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

August 16, 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)

44

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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion criteria:

  1. Age < 75 years
  2. First-episode stroke within the last 12 months
  3. Montreal Cognitive Assessment (MoCA) of 15- 25, with impairment defined as failure to achieve the prespecified minimum score on the attention-related MoCA items.
  4. Sufficient cognitive ability to follow multi-step instructions
  5. Functional use of at least one upper limb to perform musical/rhythmic movements
  6. Medically stable with the ability to maintain an upright sitting position with good balance

Exclusion criteria:

  1. Uncontrolled psychiatric or behavioural disorders that may interfere with participation
  2. Uncontrolled seizures or epilepsy
  3. Significant aphasia or hemispatial neglect
  4. Severe visual or visual field deficits

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-based Intervention Rehabilitation Program
The intervention session will last approximately 40 minutes and will comprise: (1) attentional priming for 3-5 minutes; (2) rhythm-action training for approximately 30 minutes; and (3) a brief rest, feedback and session-recording period for approximately 5 minutes. Participants will be prescribed five sessions per week for four consecutive weeks, giving a total of 20 sessions. This dosage is consistent with stroke rehabilitation recommendations promoting intensive, repetitive practice and with intervention durations used in previous music therapy studies and protocols after stroke.
Other: Musical Home-based Rehabilitation Program

The intervention session will last approximately 40 minutes, comprising: (1) 3-5 minutes of attentional priming; (2) approximately 30 minutes of rhythm-action training; and (3) approximately 5 minutes for rest, feedback and session recording. Participants will complete five sessions per week for four consecutive weeks (20 sessions), consistent with recommendations for intensive, repetitive stroke rehabilitation and previous music-based intervention protocols.⁴¹-⁴³ During rhythm-action training, participants will strike corresponding desk bells in response to visual notation and auditory cues at 60 or 90 beats per minute. Responses will be classified as correct when the appropriate bell is struck within the designated beat interval; errors include incorrect, omitted, additional or mistimed strikes.

Task difficulty will be reviewed weekly and adjusted by varying tempo, rhythmic complexity, number of tones or cueing. Participants will progress after achieving ≥80% accuracy across two cons
Placebo Comparator: Placebo Comparator: Control group

Participants in the control and intervention groups will continue to receive the usual multidisciplinary stroke rehabilitation programme as prescribed by their treating rehabilitation team at the Department of Rehabilitation Medicine, UMMC. The intervention group will receive the home-based music rehabilitation programme in addition to usual rehabilitation, whereas the control group will receive usual rehabilitation alone.

At UMMC, outpatient rehabilitation is typically delivered approximately twice weekly, with sessions lasting about 45 minutes, although frequency and content are individualised according to clinical need. Usual cognitive rehabilitation may include attention, memory and executive function training, communication and language therapy, and functional cognitive activities.
Other: Control group (standard care)
Participants in both groups will continue usual multidisciplinary stroke rehabilitation at the Department of Rehabilitation Medicine, UMMC. The intervention group will receive the home-based music rehabilitation programme in addition to usual care, while the control group will receive usual care alone. Outpatient rehabilitation is typically provided twice weekly for approximately 45 minutes per session, with frequency and content individualised according to clinical needs. Cognitive rehabilitation may include attention and memory training, executive function exercises, communication and language therapy, and functional cognitive activities integrated into daily living. Therapy type, frequency and duration will be documented throughout the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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
Test of Everyday Attention
Time Frame: 4 months
Test of Everyday Attention (TEA) is designed for adults aged 18 to 80 years. Rather than a single global scale, it evaluates distinct attentional systems through eight separate subtests, yielding individual raw scores, percentiles, and scaled scores converted via age-normed data.
4 months
Stroop Test
Time Frame: 4 months
The Stroop test assesses a person's ability to inhibit cognitive interference, measure selective attention, and evaluate processing speed. It requires participants to name the ink color of a written word while ignoring the word's actual meaning (such as naming "blue" when the word "red" is printed in blue ink)
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)

September 1, 2026

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

December 31, 2027

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)

August 19, 2026

Last Update Submitted That Met QC Criteria

August 16, 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.

Subscribe