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

Stroke Clinical Trial

Official title:

Efficacy of Therapeutic Instrumental Music Performance With Sensory-Enhanced Motor Imagery in Improving Therapeutic Outcomes for Individuals With Chronic Post-Stroke Hemiparesis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03246217
• Other study ID #: #34521
• Status: Completed
• Phase: N/A
• Start date: July 20, 2017
• Est. completion date: September 5, 2019

Study information

• Verified date: September 2019
• Source: University of Toronto
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 30
• Est. completion date: September 5, 2019
• Est. primary completion date: September 5, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 30 Years to 79 Years

Eligibility

Inclusion Criteria:

• hemiparesis following a unilateral stroke (hemorrhagic or ischemic), sustained more than 6 months prior, with at least minimal volitional movement of the affected limb

• permission from a physician to participate in an upper extremity rehabilitation program, including confirmation that the following disorders are not present: rheumatoid arthritis, upper extremity fracture, apraxia, neuropathy, somatosensory impairment

• adequate language comprehension and neurocognitive function to understand and follow simple instructions

Exclusion Criteria:

• currently enrolled in an upper extremity rehabilitation program or another upper extremity study

• comorbid neurological disorder (e.g. multiple sclerosis, Parkinson's disease)

• evidence of perceptual or cognitive impairment; e.g., unilateral spatial neglect, significant hearing impairment, Montreal Cognitive Assessment score of 25 or less

• presence of aphasia

• injections for spasticity within three months of participation

Related Conditions & MeSH terms

• Stroke

Intervention

Behavioral:
• Therapeutic Instrumental Music Performance
Participants will play a variety of instruments (acoustic and electronic) to facilitate retraining of everyday functional movements.
• Therapeutic Performance with 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
Participants will engage in motor imagery of previously practised movements.

Locations

Country	Name	City	State
Canada	Faculty of Music, University of Toronto	Toronto	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
University of Toronto

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Changes from baseline in Wolf Motor Function Test	Measures upper extremity motor ability through timed and functional tasks.	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Primary	Changes from baseline in Fugl-Meyer Assessment Upper Extremity	Performance based measure assessing motor capacity.	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary	Motor Activity Log	Individuals rate quality and amount of movement during daily functional tasks.	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary	Trunk Impairment Scale	Assessment of upper trunk impairment using the upper trunk items of the Trunk Impairment Scale	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary	Multiple Affect Adjective Check List-Revised	Measure of affective state	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary	General Self-Efficacy Scale	Assessment of perceived self-efficacy	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary	Digit Span	Assesses working memory and attention	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks
Secondary	Trail Making Test Part B	Assesses mental flexibility and processing speed	Baseline 1, Baseline 2 (1 week later), Post intervention of 4 weeks