Using Musical Keyboard to Improve Motor Skill Recovery in Subjects With Multiple Sclerosis

Journal

Physiotherapy (United Kingdom)

Year

2011

Abstract

Purpose: To study the effectiveness of active music making for improving hand motor skill recovery in the rehabilitation of subjects with Multiple Sclerosis. Relevance: Some studies have shown that learning to play a musical instrument can have an important role in the recovery of the hand in stroke patients. It is an extremely complex process of integration between auditory and motor systems, with plastic adaptation in different cerebral regions. Participants: Subjects with Multiple Sclerosis have been recruited from San Raffaele Hospital neuro-rehabilitation ward between May 2009 and August 2010. The study included adult subjects with diagnosis of primarily or secondarily progressive multiple sclerosis (SMPP or SMSP), with no relapses or pharmacological therapy variations in the last three months, with motor impairment at one or both upper limbs, with a residual mobility of at least one finger, with no previous musical experiences and without cognitive, visual or auditory deficits. Methods: 19 subjects were pseudo-randomized in two groups: 11 played repetitive isolated fingers' movements sequences on keyboard (Experimental Group = EG) and 8 played the same exercises on a drawn keyboard (Control Group = CG); training was applied half an hour per day for 15 days. Pre and post-treatment motor functions were evaluated with Nine Hole Peg Test (9HPT), Jamar and Pinch dynamometers. To be included in the study the subjects had to complete the 9HPT in more than 18 seconds. According to literature, the cut-off values of Jamar and Pinch differ depending on the age. The most affected limb was taken in consideration for the analysis. Analysis: Mann-Whitney test was used to evaluate the sample homogeneity.Wilcoxon test was used for the intra-group comparison. Mann-Whitney test was used for the inter-group comparison: for this analysis the difference between pre and post evaluations has been expressed as percentage of the initial values. All data have been analyzed utilizing the SPSS 13.0 software for Windows. Results: The statistical analysis of the most affected side in EG subjects showed significant results only in 9HPT (p = 0.004) and in Jamar (p = 0.01). The statistical analysis of the most affected side in CG subjects showed significant results only in Jamar (p = 0.018). Comparing two groups, Experimental Group subjects showed a higher increment near significance only in Jamar, considering the most affected side (p = 0.07). Conclusions: Playing a musical instrument can be a valid method for training dexterity and strength in subjects with Multiple Sclerosis. Many subjects have moreover shown good compliance with this kind of training, increasing their motivation. The small sample and the non significance of the results in the intergroup comparison does not allow yet to consider the music as a motor learning facilitation, but the positive trend encourages to go on with further studies on larger samples. Implications: The execution of repetitive fingers' movements sequences on keyboard can be used by physical therapists to train hand dexterity and strength in subjects with multiple sclerosis.

Music and Health Institute Terms

Hospital Setting; Mobility; Music Medicine; Multiple Sclerosis; Neurodegenerative Disorders; Playing an Instrument; Recreative Music Methods; Rehabilitation Exercises; Stroke

Indexed Terms

rehabilitation; control group; EMBASE keywords; human; motivation; exercise; hospital; drug therapy; diagnosis; motor system; stroke patient; adaptation; motor performance; keyboard; learning; multiple sclerosis; physiotherapy; arm; computer program; data analysis software; dynamometer; limb; motor dysfunction; physiotherapist; plastic; rank sum test; relapse; statistical analysis; ward

Study Type

Randomized Controlled; Trial; Quantitative Methods

Document Type

Article

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