Testing music therapy at home for patients who have suffered a stroke


The Bellvitge Biomedical Research Institute (IDIBELL), Hospital del Mar, the University of Helsinki and the Spanish National Research Council (CSIC) collaborate on a joint project to analyze the benefits of a new musical training therapy at home, for patients who have already completed their recovery treatment at the hospital. The already ongoing study consists in facilitating to the patients with long term hand and arm damage, a keyboard that simulates a piano linked to a smart tablet. This allows them to continue doing recovery exercises at home that progress gradually in a programmed difficulty. The application (APP) created to facilitate this learning is aimed at motivating patients to improve and progress in their musical exercises, evaluating the execution (applying gaming strategies and progressive reinforcement) and creating an environment that facilitates the patient to use more frequently the affected hand for the exercises. Around thirty people are expected to participate in this initiative, which is funded by La Marató de TV3.

A previous clinical trial from the same research group had already highlighted the beneficial effects of this type of therapy in patients that had suffered a stroke and had mobility sequelae in the upper limbs. In this trial, they demonstrated that patients treated with therapy that includes musical support (through instruments such as piano and electronic drums) improved also their quality of life and mood compared to those who only received conventional therapy. IDIBELL researcher Dr Jennifer Grau says that the next step is “to bring the therapy to the patient’s home, to offer a maintenance therapy during the chronic phase of his/her illness.”


Work at home and in group


The participants in the study, all of them patients in the chronic phase of the pathology that have already completed their phase of hospital rehabilitation, will work with the piano and tablet at home and, once a week, will practice music with a teacher in small groups (3 patients), monitored by a therapist. In these workgroups, the patients will play music pieces of their choice that will later practice at home. To do so, they have the support of the Associació Superar L’Ictus-Barcelona. The design of the application that allows to do the therapy is the result of the work of a research team in learning systems led by Dr. Josep Lluis Arcos at the UAB (IIIA-CSIC).

The intention of the study is to validate this system to allow patients, who no longer receive treatment, to maintain the recovery they gained during rehabilitation, and at the same time to be integrated into the community, encouraging the link between patients and professionals. It has been shown that during this phase there is a retreat due to lack of stimuli and decrease of social support. “That is why we want to analyze whether during this chronic phase, through new musical technologies, we can promote that they do maintenance activities at home, and, at the same time, social activity and reinsertion to the community”, explains Dr. Jennifer Grau.

Dr. Esther Duarte, head of service of the Physical Medicine and Rehabilitation Service at Hospital del Mar, from where the participants come from, points out that patients, when they finish the rehabilitation program have “functional impairment, they stop doing the instructed exercises, they do not do enough physical activity, the motivation decreases and the dependence on their caregivers grows”. “ Although the rehabilitation ends, we must avoid disuse and promote that people work at home with more motivating, fun and focused on the personality and interests of each person”, she says.

The aim of the new study, which will have 30 participants, is to analyze if the musical therapy can be adapted to these parameters. In this regard, Dr. Arcos explains that the application that his team has designed will allow to “personalize the types of exercises and activities to be carried out by patients not only at the level of difficulty, but also based on the musical preferences of everyone”, a fact that seeks to improve both the adherence to therapy and monitoring the progress of those who follow it. “In this way, we will also be able to detect and face difficulties in a personalized way”, he adds. He also explains that they tried to go beyond the easiness of navigation and use, and that this is possible.

In any case, explains Dr. Antoni Rodríguez-Fornells, head of the IDIBELL research group on brain cognition and plasticity, “we are in an initial phase of study, in which it is very important to get patients to validate our hypothesis”. “We believe that this improvement in the protocol, combining personal learning elements and group support, will keep the patients very motivated for the treatment and that we achieve notable improvements in the movement recovery and patients’ quality of life”.

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