Playing Piano to Improve Hand Function Early After Stroke
ConditionStroke
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age40-74
SponsorMcGill University
About 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).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
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
Disqualifiers
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).
Trial design
Design model
Parallel
Treatments tested in this trial
Music intervention
Other interventionParticipants 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
Other interventionParticipants 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.
Treatment groups
30 Participants
are divided into 2 treatment groupsGroup A: Piano groupExperimental treatment 1 intervention
Group B: Conventional groupActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Feasibility: Characteristics of stroke participants
Collected via chart review (e.g. CPA vs. outpatient program, age, sex/gender, stroke characteristics, upper extremity function level, cognitive function)
Time frame
Pre-intervention (week0)2
Feasibility: Number of eligible vs. referred participants
Assessed using the number of participants referred to the study in comparison to the list of admitted patients in the targeted stroke programs.
Time frame
Post-intervention (week6)3
Feasibility: adherence to intervention - number of completed sessions
Training logbook filled by researchers/clinicians (supervised sessions) and subjects (unsupervised sessions).
Time frame
Post-intervention (week6)4
Feasibility: adherence to intervention - number of piano pieces completed (piano group) vs occupational therapy exercises completed (conventional group)
Training logbook filled by researchers/clinicians (supervised sessions) and subjects (unsupervised sessions).
Time frame
Post-intervention (week6)Secondary outcomes
1
Change from Baseline in the Box and Block test at Post-intervention
Assess gross manual dexterity
Time frame
Post-intervention (week6) and Follow-up (week12)2
Change from Baseline in the Nine Hole Peg Test (NHPT) at Post-intervention
Assesses fine manual dexterity
Time frame
Post-intervention (week6) and Follow-up (week12)3
Change from Baseline in the Finger to Nose test at Post-intervention
Assesses arm movement coordination.
Time frame
Post-Intervention (week6) and Follow-up (week12)4
Change from Baseline in the Finger Tapping test at Post-intervention
Assesses finger movement coordination.
Time frame
Post-intervention (week6) and Follow-up (week12)Sponsors and contacts
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McGill University
Lead sponsor
Jewish Rehabilitation Hospital
Collaborator
Source ClinicalTrials.gov