All material Copyright © May 2009 EasyStand
Reprinted with their express permission as originally published on their website.
By: Stephenie Labandz, PT
Weakness, range of motion limitations, and spasticity prevent many people from being able to participate in highly specialized therapeutic treatment protocols, but rhythmic exercise with auditory cues can be effective even with minimal motion. It requires no special fitness equipment – just a beat and some imagination.
A case report published in 2009 by the Journal of Bodywork and Movement Therapies examined the use of rhythmic exercise in a young woman who had experienced a traumatic brain injury. After participation in rhythmic exercises with auditory cues five times per week for one year, she experienced improved mobility, decreased spasticity, and IQ increase from 78 to 94. She started the exercise program nine years after her initial injury and two years after she had been discharged from physical therapy.
The Rhythmex method incorporates multiple principles that can be remembered using the mnemonic ABCD&R.

A is for alternate extremities. The left arm moves at the same time as the right leg. The right arm moves at the same time as the left leg.
B is for bilateral. Both sides of the body take turns doing the motion.
C is for crossing midline. The arms cross the imaginary line that runs down the center of the body from the nose to the belly button with each motion.
D is for duration. Each series of alternating movements is performed for a duration of 30 to 90 seconds. This is followed by a 20 to 40 second break, then the movement is resumed and the exercise/rest cycle continues on about ten times or as tolerated.
R is for rhythm. In the study, the patient began the exercises independently and then a metronome was set to match her self-selected pace as she continued. In younger exercisers, favorite music may be extremely motivating. Bells, squeakers, drums, and other inventive percussion can also make the exercise feel more like play.
The movements can be done in any position that is safe and comfortable for the exerciser. Standing in a gait trainer, sitting with support, or lying down are options. Arm exercises could be done in a stander with alternating glut sets, quad sets, or toe taps for those who have the strength and coordination. The woman in the study would lie on her back and perform a bicycle motion with her legs while patting the knee of the flexed leg with her opposite hand. There are many possibilities, and family, friends, and caregivers can easily join in to make arms, legs, and time fly.
Rhythmex principles can also be applied to assisted and active assisted motions. Incorporating the opposite upper or lower limb into a range of motion program may help the exerciser be more involved in therapy. Getting other extremities involved in reciprocating motion can maximize the benefits of an electrical stimulation biking or neuromuscular re-education program.
Go on and tap, pat, slap, snap, stomp, and kick your way to increased function!
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