Rhythms of Recovery: Exploring Music-Based Gait Rehabilitation for Stroke Survivors

Researchers test InTandem™ neurorehabilitation system to harness music for improved mobility

By Carolann Murphy, Senior Medical Writer, Communications Department

The InTandem system by MedRhythms for music-based gait rehabilitation. — The InTandem system includes headphones, a handheld device, and shoe sensors.

Many stroke survivors have reduced mobility and gait deficits, which significantly reduce their quality of life, limit independence, and increase health care costs. To improve their walking ability, researchers are testing the effectiveness of music-based gait rehabilitation. At Kessler Foundation, Karen Nolan, PhD, associate director of the Center for Mobility and Rehabilitation Engineering Research, tested the InTandem^™ system by MedRhythms as part of a multi-center trial.

: InTandem’s shoe sensors worn by a research participant at Kessler Foundation. — Users of InTandem wear sensors on their shoes that track their walking pattern.

The InTandem system consists of three key components: (1) clinical-grade, shoe-worn gait sensors; (2) a durable control unit with advanced algorithms and a preloaded library of clinically optimized music; and (3) a headset to deliver the auditory stimulus. Precisely-timed auditory cues engage the motor system subconsciously through the mechanism of auditory-motor entrainment, leading to development of enhanced neural pathways and improved walking function. These neuroplastic effects enable participants to achieve persistent gait improvements after only a few months of use. During an InTandem session, the participant begins walking while the sensors collect real-time gait data. The hardware control unit analyzes this data to determine the optimal musical tempo to elicit entrainment and improve quality of gait. As the participant continues walking, the system makes imperceptible tempo increases to optimize gait speed, while ensuring sufficient gait quality and safety.

The study involved 87 participants across several sites, including Kessler Foundation. Divided into two groups, the treatment group used the InTandem system over a five-week period, and the control group engaged in regular walking exercises.

“We found that users of InTandem improved their walking speed and walking ability when compared to the control group,” reported Dr. Nolan, “and there was no difference between the groups in the numbers of adverse events.”

These results, which were published open access in Nature Communications, show the potential for music-based stroke rehabilitation. “InTandem appears to offer a safe, effective, and engaging way to improve mobility,” said Dr. Nolan. “Also, the person can use InTandem without the supervision of a therapist, allowing more consistent therapy that can lead to better recovery.”

For more detailed information on the study and the InTandem system, readers are referred to the full article:

Awad, LN, Jayaraman, A, Nolan, KJ, et al. Efficacy and safety of using auditory-motor entrainment to improve walking after stroke: a multi-site randomized controlled trial of InTandem™. Nature Communications. 2024; 15, 1081 (doi.org/10.1038/s41467-024-44791-5).