Why train cadence?
The walking of stroke survivors is on average half the speed and cadence of people without stroke.
What is cadence?
Cadence is defined as a rhythmic flow of sounds or music from a metronome or digitally manipulated music. The stroke survivor matches their steps to the beat, promoting more symmetrical steps. Increasing the cadence or beat then results in the stroke survivor walking with increased cadence and speed.
The evidence on cueing cadence
A systematic review (Nascimento et al 2015) of seven trials involving cueing cadence found that this intervention improved walking speed by 0.23 m/s (95% CI 0.18 to 0.27) and stride length by 0.21 m (95% CI 0.14 to 0.28, I2). As the average walking speed before intervention was 0.4m/s, this increase in walking speed represents a 50% increase. These are very impressive results for extra training of approximately 30 minutes a day for 4 weeks.
Metronome apps are available free, hence cueing of cadence is an inexpensive adjunct to walking training. Matching walking to a beat using these apps can be taught to stroke survivors and their relatives to enable independent practice.
How to do cadence cueing
- Walk next to the stroke survivor with the metronome, and match the beat to the person’s current walking speed
- Set the metronome to a speed or cadence that is 5-10% faster
- Practice walking with the faster cadence
To decrease difficulty:
- Decrease the cadence or speed of the beat
- March on the spot in time with metronome before attempting to walk
To increase difficulty:
- Increase step length
- Increase speed of metronome
- Remove cues and maintain longer step
Knowledge of results feedback
- How many steps or distance walked before losing rhythm with the metronome
- Cadence used
- Changes in walk speed/ step length over time
Try doing this yourself
It takes practice to be able to walk in time with the metronome; don’t expect someone to be able to do it immediately
Nascimento LR, de Oliveira CQ, Ada L, Michaelsen SM, Teixeira-Salmela LF (2015). Walking training with cueing of cadence improves walking speed and stride length after stroke more than walking training alone: A systematic review. Journal of Physiotherapy 61: 10–15.