Biomechanical Investigation of The Effect of Rhythmic Auditory Stimulation on Walking Skills in Children with Cerebral Palsy

Purpose: This study was conducted to investigate whether the effect of rhythmic auditory stimulation, which consists of different rhythm patterns, on the walking ability of children with Cerebral Palsy, creates a difference on walking ability in terms of biomechanics and what the effect degrees are on this difference. Materials and Method: The study is an experimental research design conducted on 12 male spastic quadriplegia children with a mean age of 13 +/- 3.5. Applications were made in the motion analysis laboratory to test the walking ability. The subjects were asked to walk freely and according to rhythm respectively. Images were recorded and analyzed with 10 cameras (330 fps) using the three-dimensional motion analysis system Vicon Motion Capture and Nexus2 as pre and post test. Rhythmic auditory stimulus walking test was performed in Bounce Metronom software program with 2, 4 and 6 beat (moderato) rhythms. SPSS 22 software program was used for statistical analysis, paired sample t-Test for comparison of differences between tests, and ANOVA test for repeated measures. Results were evaluated at the (p<0.05) significance level. Findings: In our study, according to the paired sample t-test results, significant differences were found in terms of adaptation and application to the rhythms of children with Cerebral Palsy in walking skill (p<0.05). The subjects showed improvements in gait parameters with 4 and 6 beat rhythms. It was observed that 2-beat rhythms were less effective on the walking ability of the subjects than the 4 and 6-beat rhythms. With 6-beat rhythms; Significant improvement was detected in limp index, single and double support phases. With 4-beat rhythms; Significant improvements were observed in the parameters of double step duration, double support, single support and limp index. In addition, according to the repeated measurements ANOVA test results, it was seen that 4 and 6-beat rhythms positively affect the gait parameters of the subjects. Results: It was determined that rhythmic auditory stimulation had a positive biomechanical effect on the gait parameters of children with Cerebral Palsy, compared to 2-beat rhythm, 4 and 6-beat rhythmic auditory stimulation had a positive effect on the spatial and temporal parameters of CP children's walking ability.