Enriched Music-supported Therapy for chronic stroke patients: a study protocol of a randomised controlled trial

Abstract

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.

Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives

“…However, functional gains and transfer to everyday tasks are observed after at least 4 weeks of intervention and are even more noticeable after a second training period, thus suggesting progressive improvements ( Grau-Sánchez et al, 2018 , 2020 ). Importantly, recent intervention protocols have indicated that treatment intensity and duration may need to be increased to promote effective motor recovery for patients in the chronic stage of stroke ( Grau-Sánchez et al, 2021 ).…”

Putting music to trial: Consensus on key methodological challenges investigating music‐based rehabilitation

“…Apart from adjusting the exercises to the level of participants’ ability, elements of the intervention can be chosen by patients to increase motivation and adherence to the intervention. It is common to allow the selection of different types of music according to the participant's preferences or the ideal time to do the intervention session in home‐based interventions 53,54 . These individual adjustments should be registered during data collection to consider them in the analysis or results interpretation.…”

“…It is common to allow the selection of different types of music according to the participant's preferences or the ideal time to do the intervention session in home‐based interventions. 53 , 54 These individual adjustments should be registered during data collection to consider them in the analysis or results interpretation. Articles reporting the effectiveness of music‐based interventions should describe which elements of the training program were tailored and which were strategies to ensure treatment fidelity.…”

Designing an app for home-based enriched Music-supported Therapy in the rehabilitation of patients with chronic stroke: a pilot feasibility study

“…The protocol of this study was approved by the Clinical Research Ethics Committee of the Bellvitge University Hospital (PR095/17; Barcelona, Spain) and the Hospitals del Mar i l'Esperança (Parc de Salut Mar, 2020/9523; Barcelona, Spain) and follows the Declaration of Helsinki to experiment with human beings (45). Participants signed an informed consent prior to participation explaining the feasibility objectives of the study and the absence of potential risks for completing the eMST intervention.…”

“…Secondary outcomes include other motor and cognitive functions, emotional well-being, and QoL measures as well as selfregulation and self-efficacy outcomes. Please see methods on the study protocol by Grau-Sánchez et al, 2021 (45) for more details.…”