Some studies have reported that playing musical instruments reorganises the brain and improves the hand and arm function of stroke survivors, as well as being less tiring than usual rehabilitation exercises, improving cognition and mood.
This project adds to this body of research with the first UK-based EEG study of stroke survivors receiving music therapy in their homes. Participants will be monitored in 15 sessions over a three-week period.
Upper limb hemiparesis is a common and enduring symptom of stroke. It has a profound impact on quality of life and independence, and there is a need for more motivating and effective interventions at all stages post-stroke onset.
Several randomised controlled trials and brain imaging studies have shown that when patients play structured exercises using keyboard and electronic drum pads (known as Music Supported Therapy) daily for three to four-weeks, they make significant gains in upper limb function, cognitive recovery, mood, motivation, and neural reorganisation.
We aim to conduct a single case electroencephalogram (EEG) experiment, delivering a music intervention (Therapeutic Instrumental Music Performance (TIMP)) for upper limb rehabilitation that differs from Music Supported Therapy, as follows:
Five patients will be recruited by Cambridgeshire Community Services NHS Trust community stroke team at the point that they are discharged from community rehabilitation. A music therapist, trained in the intervention delivery, will visit the participants in their home 15 times in three weeks to provide the exercises for 60 minutes each session.
In addition to the iPad, portable drums on adjustable stands and hand percussion will be used, all of which pack into a carry case.
Potential neuroplastic changes accompanied with functional changes will be assessed using three short EEG paradigms assessing neural markers of emotional processing, motor-cortical activity, and working memory processes, before and after the intervention. Each EEG recording will last approximately 60 min, including preparation and breaks.
Electroencephalogram data will be collected in a lab at CIMTR by Dr Clemens Maidhof.
A clinician who is blind to intervention type and treatment timepoint (phase) will collect upper limb assessment data using the Action Research Arm Test, Nine-Hole-Peg-Test, and quality of life data using Stroke Specific Quality of Life questionnaire at baseline (week 1), pre-intervention (week 4), post-intervention (week 7) and follow-up (week 10). This will also be done in the participant's home.
As this is a single-case series, only descriptive statistics and data visualisation (e.g. bar charts and boxplots) will be used to describe pre- and post-treatment changes in arm function and EEG measures. These consist of frontal alpha asymmetry (FAA), power in beta frequency band, and the P300 component of the event-related potential. Upper limb assessment data will be analysed, and mean and standard deviations calculated using R1.
