The Effectiveness of Piano Therapy vs. Piano Listening on Manual Dexterity in the Elderly

Active Versus Passive Piano Intervention for Dexterity in Older Adults: A Randomized Controlled Trial

Does active piano practice help recover hand dexterity in older adults, or does social interaction and music-listening alone affect motor performance? Researchers hypothesized improved dexterity after active piano playing, but not after passive piano listening. 15 residents of a retirement community were partnered together and completed 2 two-week piano training modules. In module 1, one partner played piano exercises and songs while the other listened. In module 2, partners switched roles. The Purdue Pegboard Test and Box and Block Test assessed fine and gross motor dexterity, before, between, and after the training modules. A repeated measures ANOVA showed a main effect of time on overall fine and gross motor function, but there was no main effect of playing versus listening. Results did not support the hypothesis, but indicate that piano-based therapy requires greater than 2 weeks to begin improving dexterity and may influenced co-occurring socialization.

Study Overview

• Status: Completed
• Conditions: Aging; Manual Dexterity; Piano Therapy
• Intervention / Treatment: Behavioral: Piano training (Active); Behavioral: Piano Training (Passive)

Detailed Description

The primary finding of this study is that older adults demonstrate improvements in manual dexterity after four weeks of piano training, but do not improve significantly after just two weeks. Furthermore, it does not matter whether the participants actively play for the first part and passively listen for the second part or vice versa.

Of the three proposed mechanisms of Music Supported Therapy (MST) explained in the introduction, the findings of this study may be best explained by the emotion-motivation mechanism. Though dexterity scores were organized by whether the scores followed an active playing module, all participants experienced the same amount of music-listening and social interaction. Whether the participant was playing the music him/herself or observing, both groups were always hearing the same songs and scales for the same amount of time. The emotion-motivation mechanism states that this music-listening alone may increase cognitive processes like working memory and boost both mood and motivation. Therefore, these findings may mean that listening to piano music helps dexterity performance in older adults; but it does so if and only if the participants experience the music-listening module for a sufficient duration of time.

Along with music-listening, social interaction was consistent between active and passive groups throughout the study. This interpersonal interaction may also have had an effect on mood and motivation, as piano instructors provided high levels of encouragement and complimented the participants' progress often. Relationship quality between patient and therapist is correlated with efficacy of therapy. This concept of increased socialization contributing to dexterity improvements is also supported by a study that identified social participation as a preventative factor of perceptual speed decline in older adults.

Not finding the hypothesized effect of active versus passive condition on dexterity could be due to dexterous activities that the participants were engaged in outside of the training modules. For example, three of the 15 participants reported that they currently play piano in their free time, so it can be conjectured that those participants were engaged in active piano playing even when they were in the passive listening module. Other activities enjoyed by participants include exercise classes and painting-both of which could have been improving or maintaining their dexterity throughout the study.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • New Wilmington, Pennsylvania, United States, 16172
      • Shanango on the Green

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 70 years and older (OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Able to physically and cognitively withstand 30 minute piano training sessions

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: CROSSOVER
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Active-Passive; Active Piano training (8 sessions in two weeks) followed by listening to piano training (8 sessions in 2 weeks) (Passive condition)	Behavioral: Piano training (Active); Piano Curriculum. Participants were all trained on one of four 88-key pianos located in the assisted living facility. Piano instructors were 6 undergraduate Music Education and Music Performance majors. Each lesson of the week had a different focus: right and left hands separately, bimanually coupled, and bimanually uncoupled (Loehrer et al., 2016). Each week of the module had a different focus as well: notes played one step apart, notes played multiple steps apart (intervals), and tones played together (two-note chords) (van Vugt et al., 2016; Villeneuve et al., 2014). Each session began with skill exercises and ended with learning a simple, recognizable song. Two participants with extensive piano experience progressed to playing duets with the instructor and hymns out of a hymnal after mastery of the study curriculum. These training protocols were based on those of Schneider and colleagues' 2007 study.; Other Names: Piano Training (Passive); Behavioral: Piano Training (Passive); Participants listened to their research partner complete 8 active piano training sessions across 2 weeks.
EXPERIMENTAL: Passive-Active; Passive piano training listening (8 sessions in two weeks) followed by active piano training (8 sessions in two weeks)	Behavioral: Piano training (Active); Piano Curriculum. Participants were all trained on one of four 88-key pianos located in the assisted living facility. Piano instructors were 6 undergraduate Music Education and Music Performance majors. Each lesson of the week had a different focus: right and left hands separately, bimanually coupled, and bimanually uncoupled (Loehrer et al., 2016). Each week of the module had a different focus as well: notes played one step apart, notes played multiple steps apart (intervals), and tones played together (two-note chords) (van Vugt et al., 2016; Villeneuve et al., 2014). Each session began with skill exercises and ended with learning a simple, recognizable song. Two participants with extensive piano experience progressed to playing duets with the instructor and hymns out of a hymnal after mastery of the study curriculum. These training protocols were based on those of Schneider and colleagues' 2007 study.; Other Names: Piano Training (Passive); Behavioral: Piano Training (Passive); Participants listened to their research partner complete 8 active piano training sessions across 2 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Purdue Pegboard	Fine Motor Manual Dexterity	10 minutes
Box and Block Test	Gross Motor Dexterity	5 minutes

Collaborators and Investigators

• Sponsor: Westminster College

Publications and helpful links

General Publications

• Ferreira PH, Ferreira ML, Maher CG, Refshauge KM, Latimer J, Adams RD. The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Phys Ther. 2013 Apr;93(4):470-8. doi: 10.2522/ptj.20120137. Epub 2012 Nov 8.
• Jones L, Karageorghis CI, Ekkekakis P. Can high-intensity exercise be more pleasant?: attentional dissociation using music and video. J Sport Exerc Psychol. 2014 Oct;36(5):528-41. doi: 10.1123/jsep.2013-0251.
• Lovden M, Ghisletta P, Lindenberger U. Social participation attenuates decline in perceptual speed in old and very old age. Psychol Aging. 2005 Sep;20(3):423-34. doi: 10.1037/0882-7974.20.3.423.
• Vuilleumier P, Trost W. Music and emotions: from enchantment to entrainment. Ann N Y Acad Sci. 2015 Mar;1337:212-22. doi: 10.1111/nyas.12676.

Study record dates

Study Major Dates

• Study Start (ACTUAL): August 30, 2017
• Primary Completion (ACTUAL): October 21, 2017
• Study Completion (ACTUAL): December 1, 2017

Study Registration Dates

• First Submitted: December 8, 2017
• First Submitted That Met QC Criteria: December 8, 2017
• First Posted (ACTUAL): December 13, 2017

Study Record Updates

• Last Update Posted (ACTUAL): December 15, 2017
• Last Update Submitted That Met QC Criteria: December 13, 2017
• Last Verified: December 1, 2017

More Information

Terms related to this study

• Keywords: plasticity; dexterity; multisensory integration; Music Supported Therapy; bimanual coupling; auditory feedback; piano therapy
• Other Study ID Numbers: SeylerCapstone2017

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: no identifiers. Confidential data.
• IPD Sharing Time Frame: Immediately and for the next five years
• IPD Sharing Access Criteria: Researchers
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No