Functional electrical stimulation+iPad-based music therapy for upper limb recovery after stroke: Study protocol for a mixed methods randomised controlled trial

Abstract

Introduction: Music therapy offers an effective avenue for simultaneously addressing goals of upper limb function and wellbeing post stroke. However, there are currently no trials of therapeutic music-making interventions for stroke survivors with a very weak upper limb (Grade 0-3 level of strength). This randomised controlled trial will examine the effect of Functional Electrical Stimulation (FES) with iPad-based music therapy on upper limb recovery and wellbeing outcomes for stroke survivors.Method: This convergent mixed methods study will take place at seven participating hospitals in Sydney, Australia. Forty participants will be randomly allocated to usual care only or usual care plus daily FES+iPad-based music therapy for four weeks (20 sessions). Standardised assessments of the paretic upper limb and self-report wellbeing measures will be administered at three time points (pre-and postintervention, and at three months follow up) by a blinded assessor. All participants will be interviewed about their perceptions of the way the treatment they received (usual care only or usual care plus daily FES+iPad-based music therapy) supported their recovery.Results: Ethics approval has been granted and data collection has commenced.

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

“…The introduction of music technology with the use of digital musical instruments, such as keyboards and drum pads [ 30 , 38 ] and, more recently, touchscreen devices (e.g. tablets) using commercially available music software [ 40 , 61 , 62 ], have provided novel approaches for the application of active musical instrument playing in the rehabilitation of upper extremity motor function. For instance, electronic keyboards and digital sound surfaces enable users with complex needs the possibility to play a musical instrument in an adapted form to train fine and gross movements of the paretic extremity [ 30 , 38 ].…”

Art and Craft of Music Therapy for Stroke Rehabilitation in a Remote North Indian Community

“…Having worked for about 18 years in neurorehabilitation, at every stage from acute to chronic, I have broad experience of the different needs that stroke survivors and their families have, the heterogeneity of stroke effects and the lack of rehabilitation provision that many experience. It has been reported that music therapy brings added value to multidisciplinary team (MDT) rehabilitation (Sihvonen et al, 2017) and that this is due to the holistic brain and nervous system stimulation of music (Magee, 2019) and the creative ways in which therapists can adapt musical structures, equipment and other creative materials to meet patient needs and goals (Silveira et al, 2018;Thaut & Hoemberg, 2014). There is an ever-expanding wealth of literature published in scientific journals reporting on the motor, cognitive, emotional and psychosocial benefits of music therapy in neurorehabilitation (Grau-Sánchez et al, 2020;Magee et al, 2017;Wilson, 2013).…”

Using Experience-based Co-design to develop mobile/tablet applications to support a person-centred and empowering stroke rehabilitation

“…phone calls, messages, reminders, remote monitoring or intervention, videos and images) may support the delivery of relevant, evidencebased health information (15)(16)(17), support continuity and reduce gaps in the rehabilitation process (18), and support the feeling of being connected with the therapists (17). Furthermore, stroke survivors' motivation, engagement and empowerment to independently perform person-centred exercises post-discharge (17,19), and to become more active in managing their own health may be supported by ICT and apps (15)(16)(17)(20)(21)(22)(23)(24). However, because of the lack of tailoring to individual needs, many app solutions do not support person-centred rehabilitation (13).…”