Using Rhythmic Auditory Stimulation to Increase Cadence in Individuals with Chronic Obstructive Pulmonary Disease

Rhythmic Auditory Stimulation (RAS) uses the physiologic effects of auditory rhythm to facilitate movements that are inherently rhythmical, such as walking. There is a strong sensorimotor connection between the brain and the motor system while walking to rhythmic cues that occurs without cognitive learning efforts. PURPOSE: To determine if cadence and Six-Minute Walk Distance (6MWD) are increased while walking to RAS-tempo enhanced music as compared to walking to music-without tempo enhancement (MC) or no-music (NM) in individuals with Chronic Obstructive Pulmonary Disease (COPD). METHODS: Three 6-Minute Walk Tests (6MWT) were completed in random order under three conditions (RAS, MC, NM). Tempo for the MC walk was matched to the patient’s usual cadence, which was determined by a one-minute manual step count. Cadence was measured manually for 60-seconds between minutes 1-2, 3-4, and 5-6 for all 6MWT conditions. The tempo of the music for the RAS walk was increased 5-10 beats per minute higher than usual cadence. RESULTS: Twenty-five older adults (age=71+5yr) with moderate to severe COPD (47+15.0% FEV % predicted), with 56+27 years of smoking were enrolled. The mean usual cadence was 103+8 steps/min in one minute. When comparing RAS to NM, cadence was consistently significant at all minute intervals 1-2 (110vs105), 3-4 (110vs107), and 5-6 (110vs107) respectively. When comparing cadence of NM to MC, and RAS to MC no consistent significant increases were found. Participants matched their cadence to the elevated tempo of the RAS music during the entire 6MWT (110 ± 12 steps). Individuals walked 12m further during the 6MWT with RAS (463 ± 72 m) when compared to NM (451 ± 81 m); t (24) =-2.63, p=.015) or MC (451 ± 80 m); t (24) =-2.26, p=.033). CONCLUSIONS: Best method for prescribing cadence through music tempo in individuals with COPD has not been established. Individuals walked further and were able to match and sustain elevated cadence during the RAS walking condition. This observation may support the premise that beat perception mechanisms can be neurologically entrained. RAS music may be a useful tool in pulmonary rehabilitation to increase walking distance in individuals with COPD. Supported by RR&D, Veterans Administration