Asymmetrical rhythmic auditory cueing based gait modification

1 . A method for treating gait asymmetry of a patient having asymmetric gait impairment comprising:

measuring a first baseline step time for a first leg of the patient and a second baseline step time for a second leg of the patient, the first baseline step time being shorter than the second baseline step time;

determining an asymmetrical rhythm tolerance for the patient;

determining a first target step time for the first leg and a second target step time for the second leg, the first target step time being different from the second target step time at a first time;

generating a series of auditory cues based on the asymmetrical rhythm tolerance, the series of auditory cues comprising interleaved first cues for the first leg and second cues for the second leg and having:

a first cue cadence based on the first baseline step time and the first target step time, and

a second cue cadence, different from the first cue cadence, based on the second baseline step time and the second target step time;

administering the series of auditory cues to the patient;

measuring patient gait data responsive to the patient walking in accordance with the series of auditory cues; and

monitoring the patient gait data.

2 . The method of claim 1 , further comprising:

adjusting the first target step time and the second target step time at a second time such that the first target step time is equal to the second target step time.

3 . The method of claim 1 , wherein the first target step time is determined to be between the first baseline step time and the second baseline step time, and

wherein the second target step time is determined to be between the first baseline step time and the second baseline step time.

4 . The method of claim 3 , wherein the first target step time is shorter than the second target step time.

5 . The method of claim 3 , wherein the second target step time is shorter than the first target step time.

6 . The method of claim 1 , further comprising:

adjusting the first target step time for the first leg and the second target step time such that the first target step time is equal to or longer than the second target step time.

7 . The method of claim 6 , wherein a ratio of the first target step time to the second target step time is equal to or less than 5.

8 . The method of claim 1 , further comprising:

increasing the first cue cadence from a first earlier value based on the first baseline step time to a first later value based on the first target step time, and

decreasing the second cue cadence from a second earlier value based on the second baseline step time to a second later value based on the second target step time; or

decreasing the first cue cadence from the first earlier value based on the first baseline step time to the first later value based on the first target step time, and

increasing the second cue cadence from the second earlier value based on the second baseline step time to the second later value based on the second target step time.

9 . The method of claim 1 , wherein the first baseline step time is a first average step time of a plurality of first step times of the first leg for a predetermined period of time, and

wherein the second baseline step time is a second average step time of a plurality of second step times of the second leg for the predetermined period of time.

10 . The method of claim 1 , further comprising:

determining adaptability of the patient to follow the series of auditory cues by:

decreasing the first cue cadence and increasing the second cue cadence on subsequent steps,

measuring a third baseline step time for the first leg and a fourth baseline step time for the second leg,

comparing the decreased first cue cadence to the third measured step time and the increased second cue cadence to the fourth measured step time, and

determining a maximum asymmetry that the patient follows based on a result of the comparing the decreased first cue cadence to the third measured step time and the increased second cue cadence to the fourth measured step time; and

determining the asymmetrical rhythm tolerance based on the maximum asymmetry.

11 . The method of claim 1 , further comprising:

determining rhythmic synchronization capabilities based on the monitored data and the series of audio cues; and

increasing or decreasing the first cue cadence or the second cue cadence of the series of audio cues responsive to the rhythmic synchronization capabilities.

12 . The method of claim 1 , further comprising generating the series of audio cues based on a session-specific step-time ratio.

13 . The method of claim 12 , wherein the asymmetrical rhythm tolerance comprises a current session-specific asymmetrical rhythm tolerance, and the method further comprising determining the session-specific step-time ratio based on a prior session-specific asymmetrical rhythm tolerance and the current session-specific asymmetrical rhythm tolerance.

14 . An apparatus for treating gait asymmetry of a patient having asymmetric gait impairment, comprising:

a processor; and

a memory communicatively coupled to the processor,

wherein the processor and the memory are configured to:

measure a first baseline step time for a first leg of an the patient and a second baseline step time for a second leg of the patient, the first baseline step time being shorter than the second baseline step time;

determine an asymmetrical rhythm tolerance for the patient;

determine a first target step time for the first leg and a second target step time for the second leg, the first target step time being different from the second target step time at a first time;

generate a series of auditory cues based on the asymmetrical rhythm tolerance, the series of auditory cues comprising interleaved first cues for the first leg and second cues for the second leg and having:

a first cue cadence based on the first baseline step time and the first target step time, and

a second cue cadence, different from the first cue cadence, based on the second baseline step time and the second target step time;

administer the series of auditory cues to the patient;

measure patient gait data responsive to the patient walking in accordance with the series of auditory cues; and

monitor the patient gait data.

15 . The apparatus of claim 14 , wherein the processor and the memory are further configured to:

adjust the first target step time and the second target step time at a second time such that the first target step time is equal to the second target step time.

16 . The apparatus of claim 14 , wherein the first target step time is determined to be between the first baseline step time and the second baseline step time, and

wherein the second target step time is determined to be between the first baseline step time and the second baseline step time.

17 . The apparatus of claim 16 , wherein the first target step time is shorter than the second target step time.

18 . The apparatus of claim 16 , wherein the second target step time is shorter than the first target step time.

19 . The apparatus of claim 14 , wherein the processor and the memory are further configured to:

adjust the first target step time for the first leg and the second target step time such that the first target step time is longer than the second target step time.

20 . The apparatus of claim 19 , wherein a ratio of the first target step time to the second target step time is equal to or less than 5.

21 . The apparatus of claim 14 , wherein the first cue cadence decreases from a first earlier value based on the first baseline step time to a first later value based on the first target step time, and the second cue cadence increases from a second earlier value based on the second baseline step time to a second later value based on the second target step time, or

wherein the first cue cadence increases from the first earlier value based on the first baseline step time to the first later value based on the first target step time, and the second cue cadence decreases from the second earlier value based on the second baseline step time to the second later value based on the second target step time.

22 . The apparatus of claim 14 , wherein the first baseline step time is a first average step time of a plurality of first step times of the first leg for a predetermined period of time, and

wherein the second baseline step time is a second average step time of a plurality of second step times of the second leg for the predetermined period of time.

23 . The apparatus of claim 14 , wherein the processor and the memory are further configured to:

determine adaptability of the patient to follow the series of auditory cues by:

decreasing the first cue cadence and increasing the second cue cadence on subsequent steps,

measuring a third baseline step time for the first leg and a fourth baseline step time for the second leg,

comparing the decreased first cue cadence to the third measured step time and the increased second cue cadence to the fourth measured step time, and

determining a maximum asymmetry that the patient follows based on a result of the comparing the decreased first cue cadence to the third measured step time and the increased second cue cadence to the fourth measured step time; and

determine the asymmetrical rhythm tolerance based on the adaptability.

24 . The apparatus of claim 14 , wherein the processor and the memory are further configured to:

determine rhythmic synchronization capabilities based on the monitored data and the series of audio cues; and

increase or decrease the first cue cadence or the second cue cadence of the series of audio cues responsive to the rhythmic synchronization capabilities.

25 . The apparatus of claim 14 , wherein the processor and the memory are further configured to generate the series of audio cues based on a session-specific step-time ratio.

26 . The apparatus of claim 25 , wherein the asymmetrical rhythm tolerance comprises a current session-specific asymmetrical rhythm tolerance, and wherein processor and the memory are further configured to determine the session-specific step-time ratio based on a prior session-specific asymmetrical rhythm tolerance and the current session-specific asymmetrical rhythm tolerance.