superficialis, extensor digitorum, and flexor pollicis brevis. Participants were instructed to play with the egg shaker, paddle drum mallet and clave involving different types of grasp at three different tempi (i.e., 80, 100, and 120 bpm) and sEMG data were collected during each playing. Significantly greater muscle activation was generated with the small sphere type of egg shaker, compared to the handle type of paddle drum mallet and the small cylinder type of clave. Playing at faster tempo also elicited significantly greater muscle activation than at slower tempo. With regard to the rise time of muscle activation, while tempo significantly affected the rise time, the time to peak muscle did not significantly change depending on the grasping type. This study confirmed that grasping pattern and the tempo of movement significantly influence the muscular activation of grasping involved in instrument playing. Based on these results, clinical implication for instrument selection and structured instrument playing would be suggested.

Hand rehabilitation using MIDI keyboard playing in adolescents with brain damage: A preliminary study

BACKGROUND As a sequential, programmed movement of fingers, keyboard playing is a promising technique for inducing execution and a high level of coordination during finger movements. Also, keyboard playing can be physically and emotionally rewarding for adolescents in rehabilitation settings and thereby motivate continued involvement in treatment. OBJECTIVE The purpose of this study is to evaluate the effects of keyboard playing using Musical Instrument Digital Interface (MIDI) on finger movement for adolescents with brain damage. METHODS Eight adolescents with brain damage, ages 9 to 18 years (M = 13 years, SD = 2.78), in physical rehabilitation settings participated in this study. Measurements included MIDI keyboard playing for pressing force of the fingers and hand function tests (Grip and Pinch Power Test, Box and Block Test of Manual Dexterity [BBT], and the Jebsen Taylor Hand Function Test). RESULTS Results showed increased velocity of all fingers on the MIDI-based test, and statistical significance was found in the velocity of F2 (index finger), F3 (middle finger), and F5 (little finger) between pre- and post-training tests. Correlation analysis between the pressing force of the finger and hand function tests showed a strong positive correlation between the measure of grip power and the pressing force of F2 and F5 on the Grip and Pinch Strength Test. All fingers showed strong correlation between MIDI results and BBT. For the Jebsen Taylor Hand Function Test, only the moving light objects task at post-training yielded strong correlation with MIDI results of all fingers. CONCLUSIONS The results support using keyboard playing for hand rehabilitation, especially in the pressing force of individual finger sequential movements. Further investigation is needed to define the feasibility of the MIDI program for valid hand rehabilitation for people with brain damage.

Changes in gait patterns induced by rhythmic auditory stimulation for adolescents with acquired brain injury

The effects of rhythmic auditory stimulation (RAS) on gait in adolescents with acquired brain injury (ABI) were investigated. A total of 14 adolescents with ABI were initially recruited, and 12 were included in the final analysis (n = 6 each). They were randomly assigned to the experimental (RAS) or the control (conventional gait training) groups. The experimental group received gait training with RAS three times a week for 4 weeks. For both groups, spatiotemporal parameters and kinematic data, such as dynamic motions of joints on three‐dimensional planes during a gait cycle and the range of motion in each joint, were collected. Significant group differences in pre–post changes were observed in cadence, walking velocity, and step time, indicating that there were greater improvements in those parameters in the RAS group compared with the control group. Significant increases in hip and knee motions in the sagittal plane were also observed in the RAS group. The changes in kinematic data significantly differed between groups, particularly from terminal stance to mid‐swing phase. An increase of both spatiotemporal parameters and corresponding kinematic changes of hip and knee joints after RAS protocol indicates that the use of rhythmic cueing may change gait patterns in adolescents with ABI.

Differential effects of type of keyboard playing task and tempo on surface EMG amplitudes of forearm muscles.

Despite increasing interest in keyboard playing as a strategy for repetitive finger exercises in fine motor skill development and hand rehabilitation, comparative analysis of task-specific finger movements relevant to keyboard playing has been less extensive. This study examined, whether there were differences in surface EMG activity levels of forearm muscles associated with different keyboard playing tasks. Results demonstrated higher muscle activity with sequential keyboard playing in a random pattern compared to individuated playing or sequential playing in a successive pattern. Also, the speed of finger movements was found as a factor that affect muscle activity levels, demonstrating that faster tempo elicited significantly greater muscle activity than self-paced tempo. The results inform our understanding of the type of finger movements involved in different types of keyboard playing at different tempi. This helps to consider the efficacy and fatigue level of keyboard playing tasks when being used as an intervention for amateur pianists or individuals with impaired fine motor skills.

A comparison of emotion identification and its intensity between adults with schizophrenia and healthy adults: Using film music excerpts with emotional content

ABSTRACT The purpose of this study was to examine the difference between adults with schizophrenia and healthy adults in terms of emotion identification, and the perceived intensity of the emotions in music excerpts. A total of 60 participants, including 27 adults with schizophrenia and 33 healthy adults, participated in this study. Participants listened to eight music excerpts which suggested emotions of happiness, peacefulness, anger, and sadness and were asked to choose the perceived emotion in each piece of music, and rate the intensity level of the emotion. Results of two-way ANOVA indicated that the schizophrenia group showed significantly lower concordance in recognizing all four intended emotions in music and significantly lower emotion intensity level than the healthy adult group did. Also, emotions with positive valence had relatively higher concordance rate than those with negative valence in the schizophrenia group. Further analysis within the schizophrenia group revealed that participants with positive symptoms showed significantly higher concordance rate in emotion identification than participants with negative symptoms; however, there was no significant difference in perceived intensity. The results of this study indicate that there is a disparity between adults with schizophrenia and healthy adults in identifying emotions in music. This information can be applied to develop targeted music interventions aimed at psychosocial rehabilitation of individuals with schizophrenia.

A comparative study of the perception of music emotion between adults with and without visual impairment

In music listening, limitations on visual experience affect a listener’s abstract information processing and conceptualization of the music. The aim of this study is to examine the differences in emotional responses to music between adults with visual impairment (VI) and adults with normal vision (NV). By using specific, emotion-inducing music reflecting happiness, sadness, anger, and fear, this study considers factors such as music emotion identification, emotional valence, arousal, intensity, and musical preference. A total of 120 participants (60 VI and 60 NV) listened to sixteen 15-second music excerpts and reported which emotion and to what extent they perceived it, using a self-reported music emotion evaluation scale. The results indicated that both of the groups showed high congruence in music emotion identification. However, the VI group showed significantly higher arousal, intensity and preference for sadness, while showing the lowest score for the intensity of fear. The main factor affecting emotion identification was preference for the VI group, and valence for the NV group.

Analysis of upper arm muscle activation using surface electromyography signals during drum playing

This study measured surface electromyography of the biceps brachii and triceps brachii during repeated drum playing with and without a drumstick to better understand activation of the upper arm muscles and inform the use of instrument playing for motor rehabilitation. A total of 40 healthy college students participated in this study. All participants were asked to strike a drum with their hand and with a drumstick at three different levels of stroke: soft, medium, and strong. The stroke order was randomly assigned to participants. A sound level meter was used to record the intensity of the drum playing. Surface electromyography signals were recorded at every hit during drum playing both with and without the drumstick in each of the three stroke conditions. The results demonstrated that the highest muscle activation was observed in both biceps brachii and triceps brachii with strong drum playing with and without the drumstick. A two-way repeated measures analysis of variance showed that there was a significant main effect for stroke intensity in muscle activation and produced sound level. While higher activation of the triceps brachii was observed for drum playing without a drumstick, no significant differences were found between the biceps brachii and sound level. This study demonstrated via surface electromyography data that greater muscle activation of the biceps brachii and triceps brachii does not occur with the use of drumsticks in drum playing. With the drum sound controlled, drum playing by hand can be an effective therapeutic intervention for the upper arm muscles.