Single-Session Feasibility of a Wearable Music-based Rhythmic Auditory Stimulation Device to Improve Walking in Knee Osteoarthritis

Objective: We examined the single-session feasibility of a wearable device to deliver a closed-loop music-based rhythmic auditory stimulation (RAS) walking intervention in people with knee osteoarthritis (OA). Methods: Fifteen participants with knee OA (age 70.0 (8.6) years; BMI 29.4(5.9) kg/m2; 10 women) complete a supervised 30-minute walking session using a wearable music-based RAS device. The device included shoe-worn inertial sensors, headphones, and a proprietary algorithm embedded in a touchscreen control unit. The algorithm continuously assessed the gait of the user and adjusted the tempo of the selected music to encourage improvements in gait quality. Spatiotemporal gait measures were collected using separate inertial sensors during the session. We examined change in gait during the session, report of exertion, and participant-reported acceptability. Results: On average, participants showed approximately 12%, 30%, and 15% increases in cadence, gait speed, and stride length, respectively without worsening variability or symmetry from before to during the RAS session. Of the 15 participants, 9/15, 11/15, and 9/15 showed at least 10% increase in cadence, gait speed, and stride length, respectively. Rating of Perceived Exertion was on average 13.3 (range 12-15). There were no serious adverse events and small increase in knee pain that resolved at the end of the session. Participants were highly accepting of the device and willing to use it at home for longer periods. Conclusion: A single-session feasibility study of a wearable closed-loop music-based RAS device in people with knee OA demonstrated increases in cadence and gait speed while safely walking at a moderate exercise intensity under supervision.