Examining the Effect of Piano Playing Training on Fine Motor Skills in Parkinson's Patients

Piano playing may provide an engaging and accessible setting for finger and wrist movement training. Moreover, it has been found effective for improving manual dexterity and upper-limb function in other neurologic disorders, such as stroke and additionally beneficial for cognitive and psychosocial support in Parkinson's disease. However, no study has examined the effect of piano playing on dexterity in Parkinson's disease. The aim of this study is to test the efficacy of a novel piano-based training program on fine motor function in patients with PD. Participants with Parkinson's disease will take part in an individually tailored 6-week piano training program, combining weekly supervised training sessions (6x60 min altogether), with three independent at-home weekly 30 minutes practice sessions (18x30 altogether). Participants will receive a piano MIDI keyboard for home use during the study.

Study Overview

• Status: Suspended
• Conditions: Parkinson Disease
• Intervention / Treatment: Behavioral: Piano

• Study Type: Interventional
• Enrollment (Actual): 3
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Israel
  • Tel Aviv, Israel, 6997801
    • Tel Aviv University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Idiopathic Parkinson's Disease patients
• Hoehn and Yahr stages I to III
• Self-reports of some dexterity difficulties

Exclusion Criteria:

• Participation in an ongoing clinical study or clinical study within 30 days prior to this study
• Atypical parkinsonian syndrome or secondary parkinsonism (e.g., due to drugs, metabolic neurogenetic disorders, encephalitis, cerebrovascular disease, or other degenerative disease), or other neurologic conditions influencing upper limb movement
• Significant psychiatric symptoms or history
• Significant or recent experience in piano playing (participants who are proficient piano players, or had studied piano for more than 3 years in the past, or for shorter periods in the last 5 years)
• Other significant fine motor skills (e.g., high proficiency in playing another musical instrument, video games, etc.)
• Mini Mental status examination (MMSE) score below 25
• Significant sensory deficits, e.g., hearing or sight impairment
• Unstable medical disorder
• Significant postural or action tremor, moderate dyskinesia

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Research group; Receives the full piano training	Behavioral: Piano; Receives the piano training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Box and block test	Number of blocks that can be moved over a barrier using the hand / arm in one minute	First meeting, last meeting (after 6 weeks)
9 Hole peg test	Time taken to insert 9 pegs into holes and then remove them	First meeting, last meeting (after 6 weeks)
Synergy index	Calculated from a force ramp production task using the fingers with force sensors	First meeting, last meeting (after 6 weeks)
Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor parts II (patient questionnaire) - parts 2.4 to 2.7 and III (motor examination) - parts 3.3 and 3.4	Standard questionnaire used in Parkinson's disease. Higher scores indicate more impairment. Maximum score for each part is 4, so overall for the 6 parts the maximum score is 24.	First meeting, last meeting (after 6 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quantitative Digitography - Average strike duration	Measure of speed and variability of key presses on a piano - mean of the time the key is pressed	First meeting, last meeting (after 6 weeks)
Quantitative Digitography - Coefficient of variation strike duration	Measure of speed and variability of key presses on a piano - coefficient of variation of the time the key is pressed	First meeting, last meeting (after 6 weeks)
Quantitative Digitography - Average interval between strikes (in seconds)	Measure of speed and variability of key presses on a piano - average time between subsequent key presses	First meeting, last meeting (after 6 weeks)
Quantitative Digitography - Coefficient of variation of interval between strikes	Measure of speed and variability of key presses on a piano - coefficient of variation of the time between subsequent key presses	First meeting, last meeting (after 6 weeks)
Quantitative assessment of piano performance progress	Measurement of improvement in playing the piano - the teacher (rater) will give a score (between 0 and 5) for the level of piano playing of the participant, where 0 is no ability to play and 5 is the ability to play the pieces from the workbook (a beginner's level piano book) perfectly.	First meeting, last meeting (after 6 weeks)

Collaborators and Investigators

• Sponsor: Tel Aviv University
• Collaborators: Sheba Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): August 22, 2022
• Primary Completion (Estimated): December 31, 2024
• Study Completion (Estimated): December 31, 2024

Study Registration Dates

• First Submitted: October 26, 2023
• First Submitted That Met QC Criteria: November 1, 2023
• First Posted (Actual): November 7, 2023

Study Record Updates

• Last Update Posted (Actual): November 7, 2023
• Last Update Submitted That Met QC Criteria: November 1, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: music; dexterity; piano
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease
• Other Study ID Numbers: 8407-21-SMC

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anonymous raw data from the tests will be made available on figshare
• IPD Sharing Time Frame: Upon publication
• IPD Sharing Access Criteria: Open to all
• IPD Sharing Supporting Information Type: ICF

Drug and device information, study documents

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