**Influence of Auditory Pacing on the Control of Rhythmic Movement in Physical Therapy Influence of Auditory Pacing on the Control of Rhythmic Movement in Physical Therapy**

Masanori Ito, Yuki Takahashi, Satoshi Fujiwara and Naoki Kado Fujiwara and Naoki Kado Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

Masanori Ito, Yuki Takahashi, Satoshi

http://dx.doi.org/10.5772/67428

#### **Abstract**

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The electromyographic reaction time data responses to various rhythm shifts are dis‐ cussed in Section 2 of this chapter. The following four experimental designs were intro‐ duced: (1) subliminal rhythm shift with shortened interval, (2) subliminal rhythm shift with lengthened interval, (3) subliminal rhythm shift with random interval, and (4) dif‐ ferences in the rate of rhythm shift. We found that the periodic rhythmic stimulation is predicted to comprise some time duration. Furthermore, the reactive movements can be performed without delay under conditions with an interstimulus‐onset interval shift of 7% of 1500 ms. When the physical therapist facilitates rhythmical reactive periodic movement using an external event such as a handclap, it will be desirable to keep the rhythm shift within 7% of the interstimulus‐onset interval. The variabilities of the inter‐ tap interval in the continuation paradigm of sensorimotor synchronization are discussed in Section 3. The participants performed self‐paced, synchronization‐continuation, and syncopation‐continuation tapping tasks. We found that the accuracy of the periodic movement with an interstimulus‐onset interval of 1000 ms can be improved by using auditory pacing. However, the consistency of periodic movement is mainly dependent on innate skill; thus, improvement in consistency from pacing alone is unlikely.

**Keywords:** auditory, external pacing, rhythmic movement, reaction time, sensorimotor synchronization

#### **1. Introduction**

Producing rhythmic and periodic movement is one of the important aspects of movement con‐ trol. In physical therapy, external events such as auditory stimuli and visual stimuli might be used as triggers for the facilitation of periodic movement. Rhythmic coordinated movement is

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

impaired in patients with motor diseases such as Parkinson's or those who have experienced a stroke. It is possible that an auditory pacing event could be useful as physical therapy in treat‐ ing movement disorders. In a physical therapy study, during a target‐hitting task using flex‐ ion and extension of the elbow, variability of electromyogram patterns of the biceps brachii decreased with pacing using a regular auditory rhythm, compared with that during the no‐ pacing and irregular auditory rhythm conditions [1]. In clinical studies, it has been reported that an intervention using rhythmic auditory stimulation improved gait velocity, cadence, and stride length in patients with Parkinson's disease [2] and gait velocity, stride length, and elec‐ tromyographic activity of the medial gastrocnemius in patients with hemiparetic stroke [3].

When performing a rhythmic movement using periodic auditory stimuli as a trigger, the subjects can select a variety of movement patterns (such as reaction, synchronization, and syncopation). In this chapter, the electromyographic reaction time (EMG‐RT) data responses to various rhythm shifts [4–7] are discussed in Section 2, and the variabilities of intertap inter‐ val (ITI) in the continuation paradigm of sensorimotor synchronization [8] are discussed in Section 3. Furthermore, each section includes an explanation of the clinical consideration in physical therapy.
