Piano Training for Stroke

Overseen By Myriam Villeneuve, Mec

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: McGill University

Disqualifiers: Visual field defect, Hemineglect, Dementia, others

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

Compensation: Varies

Number of Visits: 24

Duration: 6 weeks

30 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to study the feasibility of a 6-week piano playing training intervention in a subacute stroke population. More specifically, the investigators aim to (1) implement and test the feasibility of the intervention in the subacute stroke rehabilitation program; and (2) explore the acceptability of the supervised training sessions and home practice sessions. Researchers will also (3) estimate and contrast the effects of the piano training intervention as compared to conventional therapy on manual dexterity, coordination, functional use of the upper extremity, attention and mood. Therapy specifically provided as part of this project will be delivered above and beyond usual therapy time in both intervention groups. Participants of the piano group will: * Engage in a step-by-step musical training consisting of two supervised, individual 45-min sessions per week for 6 consecutive weeks, for a total of 12 sessions. * The supervised session will also be complemented with a biweekly home program (15 minutes) consisting of piano exercises. Participants in the conventional group will: * Engage in two individual 45-min sessions per week for 6 consecutive weeks consisting in conventional occupational therapy treatment. * They will also receive a biweekly home program consisting in occupational therapy exercises (15 minutes).

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on piano training and therapy, so it's best to ask the trial organizers for more details.

What data supports the effectiveness of the treatment Playing Piano, Music-Supported Therapy (MST), Piano Training, Music Therapy for stroke?

Research shows that playing piano as part of Music-Supported Therapy can improve hand and arm function in stroke survivors. Studies found that participants who engaged in piano training showed better manual dexterity and use of their affected arm, with improvements lasting even after the training ended. ^{1 2 3 4 5}

Is piano training safe for humans?

Music-supported therapy, including piano training, has been used in stroke rehabilitation and is generally considered safe for improving motor skills and emotional well-being. No specific safety concerns have been reported in the studies reviewed. ^{1 3 4 6 7}

How is the treatment of playing piano different from other treatments for stroke?

Playing piano as a treatment for stroke is unique because it uses music-supported therapy to improve motor skills and brain function by promoting neuroplasticity (the brain's ability to reorganize itself). This therapy combines structured piano lessons with home practice, engaging both motor and sensory systems, which can lead to improvements in hand dexterity and overall upper limb function. ^{1 3 4 5 8}

Research Team

Anouk Lamontagne, PhD

Principal Investigator

McGill University

Eligibility Criteria

This trial is for individuals in the early stages of recovery from a stroke. It's designed to see if playing piano can help improve hand function more than regular therapy. Participants should be able to attend two 45-minute sessions per week and do additional exercises at home.

Inclusion Criteria

Have no professional piano experience (only for the piano group)

My vision and hearing are normal or corrected to normal.

I can follow simple instructions.

Exclusion Criteria

I have vision problems, neglect one side of my body or space, and have significant memory or thinking issues.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a 6-week piano playing training intervention or conventional occupational therapy, with supervised and home practice sessions

6 weeks

12 supervised sessions (in-person), biweekly home practice

Follow-up

Participants are monitored for changes in manual dexterity, coordination, and mood after the intervention

6 weeks

Follow-up assessments at week 12

Treatment Details

Interventions

• Playing Piano

Trial Overview Researchers are testing whether a special program of piano playing helps with hand movement, coordination, attention, and mood after a stroke better than standard occupational therapy does. Both groups will also have extra practice at home.

Participant Groups

Group I: Piano group Experimental Treatment 1 Intervention

Participants will engage in a step-by-step musical training consisting of two supervised, individual 45-min sessions per week for 6 consecutive weeks, for a total of 12 sessions. They will also be asked to practice 2x/week for 15 minutes and they will report on their practice duration and content in a logbook after each practice session.

Group II: Conventional group Active Control 1 Intervention

Participants will engage in two supervised and individual 45-min session per week for 6 consecutive week, consisting in usual occupational therapy treatment. They will be asked to practice 2x/week for 15 minutes and they will report on their practice duration and content in a logbook after each practice session.

Who Is Running the Clinical Trial?

McGill University

Lead Sponsor

Trials

421

Recruited

1,017,000+

Jewish Rehabilitation Hospital

Collaborator

Trials

7

Recruited

810+

Findings from Research

A randomized controlled trial will assess the effectiveness of an enriched Music-Supported Therapy (eMST) protocol in improving motor functions, cognition, emotional well-being, and quality of life in 60 chronic stroke patients over a 10-week period.

The study aims to demonstrate that eMST will lead to greater improvements compared to a standard home-based exercise program (GRASP), with outcomes measured using the Action Research Arm Test and other assessments at baseline, post-intervention, and at a 3-month follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enriched Music-supported Therapy for chronic stroke patients: a study protocol of a randomised controlled trial. Grau-Sánchez, J., Segura, E., Sanchez-Pinsach, D., et al.[2021]

A novel musical sonification therapy was tested on four stroke patients, showing that those who received the therapy improved significantly in upper-extremity motor functions and reported better psychological well-being compared to those who received sham training.

The study suggests that engaging patients in music through their arm movements can be an effective and motivating way to retrain gross-motor functions after a stroke, highlighting its potential as a promising therapeutic approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Moving with music for stroke rehabilitation: a sonification feasibility study. Scholz, DS., Rhode, S., Großbach, M., et al.[2016]

A pilot study involving three chronic stroke survivors demonstrated that a 3-week piano training program significantly improved their manual dexterity and upper extremity function, as measured by various tests.

The improvements in fine and gross motor skills were maintained even three weeks after the intervention, suggesting that music-supported therapy could be a feasible and effective rehabilitation approach for chronic stroke patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Playing piano can improve upper extremity function after stroke: case studies. Villeneuve, M., Lamontagne, A.[2021]

A 3-week piano training program significantly improved upper extremity function in 13 chronic stroke survivors, with benefits observed immediately after the intervention and maintained at a 3-week follow-up.

Stroke survivors with higher initial levels of motor recovery experienced greater improvements in manual dexterity and functional use of their upper extremities, suggesting that the effectiveness of music-supported therapy may vary based on individual recovery levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A piano training program to improve manual dexterity and upper extremity function in chronic stroke survivors. Villeneuve, M., Penhune, V., Lamontagne, A.[2022]

Music-Supported Therapy (MST) significantly improved movement quality in a patient with chronic stroke after 20 sessions over 4 weeks, as shown by 3D movement analysis.

Neuroimaging techniques revealed that MST led to beneficial changes in brain activity and cortical excitability, indicating that it promotes neural reorganization in the sensorimotor cortex, which is crucial for recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Music-supported therapy induces plasticity in the sensorimotor cortex in chronic stroke: a single-case study using multimodal imaging (fMRI-TMS). Rojo, N., Amengual, J., Juncadella, M., et al.[2016]

This study aims to systematically evaluate the effectiveness and safety of music-supported therapy for improving mood in patients undergoing post-stroke rehabilitation, using a comprehensive search of multiple databases for randomized controlled trials.

The findings will help determine whether music-supported therapy is a viable treatment option for mood disorders in post-stroke patients, providing important insights into its clinical application.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of music-supported therapy on mood in post-stroke rehabilitation patients: A protocol for systematic review and meta-analysis. Ding, J., Xiao, Y., Yuan, F., et al.[2023]

Therapeutic keyboard music playing significantly improved finger function in subjects, as evidenced by better scores in joint position error tests, faster probe reaction times, and reduced writing times, compared to grip training.

The study involved 10 subjects divided into experimental and control groups, and while surface electromyography showed no significant changes, the other measures indicated that therapeutic music can be an effective treatment for enhancing hand function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The immediate effects of therapeutic keyboard music playing for finger training in adults undergoing hand rehabilitation. Zhang, X., Liu, S., Yang, D., et al.[2020]

Music-supported Therapy (MST) for stroke patients, involving one month of intense music learning, resulted in significant motor improvements in the affected hand, demonstrating its efficacy in restoring motor function.

The observed motor gains were linked to changes in the excitability of the motor cortex, indicating that MST promotes neuroplastic changes in the brain, which may help stroke patients regain independence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study. Grau-Sánchez, J., Amengual, JL., Rojo, N., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Enriched Music-supported Therapy for chronic stroke patients: a study protocol of a randomised controlled trial. [2021]

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

Moving with music for stroke rehabilitation: a sonification feasibility study. [2016]

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

Playing piano can improve upper extremity function after stroke: case studies. [2021]

4. Switzerland pubmed.ncbi.nlm.nih.gov

A piano training program to improve manual dexterity and upper extremity function in chronic stroke survivors. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Music-supported therapy induces plasticity in the sensorimotor cortex in chronic stroke: a single-case study using multimodal imaging (fMRI-TMS). [2016]

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

Effectiveness and safety of music-supported therapy on mood in post-stroke rehabilitation patients: A protocol for systematic review and meta-analysis. [2023]

7. Japan pubmed.ncbi.nlm.nih.gov

The immediate effects of therapeutic keyboard music playing for finger training in adults undergoing hand rehabilitation. [2020]

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

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study. [2021]