Background
Residual motor deficits of the upper limb in patients with chronic stroke are common and have a negative impact on autonomy, participation and quality of life. Music-Supported Therapy (MST) is an effective intervention to enhance motor and cognitive function, emotional well-being and quality of life in chronic stroke patients. We have adapted the original MST training protocol to a home-based intervention, which incorporates increased training intensity and variability, group sessions, and optimisation of learning to promote autonomy and motivation.
Methods
A randomised controlled trial will be conducted to test the effectiveness of this enriched MST (eMST) protocol in improving motor functions, cognition, emotional well-being and quality of life of chronic stroke patients when compared to a program of home-based exercises utilizing the Graded Repetitive Arm Supplementary Program (GRASP). Sixty stroke patients will be recruited and randomly allocated to an eMST group (n = 30) or a control GRASP intervention group (n = 30). Patients will be evaluated before and after a 10-week intervention, as well as at 3-month follow-up. The primary outcome of the study is the functionality of the paretic upper limb measured with the Action Research Arm Test. Secondary outcomes include other motor and cognitive functions, emotional well-being and quality of life measures as well as self-regulation and self-efficacy outcomes.
Discussion
We hypothesize that patients treated with eMST will show larger improvements in their motor and cognitive functions, emotional well-being and quality of life than patients treated with a home-based GRASP intervention.
Trial registration
The trial has been registered at ClinicalTrials.gov and identified as NCT04507542 on 8 August 2020.
Designing an app for home-based enriched Music-supported Therapy in the rehabilitation of patients with chronic stroke: a pilot feasibility study Objective: After completing formal stroke rehabilitation programs, most patients do not achieve full upper limb motor function recovery. Music-supported Therapy (MST) can improve motor functionality post stroke through musical training. We designed a homebased enriched Music-supported Therapy (eMST) program to provide patients with chronic stroke the opportunity of continuing rehabilitation by themselves. We developed an app to conduct the eMST sessions at home with a MIDI-piano and percussion instruments. Here, we tested the feasibility of the eMST intervention using the novel app. Method: This is a pilot study where five patients with chronic stroke underwent a 10week intervention of 3 sessions per week. Patients answered feasibility questionnaires throughout the intervention to modify aspects of the rehabilitation program and the app according to their feedback. Upper limb motor functions were evaluated pre-and postintervention as well as speed and force tapping during daily piano performance. Results: Patients clinically improved in upper limb motor function achieving the Minimal Detectable Change (MDC) or Minimal Clinically Important Difference (MCID) in most of motor tests. The app received high usability ratings postintervention.
Conclusion:The eMST program is a feasible intervention for patients with chronic stroke and its efficacy should be assessed in a clinical trial.
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