Ukulele Playing for Multiple Sclerosis

Overseen By Carolyn Phillips, PhD, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Disqualifiers: Other neurological condition, MS exacerbation, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 12 weeks

29 Participants Needed

Trial Summary

What is the purpose of this trial?

Over the past 10 years, the rates of multiple sclerosis (MS) have nearly doubled in the United States. This chronic, neuroinflammatory, and neurodegenerative disease is most often diagnosed between the ages of 20-40. Cognitive impairment effects up to 70% of people with MS (PwMS) and has a detrimental impact on mental health, social connections, and employment. Further, up to 50% of PwMS also struggle with depression. Numerous cognitive rehabilitation programs are available to address cognitive impairment, but few interventions have simultaneous effects on cognition and emotional well-being. Music interventions have potential to fill this gap. Brain imaging studies on music and emotion show that music can modulate activity in the brains structures that are known to be crucially involved in emotion. Further, music engages areas of the brain that are involved with paying attention, making predictions, and updating events in our memory. The purpose of this study is to determine the feasibility of an online musical training intervention (MTI) for PwMS and explore the potential effect on cognition, psychosocial, and functional well-being compared to an active control group (music listening (ML)). The specific aims are to: 1) determine the feasibility and acceptability of delivering the MTI virtually over three months to PwMS; 2) evaluate the effect of the MTI on cognitive functioning (processing speed, working memory, cognitive flexibility, response inhibition), psychosocial (anxiety, depression, stress, quality of life, self-efficacy) and functional (insomnia) well-being compared to ML; and 3) (exploratory aim) to utilize non-invasive neuroimaging to determine if pre-intervention brain activity predicts post-intervention cognitive functioning.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of music therapy as a treatment for multiple sclerosis?

Research shows that music therapy can help improve mood, reduce depression and anxiety, and enhance self-esteem in people with multiple sclerosis. It also suggests that music therapy can aid in functional recovery, such as improving walking ability. ^{1 2 3 4 5}

How is the Ukulele Playing for Multiple Sclerosis treatment different from other treatments for MS?

This treatment is unique because it uses music therapy, specifically ukulele playing, to help improve physical and emotional well-being in people with multiple sclerosis. Unlike traditional drug treatments, it focuses on enhancing motor skills and emotional support through musical engagement. ^{1 4 6 7 8}

Research Team

Carolyn Phillips, PhD

Principal Investigator

University of Texas at Austin

Eligibility Criteria

This trial is for people with multiple sclerosis (MS) who have been diagnosed at least 6 months ago and experience cognitive issues. Participants must be able to read, write, and understand English, and have access to a computer with Zoom. Professional musicians or those with other neurological conditions causing cognitive impairment cannot join.

Inclusion Criteria

Access to computer and zoom

Self-reported cognitive impairment as assessed by having at least 5 problems 'sometimes' or more often on the Perceived Deficits Questionnaire

I was diagnosed over 6 months ago.

Exclusion Criteria

I have had a multiple sclerosis flare-up in the last month.

I have a brain condition that affects my thinking.

Unable to travel to The University of Texas at Austin for fNIRS data collection

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a 12-week intervention to learn ukulele playing or engage in music listening

12 weeks

Weekly virtual check-ins

Follow-up

Participants are monitored for changes in cognitive and psychosocial outcomes post-intervention

4 weeks

1-month post-intervention assessment

Treatment Details

Interventions

• Music Listening
• Music Training Intervention

Trial Overview The study tests an online musical training intervention (MTI) against music listening (ML) to see if it can improve cognition, emotional well-being, and quality of life in MS patients over three months. It also explores whether brain activity before the intervention predicts cognitive outcomes after.

Participant Groups

Group I: Musical Training Intervention Experimental Treatment 1 Intervention

Participants randomized to this arm receive a 12-week intervention to teach them how to play the ukulele. The ukulele is a very manageable instrument to learn and requires less hand dexterity than other stringed instruments. Each week participants will follow the musical training intervention (MTI) protocol that provides instruction on how to tune, hold, and strum the ukulele and play basic chords. To practice the chords, they will also learn popular songs (e.g., Chain of Fools, Three Little Birds, Happy Birthday, Don't Worry Be Happy, and Stand by Me). Participants will be instructed to follow each session outlined weekly and asked to practice the instrument for at least 30 minutes, 5 days a week. They will be given a paper and digital version of the MTI protocol. A member of our research team will call the participants weekly to answer any questions about the MTI protocol.

Group II: Music Listening Active Control 1 Intervention

Participants randomized to this arm will be asked to listen to their preferred music for at least 30 minutes, 5 days a week. A member of our research team will call them every week to answer any questions they have about the ML protocol. They will be asked to record their experience in a practice log.

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Findings from Research

A systematic review of 12 studies involving Persons with Multiple Sclerosis (PwMS) found that Music Therapy (MT) significantly improves gait disorders, confirming its effectiveness as a treatment method.

While most studies focused on short-term effects, this review highlights the need for further investigation into the long-term benefits of MT for gait recovery in PwMS, providing valuable insights for therapists in treatment planning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of music therapy intervention on gait disorders in persons with multiple sclerosis: A systematic review of clinical trials. Kong, L., Zhang, X., Meng, L., et al.[2023]

In a study involving 20 multiple sclerosis patients, music therapy showed medium effect sizes in improving self-esteem, depression, and anxiety over a year, despite no significant differences between the therapy and control groups.

Patients receiving music therapy demonstrated significant improvements in mental health indicators over time, suggesting that music therapy may provide psychological benefits for individuals with chronic conditions like multiple sclerosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Active music therapy in the treatment of multiple sclerosis patients: a matched control study. Schmid, W., Aldridge, D.[2019]

Music-based therapy (MBT) has been shown to be a safe and effective rehabilitation approach for individuals with multiple sclerosis (MS), improving various motor functions such as gait, balance, and strength, as well as non-motor functions like emotional status and pain relief, based on a systematic review of 10 high-quality clinical trials involving 429 participants.

The evidence suggests that MBT outperforms conventional therapies or no intervention in enhancing physical capabilities and overall well-being in MS patients, although results regarding mental fatigability and memory were inconsistent.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Music-based therapy in rehabilitation of people with multiple sclerosis: a systematic review of clinical trials. Lopes, J., Keppers, II.[2022]

Group music therapy was offered to 225 patients with multiple sclerosis over 4-6 weeks, focusing on issues like disability, anxiety, and depression related to their condition.

The results indicate that group music therapy is beneficial for providing psychological support and enhancing individual coping strategies for patients with MS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Group music therapy in multiple sclerosis: initial report of experience]. Lengdobler, H., Kiessling, WR.[2006]

Mood disorders and depressive syndromes are common in patients with neurological disorders, affecting 20% to 50% of individuals with conditions like stroke and Parkinson's disease, yet they are often under-diagnosed and under-treated, impacting recovery and quality of life.

A review of 25 studies indicates that music therapy and musical interventions can significantly improve mood and reduce depressive symptoms in patients with various neurological disorders, suggesting their potential as effective therapeutic options.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of music and music therapy on mood in neurological patients. Raglio, A., Attardo, L., Gontero, G., et al.[2020]

Music therapy (MT) has been investigated as a complementary treatment for multiple sclerosis (MS), focusing on its effectiveness in improving physical, cognitive, and mood-behavioral disturbances in patients.

Out of 46 articles reviewed, 13 met the criteria for analysis, indicating a growing interest in music-based interventions (MBIs) as a feasible rehabilitation strategy for MS, although specific outcomes and challenges were discussed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the role of music therapy in multiple sclerosis: brief updates from research to clinical practice. Vinciguerra, C., De Stefano, N., Federico, A.[2020]

In a study involving 17 children with severe cerebral palsy, 13 sessions of neurologic music therapy (NMT) using percussion instruments led to significant improvements in participation during manual activities, including visual contact and motor participation.

The therapy also enhanced specific movements such as reaching, hitting with the hand, and grasping, indicating that therapeutic instrumental music performance (TIMP) can effectively increase engagement and motor function in children with severe CP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurologic Music Therapy Improves Participation in Children With Severe Cerebral Palsy. Santonja-Medina, CS., Marrades-Caballero, E., Santonja-Medina, F., et al.[2022]

Music training significantly improves speech perception in children with cochlear implants, particularly enhancing their ability to perceive rhythm and pitch, with the largest benefits observed from singing activities.

Longer training durations lead to greater improvements in music perception, indicating that sustained engagement in music training is crucial for maximizing benefits in children with cochlear implants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Crucial Music Components Needed for Speech Perception Enhancement of Pediatric Cochlear Implant Users: A Systematic Review and Meta-Analysis. Ab Shukor, NF., Han, W., Lee, J., et al.[2021]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Effects of music therapy intervention on gait disorders in persons with multiple sclerosis: A systematic review of clinical trials. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Active music therapy in the treatment of multiple sclerosis patients: a matched control study. [2019]

3. Germany pubmed.ncbi.nlm.nih.gov

Music-based therapy in rehabilitation of people with multiple sclerosis: a systematic review of clinical trials. [2022]

4. Germany pubmed.ncbi.nlm.nih.gov

[Group music therapy in multiple sclerosis: initial report of experience]. [2006]

5. United States pubmed.ncbi.nlm.nih.gov

Effects of music and music therapy on mood in neurological patients. [2020]

6. Italy pubmed.ncbi.nlm.nih.gov

Exploring the role of music therapy in multiple sclerosis: brief updates from research to clinical practice. [2020]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Neurologic Music Therapy Improves Participation in Children With Severe Cerebral Palsy. [2022]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Crucial Music Components Needed for Speech Perception Enhancement of Pediatric Cochlear Implant Users: A Systematic Review and Meta-Analysis. [2021]