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While useful for controlled assessment, prolonged walking better reflects real-world function. Adaptive beat-alignment algorithms using biofeedback may enhance synchronization and benefit gait dynamics but their effects in PwPMS remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the effect of walking with and without an adaptive beat-alignment algorithm on synchronization consistency during 8\u2009minutes of walking compared to walking in silence, and its effects on gait. We also examined how clinical factors like dynamic balance and cognition affect synchronization consistency during walking with music and metronomes, with and without adaptive beat alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Healthy controls (HCs) and PwPMS walked for 8\u2009minutes under 5 conditions: silence, music, and metronomes, with or without adaptive beat alignment, at their preferred pace. The algorithm adjusted phase and tempo in real time to restore baseline cadence. We measured synchronization, gait parameters, dynamics, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one PwPMS and 18 HCs participated. Adaptive beat-alignment improved synchronization consistency and gait dynamics compared to fixed-tempo walking. Cognitive flexibility and working memory explained 10% of variance in the non-adaptive and 6% in the adaptive conditions, while dynamic balance (40%) impaired synchronization across both algorithms. Auditory cues resulted in slower walking and shorter strides compared to silence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates the feasibility of adaptive beat-alignment strategies enhancing synchronization consistency and gait dynamics in PwPMS; however, cognitive flexibility, working memory, and dynamic balance influenced synchronization performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683251412280","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T09:18:18Z","timestamp":1770369498000},"page":"291-305","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Technology-Assisted Solutions to Enhance Auditory-Motor Synchronization During Walking in Progressive Multiple Sclerosis"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9325-3503","authenticated-orcid":false,"given":"Nele","family":"Vanbilsen","sequence":"first","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, University of Hasselt, Diepenbeek, Belgium"},{"name":"Universitair Multiple Sclerosis Centrum (UMSC), Hasselt-Pelt, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-5495","authenticated-orcid":false,"given":"Peter","family":"Feys","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, University of Hasselt, Diepenbeek, Belgium"},{"name":"Universitair Multiple Sclerosis Centrum (UMSC), Hasselt-Pelt, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Florio","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, University of Hasselt, Diepenbeek, Belgium"},{"name":"Universitair Multiple Sclerosis Centrum (UMSC), Hasselt-Pelt, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Moens","sequence":"additional","affiliation":[{"name":"IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, University of Ghent, Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Van Wijmeersch","sequence":"additional","affiliation":[{"name":"Universitair Multiple Sclerosis Centrum (UMSC), Hasselt-Pelt, Hasselt, Belgium"},{"name":"Rehabilitation &amp; MS Centre Overpelt, Pelt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Kos","sequence":"additional","affiliation":[{"name":"National MS Center Melsbroek, Melsbroek, Belgium"},{"name":"Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Leman","sequence":"additional","affiliation":[{"name":"IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, University of Ghent, Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-5190","authenticated-orcid":false,"given":"Lousin","family":"Moumdjian","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, University of Hasselt, Diepenbeek, Belgium"},{"name":"Universitair Multiple Sclerosis Centrum (UMSC), Hasselt-Pelt, Hasselt, Belgium"},{"name":"IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, University of Ghent, Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S10480"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00289-7"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000323"},{"issue":"2","key":"e_1_3_2_5_2","first-page":"207","article-title":"Walking capacity and ability are more impaired in progressive compared to relapsing type of multiple sclerosis","volume":"51","author":"Feys P","year":"2015","unstructured":"Feys P, Bibby BM, Baert I, Dalgas U. 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