Therapeutic Instrumental Music Performance With Sensory-Enhanced Motor Imagery in Chronic Post-Stroke Rehabilitation

Recruiting

Phase N/A Results N/A

Trial Description

Research has shown that music engages the brain bilaterally throughout cortical and subcortical regions, accessing extended sensorimotor, cognitive and affective networks. This research explores the hypothesis that use of these shared neural networks allows neurologic music therapy interventions targeting upper extremity motor control to promote plasticity and functional improvements in persons recovering from a cerebrovascular accident. The potential therapeutic benefits of these interventions on attentional processes and affective responding will also be examined.

Detailed Description

More individuals are surviving and living with the effects of stroke, a trend that is expected to continue. Upper extremity limitations present a common, persistent challenge for stroke survivors, impacting quality of life. In addition, links have been found between physical impairment and depression, and depression and stroke-induced cognitive impairment. Music has been shown to exert multimodal effects on individuals and may be used as a mediating stimulus to promote therapeutic change. Furthermore, motor imagery may enhance the effectiveness of upper extremity interventions by engaging the same brain areas that are active in physical movement. The purpose of this study is to investigate the effects of therapeutic instrumental music performance and sensory-enhanced motor imagery on upper limb movement, affect and cognition following a stroke. Participants will be assessed at two baselines, and randomly assigned to one of three intervention groups: therapeutic instrumental music performance, therapeutic instrumental music performance and sensory-enhanced motor imagery, or therapeutic instrumental music performance and motor imagery without sensory enhancement.

Conditions

Interventions

  • Therapeutic Instrumental Music Performance Behavioral
    Intervention Desc: Participants will play a variety of instruments (acoustic and electronic) to facilitate retraining of everyday functional movements.
    ARM 1: Kind: Experimental
    Label: Therapeutic Instrumental Music Performance
    Description: Therapeutic Instrumental Music Performance is a Neurologic Music Therapy technique in which selection of instruments, spatial configurations and sequences for playing are designed to facilitate retraining of movement patterns used in everyday life. Participants will receive ten individual forty-five minute sessions of Therapeutic Instrumental Music Performance, three sessions per week.
    ARM 2: Kind: Experimental
    Label: Therapeutic Performance with Sensory-Enhanced Motor Imagery
    Description: Participants will receive ten individual sessions, three times per week: thirty minutes of Therapeutic Instrumental Music Performance, followed by fifteen minutes of sensory-enhanced motor imagery. During sensory-enhanced motor imagery, participants will listen to a metronome set to their preferred pace for previously practised movements while engaging in motor imagery.
    ARM 3: Kind: Experimental
    Label: Therapeutic Performance with Motor Imagery
    Description: Participants will receive ten individual sessions, three times per week: thirty minutes of Therapeutic Instrumental Music Performance, followed by fifteen minutes of motor imagery. Motor imagery will involve mental practice of previous movement exercises.
  • Therapeutic Instrumental Music Performance (TIMP) Behavioral
    Intervention Desc: Participants will play a variety of instruments (acoustic and electronic) to facilitate retraining of everyday functional movements.
    ARM 1: Kind: Experimental
    Label: TIMP without Motor Imagery
    Description: Therapeutic Instrumental Music Performance (TIMP) is a Neurologic Music Therapy technique in which selection of instruments, spatial configurations and sequences for playing are designed to facilitate retraining of movement patterns used in everyday life. Participants will receive twelve individual forty-five minute sessions of TIMP, three times a week for four weeks.
    ARM 2: Kind: Experimental
    Label: TIMP with SEMI
    Description: Participants will receive thirty minutes of TIMP, followed by fifteen minutes of sensory-enhanced motor imagery (SEMI), three times a week for four weeks. During SEMI, participants will listen to a metronome set to their preferred pace for previously practised movements while engaging in motor imagery.
    ARM 3: Kind: Experimental
    Label: TIMP with MI
    Description: Participants will receive thirty minutes of TIMP, followed by fifteen minutes of motor imagery (MI), three times a week for four weeks. MI will involve mental practice of previous movement exercises.
  • TIMP with SEMI Behavioral
    Intervention Desc: Participants will listen to a metronome set to their preferred pace for previously practised movements while engaging in motor imagery.
    ARM 1: Kind: Experimental
    Label: TIMP with SEMI
    Description: Participants will receive thirty minutes of TIMP, followed by fifteen minutes of sensory-enhanced motor imagery (SEMI), three times a week for four weeks. During SEMI, participants will listen to a metronome set to their preferred pace for previously practised movements while engaging in motor imagery.
  • TIMP with MI Behavioral
    Intervention Desc: Participants will engage in motor imagery of previously practised movements.
    ARM 1: Kind: Experimental
    Label: TIMP with MI
    Description: Participants will receive thirty minutes of TIMP, followed by fifteen minutes of motor imagery (MI), three times a week for four weeks. MI will involve mental practice of previous movement exercises.
  • Therapeutic Performance with Sensory-Enhanced Motor Imagery Behavioral
    Intervention Desc: Participants will listen to a metronome set to their preferred pace for previously practised movements while engaging in motor imagery.
    ARM 1: Kind: Experimental
    Label: Therapeutic Performance with Sensory-Enhanced Motor Imagery
    Description: Participants will receive ten individual sessions, three times per week: thirty minutes of Therapeutic Instrumental Music Performance, followed by fifteen minutes of sensory-enhanced motor imagery. During sensory-enhanced motor imagery, participants will listen to a metronome set to their preferred pace for previously practised movements while engaging in motor imagery.
  • Therapeutic Performance with Motor Imagery Behavioral
    Intervention Desc: Participants will engage in motor imagery of previously practised movements.
    ARM 1: Kind: Experimental
    Label: Therapeutic Performance with Motor Imagery
    Description: Participants will receive ten individual sessions, three times per week: thirty minutes of Therapeutic Instrumental Music Performance, followed by fifteen minutes of motor imagery. Motor imagery will involve mental practice of previous movement exercises.

Outcomes

Type Measure Time Frame Safety Issue
Primary Changes from baseline in Wolf Motor Function Test Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Primary Changes from baseline in Fugl-Meyer Assessment Upper Extremity Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary Motor Activity Log Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary Trunk Impairment Scale Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary Multiple Affect Adjective Check List-Revised Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary General Self-Efficacy Scale Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary Digit Span Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary Trail Making Test Part B Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary Kinesthetic and Visual Imagery Questionnaire Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks

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