Music-based therapy for rehabilitation induces neuromodulation at the brain level and improves the functional recovery. In line with this, musical rhythmicity improves post-stroke gait. Moreover, an external distractor also helps stroke patients to improve locomotion. We raised the question whether music with irregular tempo (arrhythmic music), and its possible influence on attention would induce neuromodulation and improve the post-stroke gait. We tested music-induced neuromodulation at the level of a propriospinal reflex, known to be particularly involved in the control of stabilized locomotion; after stroke, the reflex is enhanced on the hemiparetic side. The study was conducted in 12 post-stroke patients and 12 controls. Quadriceps EMG was conditioned by electrical stimulation of the common peroneal nerve, which produces a biphasic facilitation on EMG, reflecting the level of activity of the propriospinal reflex between ankle dorsiflexors and quadriceps (CPQ reflex). The CPQ reflex was tested during treadmill locomotion at the preferred speed of each individual, in 3 conditions randomly alternated: without music vs. 2 arrhythmic music tracks, including a pleasant melody and unpleasant aleatory electronic sounds (AES); biomechanical and physiological parameters were also investigated. The CPQ reflex was significantly larger in patients during walking without sound, compared to controls. During walking with music, irrespective of the theme, there was no more difference between groups. In controls, music had no influence on the size of CPQ reflex. In patients, CPQ reflex was significantly larger during walking without sound than when listening to the melody or AES. No significant differences have been revealed concerning the biomechanical and the physiological parameters in both groups. Arrhythmic music listening modulates the spinal excitability during post-stroke walking, restoring the CPQ reflex activity to normality. The plasticity was not accompanied by any clear improvement of gait parameters, but the patients reported to prefer walking with music than without. The role of music as external focus of attention is discussed. This study has shown that music can modulate propriospinal neural network particularly involved in the gait control during the first training session. It is speculated that repetition may help to consolidate plasticity and would contribute to gait recovery after stroke.

中文翻译：

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音乐在中风运动期间恢复本体脊髓兴奋

基于音乐的康复疗法可诱导大脑水平的神经调节并改善功能恢复。与此一致，音乐节奏可以改善中风后步态。此外，外部牵引器还有助于中风患者改善运动。我们提出了一个问题，节奏不规则的音乐（心律失常音乐）及其对注意力的可能影响是否会引起神经调节并改善中风后步态。我们在本体脊髓反射水平上测试了音乐诱导的神经调节，众所周知，它特别涉及稳定运动的控制；中风后，偏瘫侧反射增强。该研究在 12 名中风后患者和 12 名对照组中进行。股四头肌肌电图由腓总神经的电刺激调节，其在 EMG 上产生双相促进，反映踝背屈肌和股四头肌之间的本体脊髓反射（CPQ 反射）的活动水平。CPQ 反射在跑步机运动期间以每个人的首选速度进行测试，在 3 种情况下随机交替：没有音乐与 2 条不规则的音乐曲目，包括悦耳的旋律和令人不快的电子音 (AES)；还研究了生物力学和生理参数。与对照组相比，患者在无声行走期间的 CPQ 反射明显更大。在与音乐一起行走的过程中，无论主题如何，组之间没有更多差异。在对照中，音乐对 CPQ 反射的大小没有影响。在患者中，在没有声音的情况下行走时，CPQ 反射明显大于听旋律或 AES 时。两组的生物力学和生理参数没有显着差异。听心律失常的音乐可调节中风后步行期间的脊柱兴奋性，使 CPQ 反射活动恢复正常。可塑性并没有伴随着步态参数的任何明显改善，但患者报告说他们更喜欢有音乐走路而不是没有音乐。讨论了音乐作为外部关注焦点的作用。这项研究表明，音乐可以调节本体脊髓神经网络，特别是在第一次训练期间参与步态控制。据推测，重复可能有助于巩固可塑性，并有助于中风后的步态恢复。