Music Upper Limb Therapy—Integrated: An enriched collaborative approach for stroke rehabilitation

Preeti Raghavan, Daniel Geller, Nina Guerrero, Viswanath Aluru, Joseph P. Eimicke, Jeanne A. Teresi, Gbenga Ogedegbe, Anna Palumbo, Alan Turry

Research output: Contribution to journalArticle

Abstract

Stroke is a leading cause of disability worldwide. It leads to a sudden and overwhelming disruption in one’s physical body, and alters the stroke survivors’ sense of self. Long-term recovery requires that bodily perception, social participation and sense of self are restored; this is challenging to achieve, particularly with a single intervention. However, rhythmic synchronization of movement to external stimuli facilitates sensorimotor coupling for movement recovery, enhances emotional engagement and has positive effects on interpersonal relationships. In this proof-of-concept study, we designed a group music-making intervention, Music Upper Limb Therapy-Integrated (MULT-I), to address the physical, psychological and social domains of rehabilitation simultaneously, and investigated its effects on long-term post-stroke upper limb recovery. The study used a mixed-method pre-post design with 1-year follow up. Thirteen subjects completed the 45-min intervention twice a week for 6 weeks. The primary outcome was reduced upper limb motor impairment on the Fugl-Meyer Scale (FMS). Secondary outcomes included sensory impairment (two-point discrimination test), activity limitation (Modified Rankin Scale, MRS), well-being (WHO well-being index), and participation (Stroke Impact Scale, SIS). Repeated measures analysis of variance (ANOVA) was used to test for differences between pre- and post-intervention, and 1-year follow up scores. Significant improvement was found in upper limb motor impairment, sensory impairment, activity limitation and well-being immediately post-intervention that persisted at 1 year. Activities of daily living and social participation improved only from post-intervention to 1-year follow up. The improvement in upper limb motor impairment was more pronounced in a subset of lower functioning individuals as determined by their pre-intervention wrist range of motion. Qualitatively, subjects reported new feelings of ownership of their impaired limb, more spontaneous movement, and enhanced emotional engagement. The results suggest that the MULT-I intervention may help stroke survivors re-create their sense of self by integrating sensorimotor, emotional and interoceptive information and facilitate long-term recovery across multiple domains of disability, even in the chronic stage post-stroke. Randomized controlled trials are warranted to confirm the efficacy of this approach. Clinical Trial Registration: National Institutes of Health, clinicaltrials.gov, NCT01586221.

Original languageEnglish (US)
Article number498
JournalFrontiers in Human Neuroscience
Volume10
Issue numberOCT2016
DOIs
StatePublished - Oct 7 2016
Externally publishedYes

Keywords

  • Bodily perception
  • Enriched environment
  • Functional recovery
  • Music therapy
  • Psycho-social adjustment
  • Rehabilitation
  • Sense of self
  • Social participation

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Behavioral Neuroscience

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    Raghavan, P., Geller, D., Guerrero, N., Aluru, V., Eimicke, J. P., Teresi, J. A., Ogedegbe, G., Palumbo, A., & Turry, A. (2016). Music Upper Limb Therapy—Integrated: An enriched collaborative approach for stroke rehabilitation. Frontiers in Human Neuroscience, 10(OCT2016), [498]. https://doi.org/10.3389/fnhum.2016.00498