The Role of Auditory Feedback in Music-supported Stroke Rehabilitation: A Single-blinded Randomised Controlled Intervention

Journal

Restorative Neurology and Neuroscience

Year

2016

Abstract

Purpose: Learning to play musical instruments such as pianowas previously shown to benefit post-stroke motor rehabilitation. Previous work hypothesised that the mechanism of this rehabilitation is that patients use auditory feedback to correct their movements and therefore show motor learning. We tested this hypothesis by manipulating the auditory feedback timing in a way that should disrupt such error-based learning. Methods: We contrasted a patient group undergoing music-supported therapy on a piano that emits sounds immediately (as in previous studies) with a group whose sounds are presented after a jittered delay. The delay was not noticeable to patients. Thirty-four patients in early stroke rehabilitation with moderate motor impairment and no previous musical background learned to play the piano using simple finger exercises and familiar children's songs. Results: Rehabilitation outcome was not impaired in the jitter group relative to the normal group. Conversely, some clinical tests suggests the jitter group outperformed the normal group. Conclusions: Auditory feedback-based motor learning is not the beneficial mechanism of music-supported therapy. Immediate auditory feedback therapy may be suboptimal. Jittered delay may increase efficacy of the proposed therapy and allow patients to fully benefit from motivational factors of music training. Our study shows a novel way to test hypotheses concerning music training in a single-blinded way, which is an important improvement over existing unblinded tests of music interventions.

Music and Health Institute Terms

Music Medicine; Playing an Instrument; Recreative Music Methods; Rehabilitation Exercises; Stroke

Indexed Terms

auditory feedback; cerebrovascular accident; neurorehabilitation; Elderly; Analysis of Variance; Auditory Perception; Barthel index; clinical article; controlled study; depression; EMBASE keywords; exercise; fatigue; Feedback, Sensory; finger; hostility; human; Mood Disorders; motor dysfunction; Motor Skills; pegboard test; priority journal; Profile of Mood States; Psychiatric Status Rating Scales; questionnaire; randomized controlled trial; sensorimotor integration; single blind procedure; Single-Blind Method; Stroke Rehabilitation; Stroke; Stroke

Study Type

Randomized Controlled; Trial; Quantitative Methods

Document Type

Article

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