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

Why was this research needed?  Much earlier research already exists. 

• music (94 posts back to March 2011)

• music therapy (53 posts back to October 2014)

• musical training (13 posts back to June 2014) 

  • motor imagery (60 posts to January 2013)

   

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

Author links open overlay panelCatherine M.HairePhD¹²

LucTremblayPhD³⁵VeronicaVuongMA¹²Kara K.PattersonPhD⁴⁵Joyce L.ChenPhD³⁵Jonathan H.BurdetteMD⁶NinaSchaffertPhD⁷⁸Michael H.ThautPhD¹²

https://doi.org/10.1016/j.arrct.2021.100162Get rights and content

Under a Creative Commons license

open access

Abstract

Objective

To investigate the potential benefits of three Therapeutic Instrumental Music Performance (TIMP)-based interventions in rehabilitation of the affected upper-extremity [UE] for adults with chronic post-stroke hemiparesis.

Design

Randomized-controlled pilot study

Setting

University research facility

Participants

Thirty community-dwelling volunteers [16 male/14 female; ages 33-76; mean age =55.9] began and completed the protocol. All participants had sustained a unilateral stroke > 6 months prior to enrollment [mean time post-stroke =66.9 months].

Interventions

Two baseline assessments, a minimum of one week apart; nine intervention sessions (3x/wk for 3 wks), in which rhythmically-cued, functional arm movements were mapped onto musical instruments; one post-test following the final intervention. Participants were block-randomized to one of three conditions: Group 1 - 45 minutes TIMP; Group 2 - 30 minutes TIMP, 15 minutes metronome-cued motor imagery (TIMP+cMI); Group 3 - 30 minutes TIMP, 15 minutes motor imagery without cues (TIMP+MI). Assessors and investigators were blinded to group assignment.

Main Outcome Measures

Fugl-Meyer Upper-Extremity (FM-UE); Wolf Motor Function Test- Functional Ability Scale (WMFT-FAS)

Secondary Measures

Motor Activity Log (MAL) – Amount of Use Scale; Trunk Impairment Scale.

Results

All groups made statistically significant gains on the FM-UE (TIMP, p=.005, r=.63; TIMP+cMI, p=.007, r=.63; TIMP+MI, p=.007, r=.61) and the WMFT-FAS (TIMP, p=.024, r=.53; TIMP+cMI, p=.008, r=.60; TIMP+MI, p=.008, r=.63). Comparing between-group percent change differences, on the FM-UE, TIMP scored significantly higher than TIMP+cMI (p=.032, r=.57), but not TIMP+MI. There were no differences in improvement on WMFT-FAS across conditions. On the MAL, gains were significant for TIMP (p=.030, r=.54) and TIMP+MI (p =.007, r=.63).

Conclusion

TIMP-based techniques, with and without motor imagery, led to significant improvements in paretic arm control on primary outcomes. Replacing a physical training segment with imagery-based training resulted in similar improvements; however, synchronizing internal and external cues during auditory-cued motor imagery may pose additional sensorimotor integration challenges.