Let's Improvise! iPad-based Music Therapy With Functional Electrical Stimulation for Upper Limb Stroke Rehabilitation

Journal

Australian Journal of Music Therapy

Year

2018

Abstract

This retrospective clinical case report will examine the implementation of a novel intervention combining a Functional Electrical Stimulation (FES) protocol with an iPad application. A 74-year-old female retired pianist and Professor of Music was admitted to a rehabilitation hospital following a left pontine stroke. On assessment, she was unable to use her right upper limb functionally. Conventional occupational therapy commenced soon after admission and consisted of functional retraining, including FES to the wrist and finger extensors. At week 4, the Registered Music Therapist (RMT) and Occupational Therapist (OT) collaborated to commence a trial of forearm FES in combination with an iPad-based music making application; ThumbJam. This application was used to encourage the patient to participate in touch sensitive musical improvisation using the affected hand in an attempt to promote engagement in complex motor patterns and non-verbal expression. Within 3 weeks, the patient was able to use ThumbJamwithout the FES, progressed to the keyboard in 4 weeks and has since commenced independent scales on the piano at home (21 weeks), as well as successful use of the upper limb in Activities of Daily Living (ADLs). On follow up (7 months), the patient reflected on the motivating elements of the intervention that helped her to achieve a functional outcome in her upper limb. This retrospective clinical case report will review the evidence with regard to FES and music therapy, outline the treatment protocol used and make recommendations for future research of “FES+ThumbJam” in upper limb stroke rehabilitation.

Music and Health Institute Terms

Elderly; Engagement Level; Improvisation; Inpatient Rehabilitation; Music Therapy; Occupational Therapy; Observational Measures; Rehabilitation Exercises; Stroke

Indexed Terms

Activities of daily living; Australia; Brain research; Functional electrical stimulation; Instrumental music; Intervention; Ipad; Neurosciences; Occupational therapy; Rehabilitation; Stroke; Stroke recovery

Study Type

Case-Control Study; Qualitative Methods

Document Type

Article

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