Development and evaluation of a novel music-based therapeutic device for upper extremity movement training: A pre-clinical, single-arm trial

Abstract

Restoration of upper limb motor function and patient functional independence are crucial treatment targets in neurological rehabilitation. Growing evidence indicates that music-based intervention is a promising therapeutic approach for the restoration of upper extremity functional abilities in neurologic conditions such as cerebral palsy, stroke, and Parkinson’s Disease. In this context, music technology may be particularly useful to increase the availability and accessibility of music-based therapy and assist therapists in the implementation and assessment of targeted therapeutic goals. In the present study, we conducted a pre-clinical, single-arm trial to evaluate a novel music-based therapeutic device (SONATA) for upper limb extremity movement training. The device consists of a graphical user interface generated by a single-board computer displayed on a 32” touchscreen with built-in speakers controlled wirelessly by a computer tablet. The system includes two operational modes that allow users to play musical melodies on a virtual keyboard or draw figures/shapes whereby every action input results in controllable sensory feedback. Four motor tasks involving hand/finger movement were performed with 21 healthy individuals (13 males, aged 26.4 ± 3.5 years) to evaluate the device’s operational modes and main features. The results of the functional tests suggest that the device is a reliable system to present pre-defined sequences of audiovisual stimuli and shapes and to record response and movement data. This preliminary study also suggests that the device is feasible and adequate for use with healthy individuals. These findings open new avenues for future clinical research to further investigate the feasibility and usability of the SONATA as a tool for upper extremity motor function training in neurological rehabilitation. Directions for future clinical research are discussed.

Music-based intervention drives paretic limb acceleration into intentional movement frequencies in chronic stroke rehabilitation

“…AMIs represent one potential candidate for such therapeutic exercises. The use of TIMP in the present study may have implicitly driven the paretic arm into greater and more consistent accelerations due to its cyclical and repetitive structure embedded into anticipatory entrainment cues (i.e., rhythmic beats), which is supported by results of previous AMIs ( 14 – 17 , 27 , 28 ). To test this speculative hypothesis, future therapeutic exercises may also employ frequency-based assessments during the actual execution of training exercises to measure motor recovery within and outside of AMIs.…”

“…The main digital auditory devices used for mapping rhythmically cued movements were a Yamaha CP40 Stage Piano and DTX Drums (Yamaha Corporation, Hamamatsu, Shizuoka, Japan). A specially designed digital interactive sound tablet, known as the Sonification Arm Training Apparatus (SONATA), provided real-time auditory feedback of limb tracing, and pointing movements ( 17 , 27 , 28 ). A digital metronome device was used to create anticipatory timing cues for motor entrainment ( 30 , 31 ) and ascertain the participant's preferred movement frequency.…”

“…(13)(14)(15)(16)(17) provide an ideal laboratory for studying movement acceleration parameters using kinematic assessments. Indeed, AMIs such as TIMP may facilitate temporal control (e.g., acceleration) of paretic limb movements by mapping paretic arm trajectories to the touch surfaces of acoustical and digital instruments/ devices which create auditory feedback upon contact (15, 17,27,28). Therefore, the present study utilized frequency-based analyses as dynamic movement assessments, while clinical pre-and post-test assessments were obtained via the FM-UE and WMFT in the same cohort.…”

Therapeutic Instrumental Music Training and Motor Imagery in Post-Stroke Upper-Extremity Rehabilitation: A Randomized-Controlled Pilot Study

“…TIMP exercises were designed to facilitate retraining of functional movement patterns involving proximal and distal control by mapping rhythmically cued movements onto acoustic and digital instruments, including a specially designed programmable digital interactive sound tablet with 32 surface key squares in 4 rows producing musical sounds on touch (sonification arm training apparatus). 24 An external rhythmic auditory cue, set at the participant's preferred tempo, provided a consistent template for gauging movement trajectories in accordance with spatiotemporal constraints, emphasizing accuracy over speed. Beats per minute for slower tempi were subdivided to facilitate entrainment and promote auditory-motor coupling.…”

Ultra-responsive, low-dimensional unfamiliar movement sonification guides unconstrained reaches to invisible targets in 3D space

“…Typical sonification systems sample sensors and update auditory feedback at 100Hz (Boyer et al 2013(Boyer et al , 2017Effenberg et al 2016;Schaffert et al 2017;Ahmetovic et al 2019;Fehse et al 2020;Linnhoff et al 2022;Liu et al 2022), or 200Hz or 300Hz (Danna and Velay 2017;Dyer et al 2017;), but we are not aware of any sampling faster than that. As for latency, typical systems run either in the 5-29ms range (Boyer et al 2013;Brückner et al 2014;Schaffert et al 2020) or 30-50ms range (Boyer et al 2017;Linnhoff et al 2022), with some running with 100ms or more (Reh et al 2019;Vidal et al 2020). However, audition has millisecond temporal resolution, with measured gap detection and order sensitivity down to 1-3ms (Green 1971;Fitzgibbons 1983Fitzgibbons , 1984.…”