Stepping to an Auditory Metronome Improves Weight-Bearing Symmetry in Post-Stroke Hemiparesis

Asymmetry in weight-bearing is a common feature in post-stroke hemiparesis, and is related to temporal asymmetry during walking. The aim of this study was to investigate the effect of an auditory cue for stepping in place on measures of temporal and weight-bearing asymmetry. Ten community-dwelling adults (four female) with chronic post-stroke hemiparesis performed 5 un-cued stepping trials and 5 stepping trials cued by an auditory metronome cue. A Vicon system was used to collect full body kinematic trajectories. Two force platforms were used to measure ground reaction forces. Step, swing and stance times were used to calculate temporal symmetry ratios. Weight-bearing was assessed using the vertical component of the ground reaction force, and centre of mass-centre of pressure separation at mid-stance. Weight-bearing asymmetry was significantly reduced during stepping with an auditory cue. Asymmetry values for step, swing and stance times were also significantly reduced with auditory cueing. These findings show auditory cueing, when stepping in place, produces immediate reductions in measures of temporal asymmetry and dynamic weight-bearing asymmetry.