Enriched music-supported therapy for individuals with chronic stroke: a randomized controlled trial.

TitleEnriched music-supported therapy for individuals with chronic stroke: a randomized controlled trial.
Publication TypeJournal Article
Year of Publication2024
AuthorsSegura E, Grau-Sánchez J, Cerda-Company X, Porto MF, De la Cruz-Puebla M, Sanchez-Pinsach D, Cerquides J, Duarte E, Palumbo A, Turry A, Raghavan P, Särkämö T, Münte TF, Arcos JLluis, Rodriguez-Fornells A
JournalJ Neurol
Volume271
Issue10
Pagination6606-6617
Date Published2024 Oct
ISSN1432-1459
KeywordsAged, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Music Therapy, Outcome Assessment, Health Care, Quality of Life, Stroke, Stroke Rehabilitation, Treatment Outcome, Upper Extremity
Abstract

OBJECTIVE: Many stroke survivors still present with upper-limb paresis six months post-stroke, impacting their autonomy and quality of life (QoL). We designed an enriched Music-supported Therapy (eMST) program to reduce disability in this population. We evaluated the eMST's effectiveness in improving functional abilities and QoL in chronic stroke individuals compared to the conventional motor program Graded Repetitive Arm Supplementary Program (GRASP).

METHODS: We conducted a pragmatic two-arm parallel-group randomized controlled trial with a 3-month follow-up and masked assessment. The eMST involved playing instruments during individual self-administered and group music therapy sessions. The GRASP consisted of self-administered motor exercises using daily objects. Both interventions were completed at home with telemonitoring and involved four one-hour weekly sessions for 10 weeks. The primary outcome was upper-limb motor function measured with the Action Research Arm Test. Secondary outcomes included motor impairment, daily life motor performance, cognitive functions, emotional well-being, QoL, self-regulation, and self-efficacy. Intention-to-treat (ITT) and per-protocol (PP) analyses were conducted including participants who discontinued the intervention and those who completed it entirely, respectively.

RESULTS: Fifty-eight chronic stroke patients were randomized to the eMST-group (n = 26; age: 64.2 ± 12.5; 6 [23.1%] females; 2.8 ± 2.9 years post-stroke), and the control group (n = 32; age: 62.2 ± 12; 8 [25%] females; 1.8 ± 6.2 years post-stroke). The eMST-group had more participants achieving a clinically relevant improvement in motor impairment post-intervention than the control group for the ITT (55% vs 21.6%; OR = 4.5 (95% CI 1.4-14); p = .019) and PP analyses (60% vs 20%; OR = 6 (95% CI 1.5-24.7); p = .024), sustained at follow-up. The eMST-group reported greater improvements in emotion (difference = 11.1 (95% CI 0.8-21.5; p = 0.36) and participation (difference = 10.3 (95% CI 0.6-25.9); p = 0.41) subscales of QoL, and higher enjoyment during the sessions (difference = 1 (95% CI 0.3-1.5); p = 0.12). No changes were found in other outcomes.

CONCLUSION: eMST demonstrated superiority over conventional motor rehabilitation program in enhancing upper-limb functions and QoL in chronic stroke individuals.

TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT04507542).

DOI10.1007/s00415-024-12570-3
Alternate JournalJ Neurol
PubMed ID39112892
PubMed Central ID4415968
Grant List201729.30 / / Fundació la Marató de TV3 /