Enhancing Attention and Processing Speed Through Home-based Music Rehabilitation Program After Stroke in Malaysia (HMRPAS)

April 7, 2026 updated by: University of Malaya

Enhancing Attention and Processing Speed Through Home-based Music Rehabilitation Program After Stroke in Malaysia: A Feasibility Random Controlled Study

Stroke often leads to significant cognitive impairment, impacting quality of life. While existing rehabilitation options exist, there's a need for innovative, accessible, and patient-centered solutions. Research suggests music can engage multiple brain networks associated with sensory and motor processes, cognition, and affective regulation, potentially enhancing cognitive functions like attention and processing speed as well. Home-based interventions have also demonstrated positive impacts on rehabilitation adherence and outcomes. Building on this foundation, this study proposes to develop and pilot test a home-based musical rehabilitation program to improve attention and processing speed in Malaysian stroke survivors.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Stroke often leads to significant cognitive impairment, impacting quality of life. While existing rehabilitation options exist, there's a need for innovative, accessible, and patient-centered solutions. Research suggests music can engage multiple brain networks associated with sensory and motor processes, cognition, and affective regulation, potentially enhancing cognitive functions like attention and processing speed as well. Home-based interventions have also demonstrated positive impacts on rehabilitation adherence and outcomes.

Building on this foundation, this study proposes to develop and pilot test a home-based musical rehabilitation program to improve attention and processing speed in Malaysian stroke survivors. Using a randomized controlled trial, the program's feasibility and preliminary effectiveness will be evaluated. Participants will undergo cognitive assessments at baseline, post-intervention, and follow-up, complemented by qualitative data collection to understand patient experience.

The anticipated outcomes include a culturally relevant, accessible home-based program tailored for Malaysian stroke survivors, preliminary evidence on the program's impact on attention and processing speed, insights into its feasibility and acceptability, and a foundation for a larger-scale randomized controlled trial. This research has the potential to transform stroke rehabilitation in Malaysia by offering an innovative, patient-centered approach that utilizes music therapy to enhance cognitive recovery and improve quality of life.

Study Type

Interventional

Enrollment (Estimated)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: NIK SHERINA HAIDI BT HANAFI HANAFI, MBBS
  • Phone Number: +60379492802
  • Email: niksherina@um.edu.my

Study Locations

  • Malaysia
    • Kuala Lumpur
      • Kuala Lumpur, Kuala Lumpur, Malaysia, 50603
        • Universiti Malaya Medical Centre
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed with ischemic or haemorrhagic stroke confirmed by CT scan
  • 18 to 70 years old
  • Duration of stroke within the first one year
  • Ability to provide informed consent
  • Understands Bahasa Melayu or English with basic communication abilities to follow instructions during therapy sessions
  • Mild to moderate cognitive impairments with MoCA score of 10-25, with incomplete score for the attention sections
  • Availability of caregiver (formal or informal) who can assist in the music therapy, monitor and give feedback during the music therapy sessions at home
  • Have one normal functioning hand to perform the movements during the music therapy rehabilitation program
  • Have good balance and able to sit upright

Exclusion Criteria:

  • Severe aphasia
  • Significant uncorrected hearing or visual impairments preventing engagement in music therapy.
  • Severe or unstable medical conditions (e.g., uncontrolled hypertension or diabetes).
  • Medications that significantly impair cognition or motor function (e.g., high-dose sedatives).
  • History of neurological diseases other than stroke (eg, Parkinson's disease).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental: Home-Based Music Therapy Rehabilitation Program
  1. Song Materials and Levels The song materials selected for this research will be sourced from copyrighted compositions under UM Centre of Innovation and Enterprise (UMCIE). This maximizes the utilization of readily available resources and serves as a platform for promoting the original works of UM lecturers. The songs are organised into three difficulty levels, with approximately five songs per level. Songs within each level have equivalent rhythmic and cognitive demands, allowing variation without altering task difficulty.
  2. Baseline Assessment for Music Therapy Participants will undergo an initial level assessment conducted at the hospital by the trained music therapist. If travel is not feasible, level assessment is conducted at the participant's home. The songs will be presented to the participants and they will choose one song to start.
Other: Musical Home-based Rehabilitation Program
  • A certified music therapist will conduct an initial assessment (at the hospital or at your home if travel is not feasible).
  • You and your caregiver will receive structured training so you can carry out the programme at home independently.
  • You will complete home sessions of about 40 minutes per session, daily for 5 days per week, for 4 weeks.
  • Your caregiver will use a simple checklist after each session to record completion, duration, alertness, fatigue, and any concerns.
  • The therapist will make weekly phone calls to support adherence and address questions.
  • The therapist will conduct level checks approximately after 2 weeks (at hospital or at home) and may adjust the song tasks to match your progress.
Placebo Comparator: Placebo Comparator: Control group

Participants in the control group continue with usual standard neurorehabilitation program as prescribed by the rehabilitation team, without exposure to the music-based intervention.

This will provide a baseline to compare outcomes with the intervention group and evaluate the feasibility and preliminary effects of the music therapy intervention. The usual cognitive rehabilitation program during the subacute stroke period focuses on restoring cognitive abilities such as attention, memory, executive functions, and communication.
Other: Control group (standard care)
  • You will continue with the standard neurorehabilitation programme as prescribed by your rehabilitation team.
  • You will not take part in the home-based music therapy programme.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Montreal Cognitive Assessment (MoCA)
Time Frame: 4 months

The Montreal Cognitive Assessment (MoCA) is a widely used cognitive screening tool designed to detect mild cognitive impairment. It demonstrates higher sensitivity in identifying subtle cognitive deficits compared to other screening instruments.

Scale Range: 0 to 30 Interpretation: Higher scores indicate better cognitive function Cut-off Score: A score of 26 and above is generally considered normal cognitive function
4 months
Trail Making Test (TMT A and B)
Time Frame: 4 months
Trail Making Tests are tests of speed for attention, sequencing, mental flexibility, visual search, and motor function.
4 months
Digit Span (Forward and Backward)
Time Frame: 4 months
Forward Digit Span (FDS) assesses short-term, auditory memory, while Backward Digit Span (BDS) tests working memory and central executive processing.
4 months
Clock Drawing Test (CDT)
Time Frame: 4 months
The Clock Drawing Test (CDT) is a quick,, widely used neurocognitive screening tool designed to detect dementia, Alzheimer's, and other cognitive impairments.
4 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cogniplus software for Reaction Time and Attention tests
Time Frame: 4 months

CogniPlus is a computer-based cognitive training and assessment system developed to measure and improve attention, processing speed, and executive functions, particularly in individuals with cognitive impairments following stroke or other neurological conditions.

Scale Range: Varies by subtest/module (e.g., attention, processing speed), typically reported as performance scores such as reaction time (milliseconds), accuracy (%), or standardized scores

Interpretation:

Higher accuracy (%) and standardized scores indicate better cognitive performance Lower reaction time (milliseconds) indicates better processing speed Outcome Metrics: Task-specific measures including reaction time, error rate, and level progression
4 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Malaya

Investigators

  • Principal Investigator: Wen Fen Beh, PhD, Universitiy of Malaya

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 1, 2026

Primary Completion (Estimated)

September 30, 2026

Study Completion (Estimated)

October 31, 2026

Study Registration Dates

First Submitted

March 27, 2026

First Submitted That Met QC Criteria

April 7, 2026

First Posted (Actual)

April 13, 2026

Study Record Updates

Last Update Posted (Actual)

April 13, 2026

Last Update Submitted That Met QC Criteria

April 7, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Home-based Program
  • BKP018-2024-ECRG (Other Identifier: University of Malaya)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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