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Enriched music-supported therapy for individuals with chronic stroke: a randomized controlled trial
Emma Segura1,2, Jennifer Grau-Sánchez3,4, Xim Cerda-Company1,2,5
1Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
Journal of Neurology
|August 7, 2024
Summary
Enriched Music-supported Therapy (eMST) improved upper-limb function and quality of life in chronic stroke survivors more than conventional therapy. This music therapy approach offers a superior alternative for motor rehabilitation.
Area of Science:
- Neurorehabilitation
- Music Therapy
- Stroke Recovery
Background:
- Upper-limb paresis is common in stroke survivors, significantly impacting autonomy and quality of life (QoL).
- Conventional motor programs often show limited efficacy in restoring function for chronic stroke patients.
- Novel therapeutic approaches are needed to enhance motor recovery and QoL in this population.
Purpose of the Study:
- To evaluate the effectiveness of an enriched Music-supported Therapy (eMST) program.
- To compare eMST with the Graded Repetitive Arm Supplementary Program (GRASP) in chronic stroke survivors.
- To assess improvements in functional abilities and QoL following eMST intervention.
Main Methods:
- A pragmatic, two-arm, parallel-group randomized controlled trial with 3-month follow-up.
- eMST involved instrument playing in individual and group music therapy sessions.
- The control group (GRASP) performed self-administered motor exercises with daily objects.
- Both interventions were home-based with telemonitoring, 4 weekly one-hour sessions for 10 weeks.
- Primary outcome: upper-limb motor function (Action Research Arm Test); Secondary outcomes: motor impairment, QoL, emotional well-being, etc.
- Intention-to-treat (ITT) and per-protocol (PP) analyses were performed.
Main Results:
- Fifty-eight chronic stroke patients were randomized (eMST: n=26, GRASP: n=32).
- The eMST group showed significantly higher rates of clinically relevant motor improvement compared to GRASP in both ITT (55% vs 21.6%) and PP (60% vs 20%) analyses.
- Improvements in motor function for the eMST group were sustained at follow-up.
- Greater improvements in QoL subscales (emotion, participation) and session enjoyment were reported in the eMST group, though not all reached statistical significance.
- No significant changes were observed in other secondary outcomes.
Conclusions:
- Enriched Music-supported Therapy (eMST) demonstrated superiority over the conventional GRASP program for upper-limb motor function recovery in chronic stroke survivors.
- eMST also showed positive trends in improving QoL and emotional well-being.
- This study supports eMST as an effective therapeutic strategy for enhancing functional outcomes and QoL post-stroke.
