Objective: To assess the feasibility of a randomized controlled trial to evaluate music therapy as a home-based intervention for arm hemiparesis in stroke.
Design: A pilot feasibility randomized controlled trial, with cross-over design. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes.
Setting: Participants’ homes across Cambridgeshire, UK.
Subjects: Eleven people with stroke and arm hemiparesis, 3–60 months post stroke, following discharge from community rehabilitation.
Interventions: Each participant engaged in therapeutic instrumental music performance in 12 individual clinical contacts, twice weekly for six weeks.
Main measures: Feasibility was estimated by recruitment from three community stroke teams over a 12-month period, attrition rates, completion of treatment and successful data collection. Structured interviews were conducted pre and post intervention to establish participant tolerance and preference. Action Research Arm Test and Nine-hole Peg Test data were collected at weeks 1, 6, 9, 15 and 18, pre and post intervention by a blinded assessor.
Results: A total of 11 of 14 invited participants were recruited (intervention n = 6, waitlist n = 5). In total, 10 completed treatment and data collection.
Conclusion: It cannot be concluded whether a larger trial would be feasible due to unavailable data regarding a number of eligible patients screened. Adherence to treatment, retention and interview responses might suggest that the intervention was motivating for participants.
A total of 80% of stroke cases result in hemiparesis,1 and half this number experience persistent lack of arm function.2 Effective interventions are lacking, and evidence to support those that are accessible is insufficient.3 A clear need has been identified for long-term support in the community for people with stroke, but services are limited and few studies have examined home-based interventions and provided sufficient detail of the protocols used.4
Music interventions may be beneficial for improving arm function following stroke,5,6 and a strong rhythmic stimulus embedded within music may enhance motor performance more than the use of a rhythmic stimulus alone without music.7 More research is needed to establish the effects of music interventions on arm function, and with the majority of rehabilitation being delivered in patients’ homes it is useful to determine the feasibility of home-based treatment delivery and research. This article reports on the feasibility of conducting a randomized controlled trial where a music intervention, for which there was a clear protocol based on published guidelines,8,9 was delivered in a variety of home environments.[…]