Relationship between output from MIDI-keyboard playing and hand function assessments on affected hand after stroke

Abstract

BACKGROUND: While a number of studies have tested the therapeutic effectiveness of playing musical instruments, such as the electronic keyboard using Musical Instrument Digital Interface (MIDI), it is still unclear whether outcomes of electronic keyboard playing are related to hand function tests. OBJECTIVE: The purpose of this study was to investigate the correlation between MIDI-keyboard playing and hand function tests, including grip strength, Box and Block test (BBT), and Jensen-Taylor Hand Function Test (JTHF). METHODS: A total of 66 stroke patients were recruited from medical centers and were classified into acute (n = 21), subacute (n = 28), and chronic (n = 17) recovery stages. The participants' mean age was 60.5 years. The MIDI-keyboard playing protocol based on sequential key pressing was implemented. All hand function tests were performed by certified occupational therapists. RESULTS: MIDI scores from participants at all three recovery stages were significantly correlated with BBT and grip strength. Overall, MIDI-keyboard playing scores demonstrated moderate to high correlations with hand function tests except for participants at the chronic stage and the JTHF, which showed no correlation. CONCLUSIONS: These findings suggest that MIDI-keyboard playing has great potential as an assessment tool of hand function, especially hand dexterity in acute and subacute stroke patients. Further studies are needed to refine the specific keyboard playing tasks that increase responsiveness to traditional hand function tests.

Music Therapy and Stroke: An Integrative Review

“…Chong et al [58] Counterbalanced Thaut et al [71] Experimental Design Carruth [50] Cofrancesco [80] Cohen & Ford [45] Mixed Design Forsblum et al [37] Forsblum et al [38] Street et al [55] Multiple Trials Thaut et al [62] Multi-variant analysis Haydn et al [64] Shin et al [67] Pilot Study Malcolm et al [60] Pfeiffer & Sabe [59] Protocol Review Kim & Tomaino [57] Kim [81] Kim & Jo [65] RCT Conklyn et al [82] Paul & Ramsey [48] Särkämö et al [43] Särkämö et al [83] Thaut et al [61] Repeated Measures Kim et al [48] Nayak et al [41] Prassas et al [42] Suh et al [68] Thaut et al [70] Tsai et al [53] Wheeler et al [44] [50] Cofrancesco [80] Cohen [52] Cohen [79] Erdonmez & Morley [63] Hurkmans et al [47] Kim [81] Kim & Jo [65] Kim & Tomaino [57] Malcolm et al [60] Montgomery et al [40] Poćwierz-Marciniak [51] Prassas et al [42] Purdie [42] Tamplin [69] Tomaino …”

“…Tsai et al [53] MMD [52] Breathing and vocal exercises Rhythmic speech drills Singing familiar songs Cohen [79] Breathing and vocal exercises Paired with Visi-Pitch™ feedback Cohen & Ford [45] Singing familiar songs Conklyn et al [82] Modified Melodic Intonation Therapy Hurkmans et al [47] Singing and rhythmic chanting Vocal warm-ups Kim & Tomaino [57] Singing familiar songs Breathing into single-syllable sounds Musically assisted speech Dynamically cued singing Rhythmic speech cueing Oral motor exercises Vocal intonation Kim & Jo [65] Accent-based Music Speech Protocol (physical warm-up, breathing and vocal exercises, singing familiar songs) Tamplin [69] Physical, breathing, vocal, exercises Rhythmic and melodic articulation exercises Rhythmic speech cuing Vocal intonation therapy Singing familiar songs Tomaino [46] Singing familiar songs Memorization of lyrics Using expressivity Chong et al [58] Guerrero et al [39] Playing percussion instruments Arm (shoulder and elbow flexion)…”

“…Thaut et al [70] RAS (original composition in Renaissance style/ accented beats) or metronome Pre-selected by researcher Chong et al [58] Cohen [52] Cohen [79] Conklyn et al [82] Hurkmans et al [47] Kim & Jo [65] Malcolm et al [60] Montgomery et al [40] Nayak et al [41] Paul & Ramsey [48] Pfeiffer & Sabe [59] Shin et al [67] Street et al [55] Suh et al [68] Thaut et al [71] * Thaut et al [61] * Thaut et al [62] * Thaut et al [70] * Tsai et al [53] Wheeler et al [44] Participant selected Cohen [92] Cohen [79] Cohen & Ford [45] Guerrero et al [39] Haydn et al [64] * Nayak et al [41] Prassas et al [42] * Tamplin [69] Thaut et al [70] * Wheeler et al [44] Participant selected from own collection Cofrancesco [80] Cohen [52] Erdonmez & Morley [63] Forsblum et al [37] Forsblum et al [38] Kim & Tomaino [58] Kim [81] Paul & Ramsey [48] Särkämö et al [83] Särkämö et al [43] Tomaino [46] Music was improvised in the moment Guerrero et al [39]<...>…”

“…The researchers stated that increasing the speed with which the participants walked enhanced stride symmetry and was "an important functional goal in gait rehabilitation" [70,p211]. Carruth [50] Chong et al [58] Cofrancesco [80] * Cohen [52] * Cohen [79] Cohen & Ford [45] Conklyn et al [82] Cross et al [36] Erdonmez & Morley [63] * Guerrero et al [39] Hurkmans et al [47] * Kim & Tomaino [57] Kim [81] Kim & Jo [65] Kim et al [48] * Montgomery et al [40] Nayak et al [41] * Paul & Ramsey [48] * Pfeiffer & Sabe [59] * Poćwierz-Marciniak [51] * Purdie [42] Street et al [55] Tamplin [69] Tomaino [46] Wheeler et al [44] * Improvising Guerrero et al [39] Kim et al [48] * Nayak et al [41] * Paul & Ramsey [48] * Purdie [42] Wheeler et al [44] *…”

“…Listening Cofrancesco [80] * Cohen [52] * Erdonmez & Morley [63] * Forsblum et al [37] Forsblum et al [38] Haydn et al [64] Hurkmans et al [47] * Malcolm et al [60] Nayak et al [41] * Pfeiffer & Sabe [59] * Poćwierz-Marciniak [51] * Prassas et al [42] Särkämö et al [83] Särkämö et al [43] Shin et al [67] Suh et al [68] Thaut et al [62] Thaut et al [70] Thaut et al [71] Thaut et al [61] Tsai et al [53] Wheeler et al [44] * Composing Kim et al [48] * Nayak et al [41] * Wheeler et al [44] * * = used more than one intervention strategy [50] Voice, guitar Chong et al [58] MIDI keyboard Cofrancesco [80] Piano, tambourine, cymbal, drum, autoharp, tom-tom or claves Cohen [52] Voice, electric keyboard, Suzuki hand drum Cohen [79] Voice, electric keyboard Cohen & Ford [45] Voice, hand drum, electric keyboard Conklyn et al [82] Voice Cross et al [36] Autoharp, hand drum, Orff mallet, maracas, tambourine, kazoo, piano, recorder Erdonmez & Morley [63] Piano Guerrero et al [39] Piano, percussion Hurkmans et al [47] Voice Kim [81] Voice, keyboard Kim & Jo [65] Voice, drum Kim & Tomaino [57] Voice, guitar, drum Kim et al [48] Voice, handbells, keyboard, percussion,...…”