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Peer-reviewedCC BY 4.0Frontiers in Neurology

Rhythmic auditory stimulation combined with split-belt treadmill training improves spatiotemporal gait parameters in hemiparetic stroke patients: a randomized controlled trial

  • Minghui Du1
  • Wei Zhang1
  • Liang Xia1
  • Xiaowu Xia2
  • Chenglin Qiu3
  • Yixin Zhan1
  • Zhiyuan Zhang1
  • Longwei Chen1,4
4 affiliations
  1. 1School of Physical Education, Xi’an Jiaotong University
  2. 2Lizhi College, Xi’an Jiaotong University
  3. 3Human Resources Department, Xi’an Jiaotong University
  4. 4Rehabilitation Science Institute, Shaanxi Provincial Rehabilitation Hospital
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Abstract

Background: Split-belt walking training (SWT) primarily ameliorates spatial gait asymmetry after stroke, yet its effect on temporal gait parameters remains limited. Rhythmic auditory stimulation (RAS) enhances cadence and rhythmicity via auditory–motor coupling. This study examined whether combining RAS with SWT yields greater walking benefits than SWT alone or conventional rehabilitation.

Methods: Thirty patients with post-stroke hemiparesis were randomized to RAS+SWT ( n = 11), SWT alone ( n = 8), or conventional rehabilitation (control, n = 11). Interventions were delivered for three weeks (five sessions/week). Primary outcomes were spatiotemporal gait parameters: walking speed, cadence, step length, and limping index. Linear mixed-effects models were used, with Hedges’ g for effect sizes.

Results: No dropouts occurred. Significant time-group interactions were found for walking speed ( F = 10.68, p < 0.001), cadence ( F = 5.01, p = 0.014), and affected-side step length ( F = 6.21, p = 0.006). The RAS+SWT group showed greater improvements than controls in walking speed (mean difference = 0.167, 95% CI [0.090, 0.245]), cadence (mean difference = 9.340, 95% CI [4.456, 14.223]), and step length (unaffected: mean difference = 0.077, 95% CI [0.039, 0.116]; affected: mean difference = 0.081, 95% CI [0.035, 0.127]), and greater walking speed improvements than the SWT group (mean difference = 0.110, 95% CI [0.022, 0.197]). For the limping index, a significant main effect of group was observed ( F = 5.41, p = 0.011); however, the time-by-group interaction was not significant ( F = 0.430, p = 0.655).

Conclusion: RAS combined with SWT is more effective than conventional rehabilitation in improving multidimensional spatiotemporal gait parameters—including walking speed, cadence, and affected-side step length—in patients with post-stroke hemiparesis. Compared with SWT alone, the combined intervention yielded greater improvements in walking speed, while no significant between-group differences were observed for cadence or step length. The combined protocol is feasible and safe.

Clinical trial registration: ChiCTR2600121963.

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Cite

BibTeXRIS
BibTeX
@article{du2026rhythmic,
  title = {{Rhythmic auditory stimulation combined with split-belt treadmill training improves spatiotemporal gait parameters in hemiparetic stroke patients: a randomized controlled trial}},
  author = {Minghui Du and Wei Zhang and Liang Xia and Xiaowu Xia and Chenglin Qiu and Yixin Zhan and Zhiyuan Zhang and Longwei Chen},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1904812},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1904812/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Rhythmic auditory stimulation combined with split-belt treadmill training improves spatiotemporal gait parameters in hemiparetic stroke patients: a randomized controlled trial
AU  - Minghui Du
AU  - Wei Zhang
AU  - Liang Xia
AU  - Xiaowu Xia
AU  - Chenglin Qiu
AU  - Yixin Zhan
AU  - Zhiyuan Zhang
AU  - Longwei Chen
PY  - 2026
DA  - 2026/10/14
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1904812
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1904812/full
AB  - Background: Split-belt walking training (SWT) primarily ameliorates spatial gait asymmetry after stroke, yet its effect on temporal gait parameters remains limited. Rhythmic auditory stimulation (RAS) enhances cadence and rhythmicity via auditory–motor coupling. This study examined whether combining RAS with SWT yields greater walking benefits than SWT alone or conventional rehabilitation.  Methods: Thirty patients with post-stroke hemiparesis were randomized to RAS+SWT ( n = 11), SWT alone ( n = 8), or conventional rehabilitation (control, n = 11). Interventions were delivered for three weeks (five sessions/week). Primary outcomes were spatiotemporal gait parameters: walking speed, cadence, step length, and limping index. Linear mixed-effects models were used, with Hedges’ g for effect sizes.  Results: No dropouts occurred. Significant time-group interactions were found for walking speed ( F = 10.68, p < 0.001), cadence ( F = 5.01, p = 0.014), and affected-side step length ( F = 6.21, p = 0.006). The RAS+SWT group showed greater improvements than controls in walking speed (mean difference = 0.167, 95% CI [0.090, 0.245]), cadence (mean difference = 9.340, 95% CI [4.456, 14.223]), and step length (unaffected: mean difference = 0.077, 95% CI [0.039, 0.116]; affected: mean difference = 0.081, 95% CI [0.035, 0.127]), and greater walking speed improvements than the SWT group (mean difference = 0.110, 95% CI [0.022, 0.197]). For the limping index, a significant main effect of group was observed ( F = 5.41, p = 0.011); however, the time-by-group interaction was not significant ( F = 0.430, p = 0.655).  Conclusion: RAS combined with SWT is more effective than conventional rehabilitation in improving multidimensional spatiotemporal gait parameters—including walking speed, cadence, and affected-side step length—in patients with post-stroke hemiparesis. Compared with SWT alone, the combined intervention yielded greater improvements in walking speed, while no significant between-group differences were observed for cadence or step length. The combined protocol is feasible and safe.  Clinical trial registration: ChiCTR2600121963.
SN  - 1664-2295
ER  -