A piano training program to improve manual dexterity and upper extremity function in chronic stroke survivors

Myriam Villeneuve, Virginia Penhune, Anouk Lamontagne, Myriam Villeneuve, Virginia Penhune, Anouk Lamontagne

Abstract

Objective: Music-supported therapy was shown to induce improvements in motor skills in stroke survivors. Whether all stroke individuals respond similarly to the intervention and whether gains can be maintained over time remain unknown. We estimated the immediate and retention effects of a piano training program on upper extremity function in persons with chronic stroke.

Methods: Thirteen stroke participants engaged in a 3-week piano training comprising supervised sessions (9 × 60 min) and home practice. Fine and gross manual dexterity, movement coordination, and functional use of the upper extremity were assessed at baseline, pre-intervention, post-intervention, and at a 3-week follow-up.

Results: Significant improvements were observed for all outcomes at post-intervention and follow-up compared to pre-intervention scores. Larger magnitudes of change in manual dexterity and functional use of the upper extremity were associated with higher initial levels of motor recovery.

Conclusion: Piano training can result in sustainable improvements in upper extremity function in chronic stroke survivors. Individuals with a higher initial level of motor recovery at baseline appear to benefit the most from this intervention.

Keywords: cerebrovascular accident; hand; learning; music; paresis; rehabilitation.

Figures

Figure 1
Figure 1
Excerpts of musical scores of three pieces, one at each level, with digit number under each note.
Figure 2
Figure 2
(A) Structured training session setting; (B) screen shot of Synthesia Musical Instrument Digital Interface (MIDI) piano program; (C) Roll-up flexible piano.
Figure 3
Figure 3
Individual performances for all participants [severely affected (gray solid line), moderately affected (black dashed line), and mildly affected (black solid line)] on the (A) Box and Block Test (BBT); (B) Nine Hole Peg Test (NHPT) and; (C) Jebsen Hand Function Test (Jebsen) at baseline, pre-intervention, post-intervention, and follow-up. The area between the vertical doted lines represents the 3-week intervention period. In (C), the y-axis is discontinued for a better overview of results. Note that four participants could not complete the NHPT and one could not complete the Jebsen (see text for more details).

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Source: PubMed

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