The physio at Dad's home wants him to practise walking to a beat on a phone app after his stroke. Is that the same as music therapy, and is there any evidence it works?

#1stillpainting62(Joined Nov 2024 · 26 posts)September 29, 2026, 8:12 pm

Regulars will know Dad, 81, mixed dementia with a stroke behind it, in a home since February. He had a small further stroke in August and his walking has gone backwards. Short shuffling steps, and he stops dead in doorways.

The physio who comes in has started something I had never heard of. She puts a beat on her phone, a click like a metronome, set to a speed she has worked out for him, and walks alongside him while he steps to it. She says it is based on rhythmic something. Dad seems to like it, or at least he does not mind it, and the carers say he walks better for a few minutes afterwards.

Two questions. Is this music therapy? Because if it is, I would like to know why nobody has offered us an actual music therapist. And is there real evidence for it, or is it one of those things that sounds scientific?

#2two_left_feet_dave(Joined Apr 2026 · 6 posts)September 30, 2026, 9:31 am

Parkinson's here, not stroke, but my physio did something similar with me before I found the dance class. A beat to step to. The doorway thing you describe is very familiar. The beat genuinely helped me get going again, though it did not last once the phone was off.

#3Yusuf A.(Joined Aug 2025 · 17 posts)October 1, 2026, 6:20 pm

Our music therapist mentioned rhythm and walking once when I asked her what music therapy is actually used for. She said it is one of the areas with the best evidence and also one of the most misunderstood, but she did not go into it because it was not what she was doing with my father.

#4Dr Rhian VaughanMusic therapist moderator(Joined May 2024 · 91 posts)October 5, 2026, 11:20 am

I am the music therapist moderator here, and I work on a stroke unit, so this is close to home. I have not met your father and cannot say whether it suits him; his physiotherapist and the team at the home are the people to ask about that.

What she is describing sounds like rhythmic auditory stimulation, usually called RAS. A steady external beat, set to a tempo matched to the person, which they step to while walking, often with the tempo adjusted as they improve. It can be delivered by a physiotherapist, a music therapist trained in the technique, or a combination. So it is not quite "music therapy" in the sense the rest of this board usually means, which is a therapist and a client making music together over a course of sessions. It is a specific technique that uses rhythm as a cue for movement.

On evidence, this is one of the strongest results anywhere on this site, with conditions attached. The Cochrane review of music interventions after acquired brain injury pooled 9 trials and 268 participants and found RAS improved gait velocity by 11.34 metres per minute, moderate quality evidence. That is a Tier 1 result here. The conditions matter. It is a finding about walking speed in people after stroke, mostly not people with dementia as well, and it is an average across a group rather than a prediction for one person. The carers noticing a better walk for a few minutes afterwards is consistent with what the technique does, and so is Dave noticing that it fades when the beat stops.

Rhythmic auditory stimulation sets out the review and what was measured, and music therapy after stroke covers the wider work, including communication and mood, where the evidence is thinner. If you want to ask about a music therapist as well, the physio is a good person to raise it with, because she can say what the walking work is for and whether anything else would add to it.

#5stillpainting62(Joined Nov 2024 · 26 posts)October 6, 2026, 9:50 pm

That is the first time anything on this board has come back "yes, actually, good evidence", and I did not know what to do with it.

Asked the physio on Friday. She said she learned it on a course and that a music therapist would be lovely but there is not one within forty miles that the home could get. She has put the tempo on the phone in his room so the carers can use it when they walk him to lunch. He stopped in the dining room doorway yesterday and the carer put the click on and he went through. Small thing. Not small at all, actually.