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Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage-a feasibility study protocol.

Street AJ, Magee WL, Odell-Miller H, Bateman A, Fachner JC - Front Hum Neurosci (2015)

Bottom Line: The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance.A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies.The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

View Article: PubMed Central - PubMed

Affiliation: Music and Performing Arts, Music for Health Research Centre, Anglia Ruskin University Cambridge, UK.

ABSTRACT

Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements.

Methods: For this feasibility study a small sample size of 14 participants (3-60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies.

Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

No MeSH data available.


Related in: MedlinePlus

The action research arm test.
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Figure 2: The action research arm test.

Mentions: A wide range of assessment tools and technology has been used to record outcomes in upper limb post-stroke rehabilitation. The selection of assessment tools for this feasibility study has been determined by two major factors: (1) the restrictions enforced by the ethics committee who approved the study according to UK ethics procedures for research within the NHS via the Integrated Research Application System (IRAS), (2) availability of assessment tools and training requirements for their application. The Action Research Arm Test (ARAT), will be the primary outcome measure for this study; 9HPT will measure finger dexterity and semi-structured interviews allow for the collection of qualitative data on the participant experience. The ARAT has also been used in constraint-induced movement therapy studies (Kitago et al., 2013), and a study using rhythm and music with stroke patients (Bunketorp Kall et al., 2012). It has excellent inter-rater reliability (Hsieh et al., 1998; van der Lee et al., 2002), excellent intra-rater reliability (van der Lee et al., 2002), and excellent convergent validity against the Fugl-Meyer (De Weerdt, 1985). The ARAT is a timed, 19 item measure that is divided into four categories: grasp, grip, pinch and gross movement. Each item, or action, is performed by the participant while seated with their back against the chair, a measured distance from the table (15 cm), where all of the assessment items are individually placed for each task (see Figure 2). The test recreates the movements or sequences of movements required to perform many ADLs, such as reaching up onto a shelf to obtain a food ingredient or pouring liquid from one container to another. A table map for the ARAT is laid out flat on the table top and this has markers on it to indicate the start and end position for each object used in the test, thus optimizing consistency between patients and settings. The assessment can take up to 30 min if the patient needs to complete all items in every subcategory.


Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage-a feasibility study protocol.

Street AJ, Magee WL, Odell-Miller H, Bateman A, Fachner JC - Front Hum Neurosci (2015)

The action research arm test.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585041&req=5

Figure 2: The action research arm test.
Mentions: A wide range of assessment tools and technology has been used to record outcomes in upper limb post-stroke rehabilitation. The selection of assessment tools for this feasibility study has been determined by two major factors: (1) the restrictions enforced by the ethics committee who approved the study according to UK ethics procedures for research within the NHS via the Integrated Research Application System (IRAS), (2) availability of assessment tools and training requirements for their application. The Action Research Arm Test (ARAT), will be the primary outcome measure for this study; 9HPT will measure finger dexterity and semi-structured interviews allow for the collection of qualitative data on the participant experience. The ARAT has also been used in constraint-induced movement therapy studies (Kitago et al., 2013), and a study using rhythm and music with stroke patients (Bunketorp Kall et al., 2012). It has excellent inter-rater reliability (Hsieh et al., 1998; van der Lee et al., 2002), excellent intra-rater reliability (van der Lee et al., 2002), and excellent convergent validity against the Fugl-Meyer (De Weerdt, 1985). The ARAT is a timed, 19 item measure that is divided into four categories: grasp, grip, pinch and gross movement. Each item, or action, is performed by the participant while seated with their back against the chair, a measured distance from the table (15 cm), where all of the assessment items are individually placed for each task (see Figure 2). The test recreates the movements or sequences of movements required to perform many ADLs, such as reaching up onto a shelf to obtain a food ingredient or pouring liquid from one container to another. A table map for the ARAT is laid out flat on the table top and this has markers on it to indicate the start and end position for each object used in the test, thus optimizing consistency between patients and settings. The assessment can take up to 30 min if the patient needs to complete all items in every subcategory.

Bottom Line: The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance.A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies.The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

View Article: PubMed Central - PubMed

Affiliation: Music and Performing Arts, Music for Health Research Centre, Anglia Ruskin University Cambridge, UK.

ABSTRACT

Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements.

Methods: For this feasibility study a small sample size of 14 participants (3-60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies.

Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

No MeSH data available.


Related in: MedlinePlus