Important findings of a technology-assisted in-home music-based intervention for individuals with stroke: a small feasibility study

Abstract

Purpose

To examine the feasibility of stroke survivors receiving music-based rehabilitation via a mobile app.

Materials and Methods

We recruited ten chronic stroke survivors who were community-dwelling with mild-moderate upper extremity (UE) paresis. Participants were encouraged to exercise their paretic UE with a commercial instrument training app, Yousician, with a piano keyboard at home for three weeks. The feasibility of the training was measured by: (a) the acceptance of using the app to receive in-home piano training (e.g., daily usage time, exit interview) and (b) the effects of the app functionality as a rehabilitation tool (e.g., participants’ motor improvements after training).

Results

Our small sample size of participants demonstrated general positive feedback and self-motivation (e.g., interest in extended training time) about using a mobile app to receive in-home, music-based UE training. Participants showed no trend of declined usage and practiced on average ∼33 min per day for 4–5 days per week during the 3-week participation. We also observed positive results in the Fugl-Meyer Assessment, Action Research Arm Test, and Nine Hole Peg Test after training.

Conclusions

This study provided insight into the feasibility of delivering music-based interventions through mobile health (mHealth) technology for stroke populations. Although this was a small sample size, participants’ positive and negative comments and feedback provided useful information for future rehab app development. We suggest four ways to further improve and design a patient-oriented app to facilitate the use of a mHealth app to deliver in-home music-based interventions for stroke survivors.

IMPLICATIONS FOR REHABILITATION

• Stroke survivors showed acceptance and positive feedback on receiving in-home music-based training via a mobile app.

• mHealth technologies may allow positive effects of music-based interventions in motor performance and home practice compliance.

• Further developments in the co-design process with patients, caregivers, and therapists are needed to design a patient-oriented app to deliver better in-home music-based interventions for stroke survivors.

Keywords:

• Upper extremity
• stroke
• music therapy
• mobile health units
• telemedicine

Acknowledgement

We appreciate the support from Yousician to allow us to use the app during the data collection period. We thank Dr. Kinsuk Maitra and Dr. Emily Buchman from the Department of Occupational Therapy, Georgia State University, for their initial assistance on grant submission and data collection for this study. We also acknowledge the help of editorial editing by Andrew Schmidt from the School of Music, Georgia State University, on this manuscript.

Disclosure statement of conflicting interests

The authors report there are no competing interests to declare.

Additional information

Funding

This work was supported by the Georgia State University under Lewis College Intramural Grant Program.

Notes on contributors

Yi-An Chen

Yi-An Chen an Assistant Professor in the Department of Occupational Therapy at Georgia State University, USA. Her work investigates the intersection of motor, cognitive, and psychosocial behaviors of individuals with upper extremity impairments after neurological disorders (e.g., stroke, Parkinson’s disease). She is particularly interested in understanding the effectiveness of engaging interventions (e.g., music-based home training) and the feasibility of ecological assessments (e.g., wearable sensors, EMA) to empowering and motivating patients for self-directed recovery.

Martin Norgaard

Martin Norgaard is an Associate Professor of Music Education and Director of the Music Cognition and Creativity Lab at Georgia State University in Atlanta. He collaborates with faculty in occupational therapy, neuroscience, psychology, anthropology, mathematics, and computer science to investigate the cognitive processes underlying improvisation and related therapeutic applications.