Home-based Neurologic Music Therapy for Upper Limb Hemiparesis: A Feasibility Study

Journal

International Journal of Stroke

Year

2016

Abstract

Introduction: Upper limb hemiparesis following stroke is extremely resistant to treatment and more repetitive, task driven interventions are required in order to improve ADLs, particularly at community stage. Studies using musical instrument playing to reduce hemiparesis have produced compelling evidence. Therapeutic Instrumental Music Performance (TIMP), a neurologic music therapy (NMT) technique, has not been extensively studied in stroke. Here the feasibility and effects were investigated as a home-based intervention. Method: 11 NHS stroke patients were recruited at the end of statutory community rehabilitation and randomised into treatment (n=6) or waitlist (n=5), using a crossover design. TIMP was delivered twice weekly over 6 weeks. Each participant played through a number of pre-designed upper limb exercises, playing musical instruments and attuning arm/finger movement to musical patterns. Data were collected at 4 time points over 15 weeks using the Action Research Arm Test. A blind assessor collected data pre- and post- 6 weeks of TIMP. Results: 10 participants completed the study. Adherence to treatment indicates the intervention to be motivating and supporting high levels of repetition and tolerance. An analysis of variance for the crossover study found statistical significance between period means (p=0.03) but no difference between treatment and waitlist means (p=0.06). Conclusion: The treatment can be delivered at this dosage and in a variety of different home environments by a trained clinician. The analysis of ARAT data indicates that TIMP might improve hemiparetic upper limb function. A larger RCT is warranted comparing the intervention plus standard care with standard alone.

Music and Health Institute Terms

Observational Measures; Playing an Instrument; Recreative Music Methods; Rehabilitation Exercises; Stroke

Indexed Terms

feasibility study; finger; hemiparesis; nervous system; analysis of variance; clinical article; controlled clinical trial; controlled study; crossover procedure; EMBASE keywords; exercise; health care quality; home environment; human; randomized controlled trial; rehabilitation; statistical significance; stroke patient

Study Type

Randomized Controlled; Trial; Quantitative Methods

Document Type

Article

More Info

Share

COinS