Posts Tagged Music-supported therapy
Novel rehabilitation interventions have improved motor recovery by induction of neural plasticity in individuals with stroke. Of these, Music-supported therapy (MST) is based on music training designed to restore motor deficits.
Music training requires multimodal processing, involving the integration and co-operation of visual, motor, auditory, affective and cognitive systems. The main objective of this study was to assess, in a group of 20 individuals suffering from chronic stroke, the motor, cognitive, emotional and neuroplastic effects of MST.
Using functional magnetic resonance imaging (fMRI) we observed a clear restitution of both activity and connectivity among auditory-motor regions of the affected hemisphere. Importantly, no differences were observed in this functional network in a healthy control group, ruling out possible confounds such as repeated imaging testing. Moreover, this increase in activity and connectivity between auditory and motor regions was accompanied by a functional improvement of the paretic hand. The present results confirm MST as a viable intervention to improve motor function in chronic stroke individuals.
[ARTICLE] The Motor Function Improvement of the Affected Hand after Stroke Induced by Music-supported Therapy: A Randomized Control Clinical Trail – Full Text PDF
Stroke is the second most common cause of death and major cause of disability worldwide. Hand motor dysfunction is a common impairment in stroke patients, as the cortical projection area of our fingers is large. Once it is damaged, it will be very difficult to restore the function, and has long been the focus and difficulty of stroke rehabilitation. Music- supported therapy in recent study was shown to induce improvements in motor skills in stroke survivors.
Objective: This study aimed at assessing the motor recovery of the affected hand induced by music-supported therapy in chronic stroke patients.
Methods: 14 patients with subcortical stroke, mild to moderately impaired hand function fulfilling the inclusion criteria were randomly assigned to the music group and control group. Both groups received keyboard (Yamaha) training for 30min, 20 times over 4 weeks in addition to conventional treatments. And the only difference between the two groups was that control group’s keyboard could not make any sound. They were trained in an intensive step by step training program. Patients were assessed by Wolf Motor Function Test before and after training.
Results: Both groups showed improvement in motor function assessed by Wolf Motor Function Test scores, and the improvement in music group was significantly better than that of the control group.
Conclusions: The music-supported training with sound can enhance the restoration of hand function much better than the training with no sound in which the music played an important role.
Stroke is the second most common cause of death and major cause of disability worldwide . The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Music therapy has been used to improve patients’ health in several domains, such as cognitive functioning, emotional development, social skills, and quality of life, by using music experiences such as free improvisation, singing, and listening to, discussing, and moving to music to achieve treatment goals. Music- supported therapy (MST) in recent studies has been used in the rehabilitation of stroke survivors with mild or moderate motor disfunction [2-7]. Most of the randomized controlled trial studies were interested in the gross motor function of affected upper extremities after stroke, and the results often showed greater improvements compared with other traditional rehabilitation therapies. But the affected hand function was not especially focused on. Hand motor dysfunction is a common impairment in stroke patients, as the cortical projection area of our fingers is large. Once it is damaged, it will be very difficult to restore the function, and has long been the focus and difficulty of stroke rehabilitation. So we wanted to find out what can music-supported therapy do to the affected hand function after stroke. Since the improvement of the upper extremities after music- supported training was demonstrate, we supposed that the affected hand function would also regain after certain MST programme. It is well known that repetitive practice is one of the basic elements of music supported therapy which can induce the recovery of motor function after stroke, and we would like to find out what the music itself played part in this new therapy.
[ARTICLE] Home-based Neurologic Music Therapy for Upper Limb Rehabilitation with Stroke Patients at Community Rehabilitation Stage – a Feasibility Study Protocol.
Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements.
Methods: For this feasibility study a small sample size of 14 participants (3 – 60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n=7) or wait list control (n=7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies.
Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.
Source: Frontiers | Home-based Neurologic Music Therapy for Upper Limb Rehabilitation with Stroke Patients at Community Rehabilitation Stage – a Feasibility Study Protocol. | Frontiers in Human Neuroscience
[ARTICLE] Music-supported therapy (MST) in improving post-stroke patients’ upper-limb motor function
Objective: Music-supported therapy (MST) is a new approach for motor rehabilitation of stroke patients. Recently, many studies have demonstrated that MST improved the motor functions of post-stroke patients. However, the underlying mechanism for this effect is still unclear. It may result from repeated practice or repeated practice combined with musical stimulation. Currently, few studies have been designed to clarify this discrepancy. In this study, the application of “mute” musical instruments allowed for the study of music as an independent factor.
Methods: Thirty-three post-stroke patients with no substantial previous musical training were included. Participants were assigned to either audible music group (MG) or mute music group (CG), permitting observation of music’s independent effect. All subjects received the conventional rehabilitation treatments. Patients in MG (n = 15) received 20 extra sessions of audible musical instrument training over 4 weeks. Patients in CG (n = 18) received “mute” musical instrument training of the same protocol as that of MG. Wolf motor function test (WMFT) and Fugl—Meyer assessment (FMA) for upper limbs were utilised to evaluate motor functions of patients in both groups before and after the treatment. Three patients in CG dropped out.
Results: All participants in both groups showed significant improvements in motor functions of upper limbs after 4 weeks’ treatment. However, significant differences in the WMFT were found between the two groups (WMFT-quality: P = 0.025; WMFT-time: P = 0.037), but not in the FMA (P = 0.448). In short, all participants showed significant improvement after 4 weeks’ treatment, but subjects in MG demonstrated greater improvement than those in CG.
Discussion: This study supports that MST, when combined with conventional treatment, is effective for the recovery of motor skills in post-stroke patients. Additionally, it suggests that apart from the repetitive practices of MST, music may play a unique role in improving upper-limb motor function for post-stroke patients.