The objective of the study is to compare the time taken for prosthetic training using rhythmic auditory stimulation with that of conventional therapy, for unilateral transtibial amputee patients. We will also compare the gait parameters in unilateral transtibial amputee patients trained with and without rhythmic auditory stimulation.

Design: randomized-controlled trial with two groups - RAS group and control group. Setting: outpatient and inpatient rehabilitation units, department of PMR, CMC, Vellore. Participants: 29 unilateral transtibial amputee patients ready for prosthetic training, 13 in the RAS group, 16 in the control group (age range 18–65 years). Intervention: rhythmic beats introduced through MP3 players and earphones during prosthetic training for one hour daily. Main outcome measures: the primary outcome measures - included time to complete training, timed up and go (TUG) test and 6minute walk test (6MWT). The secondary outcome measures were gait velocity, gait cadence, step length, stride length, symmetry, and Physiological Cost Index (PCI).

Time required to complete training was 6.08hours in RAS group and 7.44hours in the conventional group (P=0.159). The mean TUG was 11.09 s in RAS group and 13.43 s in control group (P-value 0.061). The mean 6MWT was 323.37m in RAS and 288.96m in control group (P-value 0.390). On sub-analysis with exclusion of two skewed variables, statistical significance was found for the TUG test (P-value 0.020). Step length was found to be better for those in the control group (P=0.016 on amputated side and 0.019 on normal side) probably because of external cueing possibly leading to “forced gait” in RAS patients.

RAS may potentially decrease the time to completion of training in patients with transtibial amputation. Its effect on improving walking endurance and enabling independent community ambulation for unilateral transtibial amputee patients needs further research with larger studies.