The effects of music-supported therapy on motor, cognitive, and psychosocial functions in chronic stroke
Corresponding Author
Takako Fujioka
Center for Computer Research in Music and Acoustics, Department of Music, Stanford University, Stanford, California
Stanford Neurosciences Institute, Stanford University, Stanford, California
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Address for correspondence: Takako Fujioka, Ph.D., Center for Computer Research in Music and Acoustics, Department of Music, Stanford University, Stanford, CA, 94305-8180. [email protected]Search for more papers by this authorDeirdre R. Dawson
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorRebecca Wright
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Search for more papers by this authorKie Honjo
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Search for more papers by this authorJoyce L. Chen
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJ. Jean Chen
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorSandra E. Black
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Department of Medicine, Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorDonald T. Stuss
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
Department of Psychology, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorBernhard Ross
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorCorresponding Author
Takako Fujioka
Center for Computer Research in Music and Acoustics, Department of Music, Stanford University, Stanford, California
Stanford Neurosciences Institute, Stanford University, Stanford, California
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Address for correspondence: Takako Fujioka, Ph.D., Center for Computer Research in Music and Acoustics, Department of Music, Stanford University, Stanford, CA, 94305-8180. [email protected]Search for more papers by this authorDeirdre R. Dawson
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorRebecca Wright
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Search for more papers by this authorKie Honjo
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Search for more papers by this authorJoyce L. Chen
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorJ. Jean Chen
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorSandra E. Black
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Department of Medicine, Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorDonald T. Stuss
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
Department of Psychology, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorBernhard Ross
Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorAbstract
Neuroplasticity accompanying learning is a key mediator of stroke rehabilitation. Training in playing music in healthy populations and patients with movement disorders requires resources within motor, sensory, cognitive, and affective systems, and coordination among these systems. We investigated effects of music-supported therapy (MST) in chronic stroke on motor, cognitive, and psychosocial functions compared to conventional physical training (GRASP). Twenty-eight adults with unilateral arm and hand impairment were randomly assigned to MST (n = 14) and GRASP (n = 14) and received 30 h of training over a 10-week period. The assessment was conducted at four time points: before intervention, after 5 weeks, after 10 weeks, and 3 months after training completion. As for two of our three primary outcome measures concerning motor function, all patients slightly improved in Chedoke–McMaster Stroke Assessment hand score, while the time to complete Action Research Arm Test became shorter in the MST group. The third primary outcome measure for well-being, Stroke Impact Scale, was improved for emotion and social communication earlier in MST and coincided with the improved executive function for task switching and music rhythm perception. The results confirmed previous findings and expanded the potential usage of MST for enhancing quality of life in community-dwelling chronic-stage survivors.
Supporting Information
| Filename | Description |
|---|---|
| nyas13706-sup-0001-TableS1.docx15.3 KB | Table S1. Participant lesion information |
| nyas13706-sup-0002-TableS2.docx18.3 KB | Table S2. Group mean, SD, Min, and Max of the outcome measures |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1 World Health Organization. 2003. Diet, nutrition, and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. Vol. 916. Dimond Pocket Books (P) Ltd.
- 2Joo, H., D.O. Dunet, J. Fang, et al. 2014. Cost of informal caregiving associated with stroke among the elderly in the United States. Neurology 83: 1831–1837.
- 3Skolarus, L.E., V.A. Freedman, C. Feng, et al. 2016. Care received by elderly US stroke survivors may be underestimated. Stroke 47: 2090–2095.
- 4Krakauer, J.W. 2006. Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr. Opin. Neurol. 19: 84–90.
- 5Herholz, S.C. & R.J. Zatorre. 2012. Musical training as a framework for brain plasticity: behavior, function, and structure. Neuron 76: 486–502.
- 6Ross, B., M. Barat & T. Fujioka. 2017. Sound-making actions lead to immediate plastic changes of neuromagnetic evoked responses and induced beta-band oscillations during perception. J. Neurosci. 37: 5948–5959.
- 7Cirelli, L.K., K.M. Einarson & L.J. Trainor. 2014. Interpersonal synchrony increases prosocial behavior in infants. Dev. Sci. 17: 1003–1011.
- 8Kirschner Sebastian, S. & M. Tomasello. 2010. Joint music making promotes prosocial behavior in 4-year-old children. Evol. Hum. Behav. 31: 354–364.
- 9Kokal, I., A. Engel, S. Kirschner, et al. 2011. Synchronized drumming enhances activity in the caudate and facilitates prosocial commitment—if the rhythm comes easily. PLoS One 6: e27272
- 10Thaut, M.H. & V. Hoemberg. 2016. Handbook of Neurologic Music Therapy. Oxford University Press.
- 11Altenmüller, E., J. Marco-Pallares, T.F. Münte, et al. 2009. Neural reorganization underlies improvement in stroke-induced motor dysfunction by music-supported therapy. Ann. N.Y. Acad. Sci. 1169: 395–405.
- 12Schneider, S., T. Münte, A. Rodriguez-Fornells, et al. 2010. Music-supported training is more efficient than functional motor training for recovery of fine motor skills in stroke patients. Music Percept. 27: 271–280.
- 13Schneider, S., P.W. Schonle, E. Altenmüller, et al. 2007. Using musical instruments to improve motor skill recovery following a stroke. J. Neurol. 254: 1339–1346.
- 14Rojo, N., J. Amengual, M. Juncadella, et al. 2011. Music-supported therapy induces plasticity in the sensorimotor cortex in chronic stroke: a single-case study using multimodal imaging (fMRI-TMS). Brain Inj. 25: 787–793.
- 15Ripollés, P., N. Rojo, J. Grau-Sánchez, et al. 2016. Music supported therapy promotes motor plasticity in individuals with chronic stroke. Brain Imaging Behav. 10: 1289–1307.
- 16Grau-Sánchez, J., J.L. Amengual, N. Rojo, et al. 2013. Plasticity in the sensorimotor cortex induced by music-supported therapy in stroke patients: a TMS study. Front. Hum. Neurosci. 7: 494
- 17Amengual, J.L., N. Rojo, M. Veciana de las Heras, et al. 2013. Sensorimotor plasticity after music-supported therapy in chronic stroke patients revealed by transcranial magnetic stimulation. PLoS One 8: e61883.
- 18Fujioka, T., J.E. Ween, S. Jamali, et al. 2012. Changes in neuromagnetic beta-band oscillation after music-supported stroke rehabilitation. Ann. N.Y. Acad. Sci. 1252: 294–304.
- 19Jamali, S., T. Fujioka & B. Ross. 2014. Neuromagnetic beta and gamma oscillations in the somatosensory cortex after music training in healthy older adults and a chronic stroke patient. Clin. Neurophysiol. 125: 1213–1222.
- 20Harris, J.E., J.J. Eng, W.C. Miller, et al. 2009. A self-administered Graded Repetitive Arm Supplementary Program (GRASP) improves arm function during inpatient stroke rehabilitation: a multi-site randomized controlled trial. Stroke 40: 2123–2128.
- 21Gowland, C., P. Stratford, M. Ward, et al. 1993. Measuring physical impairment and disability with the Chedoke–McMaster Stroke Assessment. Stroke 24: 58–63.
- 22Radloff, L.S. & L. Teri. 1986. Use of the center for epidemiological studies—depression scale with older adults. Clin. Gerontol. 5: 119–136.
- 23Huskisson, E.C. 1974. Measurement of pain. Lancet 2: 1127–1131.
- 24Lyle, R.C. 1981. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int. J. Rehabil. Res. 4: 483–492.
- 25Mathiowetz, V., G. Volland, N. Kashman, et al. 1985. Adult norms for the Box and Block Test of manual dexterity. Am. J. Occup. Ther. 39: 386–391.
- 26Delis, D.C., E. Kaplan & J.H. Kramer. 2001. The Delis–Kaplan Executive Function System: Examiner's Manual. San Antonio, TX: The Psychological Corporation.
- 27Strauss, E., E.M.S. Sherman & O. Spreen. 2006. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. New York: Oxford University Press.
- 28Stuss, D.T., D. Floden, M.P. Alexander, et al. 2001. Stroop performance in focal lesion patients: dissociation of processes and frontal lobe lesion location. Neuropsychologia 39: 771–786.
- 29Stuss, D.T., J.P. Toth, D. Franchi, et al. 1999. Dissociation of attentional processes in patients with focal frontal and posterior lesions. Neuropsychologia 37: 1005–1027.
- 30Spreen, O. & E. Strauss. 1998. A Compendium of Neuropsychological Tests; Administration, Norms, and Commentary. New York: Oxford University Press.
- 31Wallentin, M., A.H. Nielsen, M. Friis-Olivarius, et al. 2010. The Musical Ear Test, a new reliable test for measuring musical competence. Learn. Individ. Differ. 20: 188–196.
- 32Watson, D., L.A. Clark & A. Tellegen. 1988. Development and validation of brief measures of positive and negative affect: the PANAS scales. J. Pers. Soc. Psychol. 54: 1063–1070.
- 33Duncan, P.W., D. Wallace, S.M. Lai, et al. 1999. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke 30: 2131–2140.
- 34Fugl-Meyer, A.R., L. Jaasko, I. Leyman, et al. 1975. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand. J. Rehabil. Med. 7: 13–31.
- 35Horgan, N.F., M. O'Regan, C.J. Cunningham, et al. 2009. Recovery after stroke: a 1-year profile. Disabil. Rehabil. 31: 831–839.
- 36Cortes, J.C., J. Goldsmith, M.D. Harran, et al. 2017. A short and distinct time window for recovery of arm motor control early after stroke revealed with a global measure of trajectory kinematics. Neurorehabil. Neural Repair 31: 552–560.
- 37Wolf, S.L., C.J. Winstein, J.P. Miller, et al. 2006. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA 296: 2095–2104.
- 38Park, H., S. Kim, C.J. Winstein, et al. 2016. Short-duration and intensive training improves long-term reaching performance in individuals with chronic stroke. Neurorehabil. Neural Repair 30: 551–561.
- 39Kesar, T.M., D.S. Reisman, J.S. Higginson, et al. 2015. Changes in post-stroke gait biomechanics induced by one session of gait training. Phys. Med. Rehabil. Int. 2. pii: 1072.
- 40van der Lee, J.H., H. Beckerman, G.J. Lankhorst, et al. 2001. The responsiveness of the Action Research Arm test and the Fugl–Meyer Assessment scale in chronic stroke patients. J. Rehabil. Med. 33: 110–113.
- 41Lang, C.E., D.F. Edwards, R.L. Birkenmeier, et al. 2008. Estimating minimal clinically important differences of upper-extremity measures early after stroke. Arch. Phys. Med. Rehabil. 89: 1693–1700.
- 42Barreca, S.R., P.W. Stratford, C.L. Lambert, et al. 2005. Test–retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke. Arch. Phys. Med. Rehabil. 86: 1616–1622.
- 43Moradzadeh, L., G. Blumenthal & M. Wiseheart. 2015. Musical training, bilingualism, and executive function: a closer look at task switching and dual-task performance. Cogn. Sci. 39: 992–1020.
- 44Hanna-Pladdy, B. & A. MacKay. 2011. The relation between instrumental musical activity and cognitive aging. Neuropsychology 25: 378–386.
- 45Bugos, J.A., W.M. Perlstein, C.S. McCrae, et al. 2007. Individualized piano instruction enhances executive functioning and working memory in older adults. Aging Ment. Health 11: 464–471.
- 46Zuk, J., C. Benjamin, A. Kenyon, et al. 2014. Behavioral and neural correlates of executive functioning in musicians and non-musicians. PLoS One 9: e99868.
- 47Bialystok, E. & A.M. Depape. 2009. Musical expertise, bilingualism, and executive functioning. J. Exp. Psychol. Hum. Percept. Perform. 35: 565–574.
- 48Parbery-Clark, A., D.L. Strait, S. Anderson, et al. 2011. Musical experience and the aging auditory system: implications for cognitive abilities and hearing speech in noise. PLoS One 6: e18082.
- 49Amer, T., B. Kalender, L. Hasher, et al. 2013. Do older professional musicians have cognitive advantages? PLoS One 8: e71630.
- 50Hove, M.J. & J.L. Risen. 2009. It's all in the timing: interpersonal synchrony increases affiliation. Soc. Cogn. 27: 949–960.
- 51Valdesolo, P., J. Ouyang & D. DeSteno. 2010. The rhythm of joint action: synchrony promotes cooperative ability. J. Exp. Soc. Psychol. 46: 693–695.
- 52Wiltermuth, S.S. & C. Heath. 2009. Synchrony and cooperation. Psychol. Sci. 20: 1–5.
- 53McEwen, S., H. Polatajko, C. Baum, et al. 2015. Combined cognitive-strategy and task-specific training improve transfer to untrained activities in subacute stroke: an exploratory randomized controlled trial. Neurorehabil. Neural Repair 29: 526–536.
- 54Skidmore, E.R., D.R. Dawson, M.A. Butters, et al. 2015. Strategy training shows promise for addressing disability in the first 6 months after stroke. Neurorehabil. Neural Repair 29: 668–676.
- 55Grau-Sánchez, J., N. Ramos, E. Duarte, et al. 2017. Time course of motor gains induced by music-supported therapy after stroke: an exploratory case study. Neuropsychology 31: 624–635.
- 56Rand, D., H. Weingarden, R. Weiss, et al. 2017. Self-training to improve UE function at the chronic stage post-stroke: a pilot randomized controlled trial. Disabil. Rehabil. 39: 1541–1548.
Citing Literature
