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Rhythmic Auditory Stimulation & Gait Training

Not Applicable
Completed
Conditions
Multiple Sclerosis
Gait Disorders, Neurologic
Interventions
Other: Rhythmic auditory stimulation
Other: Gait Training
Registration Number
NCT04314076
Lead Sponsor
The Cleveland Clinic
Brief Summary

This study will enroll patients with Multiple Sclerosis and some difficulty with walking. The purpose of this study is to use Rhythmic Auditory Stimulation (RAS) a music therapy technique that provides rhythmic auditory cues (like a beat) to help improve a patient's movements, especially when walking.

Participants will be asked to participate in a walking program (WP) with Rhythmic Auditory Stimulation (RAS), or a WP without RAS.

Detailed Description

Rhythmic Auditory Stimulation (RAS) is a music therapy technique that provides rhythmic auditory cues (like a beat) to help improve patients' movements, especially when walking. The RAS can be delivered at a fixed tempo or interactive tempo.

The device used in this study will deliver an interactive tempo. The equipment will include a mobile device app and sensors that are attached to the participant's shoes. Headphones and smartphones will be required to use the device and will be provided to the study team and kept at the center for this study. The device is designed to use audio cues to facilitate improvements in the participant's walking speed while listening to music.

The overall purpose of this study is to assess the safety and acceptability of interactive RAS music combined with gait training in individuals with MS and walking impairment, and to gather preliminary efficacy data for future studies.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  • Diagnosis of MS based on 2017 revised McDonald criteria (relapsing or progressive course)
  • Performs the T25FW in 8 to 30 seconds (cane(s), walking stick(s), crutch(es), or wheeled walker allowed)
Exclusion Criteria
  • Physical therapy in the past 3 months or immediate need for PT due to safety concerns (e.g. falls)
  • Requires at least one seated rest during the 6 MW test
  • Treatment with high-dose corticosteroids in the past 2 months or planned during the study period
  • Lower extremity botulinum toxin (BT) injections for spasticity in the past 3 months, or planned during the study period
  • Initiation of an oral symptomatic therapy which could affect walking in the past 4 weeks (particularly dalfampridine and medications for spasticity)
  • Initiation of a new disease-modifying therapy for MS in the past 3 months
  • Comorbidity compromising safe participation or affecting walking (e.g. uncontrolled cardiac or respiratory illness, musculoskeletal disorder)
  • Severe hearing impairment with or without the use of hearing aids, such that the participant cannot hear the rhythmic music stimulus consistently.

Inability to walk safely to the rhythmic music stimulus during the baseline visit.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Gait Training (GT) with Rhythmic Auditory Stimulation (RAS)Rhythmic auditory stimulationParticipants in this arm will complete 16 supervised gait training sessions consisting of continuous overground walking on a track for 30 minutes,with RAS
Gait training (GT) without Rhythmic Auditory Stimulation (RAS)Gait TrainingParticipants in this arm will complete 16 supervised gait training sessions consisting of continuous overground walking on a track for 30 minutes without RAS
Primary Outcome Measures
NameTimeMethod
Number of patients with adverse eventsthrough study completion, up to 16 weeks

Adverse events will be collected throughout the study period to assess treatment safety.

Percentage of training sessions missed.through end of treatment, up to 9 weeks

Training session attendance will be tracked as an indicator of feasibility throughout the treatment period.

Secondary Outcome Measures
NameTimeMethod
Spatiotemporal gait parametersWeek 0, Week 9 and week 16

Gait parameters at self-selected pace will be collected on an electronic walkway.

MS Walking Scale - 12Week 0, Week 9 and week 16

The MSWS-12 consists of 12 items inquiring about the impact of MS on various aspects of walking. Score range is from 0 to 100, with higher scores indicating a worse outcome.

6-Minute WalkWeek 0, Week 9 and week 16

Participants are instructed to walk for 6 minutes.

Timed 25 Foot WalkWeek 0, Week 9 and week 16

Participants are instructed to walk as fast as possible but safely on a 25-foot straight course.

Trial Locations

Locations (1)

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

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