Music intervention: Participants will engage in a step-by-step piano training consisting in playing piano pieces designed to involve all 5 digits of the paretic hand and increasing in complexity. They will be using a Musical Instrument Digital Interface (MIDI) piano program called Synthesia to display musical pieces on a computer screen that is adapted for people with no music reading abilities and will be playing on a touch sensitive piano keyboard. The supervised session will also be complemented with a unsupervised home program consisting of piano sequence exercises comprising short excerpts of the same musical pieces practiced during the supervised sessions and they will receive a roll-up flexible piano
Occupational Therapy: Participants will receive conventional occupational therapy treatment (e.g., mobility, ADL, IALD, information session), excluding treatments focusing specifically on arm and hand motor recovery.The supervised session will also be complemented with an unsupervised home program consisting of assignments related to occupational therapy exercises and/or IALD/ADLs.
Study summary
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).
Eligibility
Sex
ALL
Min age
40 Years
Max age
74 Years
Healthy volunteers
No
Inclusion Criteria:
* Have normal/corrected visual and auditory acuity
* Present a first-ever supratentorial unilateral stroke (1-24 weeks post-stroke)
* Present some capacity of dissociation of arm and finger movements, as reflected by scores of 3 to 6 on the arm and hand components of the Chedoke McMaster Stroke Assessment
* Have the capacity to follow simple instructions
* Have no professional piano experience (only for the piano group)
Exclusion Criteria:
* Presence of visual field defect, hemineglect as well as dementia or moderate-to-severe cognitive deficits (score less than 18 on the Montreal Cognitive Assessment).
Primary outcome measure(s)
Feasibility: Characteristics of stroke participants — Pre-intervention (week0) Collected via chart review (e.g. CPA vs. outpatient program, age, sex/gender, stroke characteristics, upper extremity function level, cognitive function)
Feasibility: Number of eligible vs. referred participants — Post-intervention (week6) Assessed using the number of participants referred to the study in comparison to the list of admitted patients in the targeted stroke programs.
Feasibility: adherence to intervention - number of completed sessions — Post-intervention (week6) Training logbook filled by researchers/clinicians (supervised sessions) and subjects (unsupervised sessions).
Feasibility: adherence to intervention - number of piano pieces completed (piano group) vs occupational therapy exercises completed (conventional group) — Post-intervention (week6) Training logbook filled by researchers/clinicians (supervised sessions) and subjects (unsupervised sessions).
Feasibility: adherence to intervention - number of home practice sessions — Post-intervention (week6) Training logbook filled by researchers/clinicians (supervised sessions) and subjects (unsupervised sessions).
Feasibility: adherence to intervention - time of home practice sessions — Post-intervention (week6) Training logbook filled by researchers/clinicians (supervised sessions) and subjects (unsupervised sessions).
Feasibility: presence of adverse or undesirable effects during the intervention — Post-Intervention (week6) Collected with open-ended questions.
Acceptability of the intervention — Post-intervention (week6) Participant's comments and observations collected using the Theoretical Framework of Acceptability (TFA) Questionnaire, which considers different dimensions such as affective attitude, perceived effectiveness, ethicality and opportunity cost. It comprises 8 items rated from 1 to 5. Minimum value is 8 and maximum value is 40. A higher score is associated with better outcomes.
Acceptability: Overall experience — Post-intervention (week6) Investigated through open-ended questions
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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