The Effect of Rhythmic Auditory Stimulation on Gait in Adults with Multiple Sclerosis: A Literature Review

Abstract

Introduction: Multiple sclerosis (MS) is a neurodegenerative disease that attacks the central nervous system, leading to a buildup of sclerotic plaques, demyelination, and lesions. While the nature of the disease varies per individual, the most common symptom is impaired gait related to sensory deficits, fatigue, and muscle weakness. These deficits impact quality of life and the ability to complete activities of daily living. While current rehabilitative treatments help prevent further disability, they generally do not improve existing mobility. Rhythmic auditory stimulation (RAS) is a therapeutic approach to restoring mobility using metronomic and musical cues to improve gait parameters such as speed, distance, and double support time. While the positive effects of RAS have been well documented in other neurologic conditions, there is limited research regarding RAS and MS. This literature review aims to summarize the rehabilitative potential of RAS and how this impacts gait in adults with MS.

Methods: A literature search was performed using keywords including, but not limited to, multiple sclerosis, rhythmic auditory stabilization and cueing, gait, and ambulation. Databases included in the search were Web of Science, Ovid - Medline, PubMed, Google Scholar, and EBSCO. The search yielded six articles published in the English language between 2010 and 2021 that were included for review. 

Results: RAS was found to significantly improve gait parameters including speed, distance, and double support time. RAS was both used alone and in combination with either motor imagery or verbal cueing. Aspects of quality of life including fatigue, mood and pain were also positively impacted for participants in some of the studies. 

Discussion: Improvements in mobility correspond with increased ability to complete activities of daily living, ambulate in the community, and maintain social wellbeing. Despite promising results, several limitations were identified for the studies that may have impacted results. Furthermore, the therapeutic effect of RAS may vary depending on the auditory stimulus used. 

Conclusion: RAS shows great potential as an accessible, cost-effective therapy that may help people with MS regain lost mobility, however further research with larger sample sizes and longer intervention timeframes is warranted to determine the rehabilitative use of RAS.