Hand rehabilitation with sonification techniques in the subacute stage of stroke

Eleonora Baldissarro,Daniele Molteni,Laura Eretti,Sara Mastrogiacomo,Marco Tramontano,Marco Iosa,Alfredo Raglio,Roberto Colombo,Carlo Caltagirone,Paola Baiardi,Caterina Pistarini,Monica Panigazzi,Marcello Imbriani,Gian Luigi Mancardi,Chiara Imbriani,Chiara Imarisio,Mehrnaz Hamedani

doi:10.1038/s41598-021-86627-y

Abstract

After a stroke event, most survivors suffer from arm paresis, poor motor control and other disabilities that make activities of daily living difficult, severely affecting quality of life and personal independence. This randomized controlled trial aimed at evaluating the efficacy of a music-based sonification approach on upper limbs motor functions, quality of life and pain perceived during rehabilitation. The study involved 65 subacute stroke individuals during inpatient rehabilitation allocated into 2 groups which underwent usual care dayweek) respectively of standard upper extremity motor rehabilitation or upper extremity treatment with sonification techniques. The Fugl-Meyer Upper Extremity Scale, Box and Block Test and the Modified Ashworth Scale were used to perform motor assessment and the McGill Quality of Life-it and the Numerical Pain Rating Scale to assess quality of life and pain. The assessment was performed at baseline, after 2 weeks, at the end of treatment and at follow-up (1 month after the end of treatment). Total scores of the Fugl-Meyer Upper Extremity Scale (primary outcome measure) and hand and wrist sub scores, manual dexterity scores of the affected and unaffected limb in the Box and Block Test, pain scores of the Numerical Pain Rating Scale (secondary outcomes measures) significantly improved in the sonification group compared to the standard of care group (time*group interaction < 0.05). Our findings suggest that music-based sonification sessions can be considered an effective standardized intervention for the upper limb in subacute stroke rehabilitation.

Highlights

Sex Age Handedness Acute event Median Interquartile Range Min–Max Lesion side Right Left and elbow)[11], the functional recovery of the hand still presents some issues[12,13]
Allocated to the Sonification Group: n= 33 - Received the full dose of the intervention: n=31 - Discontinued intervention: n= 2; 1 patient worsened his/her clinical conditions, 1 patient was hospitalized - Tested at T1: n=32; Tested at T2: n=31
Main results are related to the global upper limb impairment, assessed by the Fugl-Meyer Upper Extremity scale (FM-UE)

Summary

Introduction

Sex (males/females) Age (years) Handedness (right handed) Acute event (days) Median Interquartile Range Min–Max Lesion side Right Left and elbow)[11], the functional recovery of the hand (in particular of the prehension function) still presents some issues[12,13]. Many studies document the possibility that exposure to music during training, but, through specific rehabilitation interventions, may induce plastic changes[15,16,17,18,19] in the sensory-auditory circuits and motor a reas[20,21] These changes, resulting in a neuronal reorganization in the nodal points of the brain networks and in fiber bundles, can determine effects lasting beyond the actual duration of the rehabilitation intervention[15]. Sonification can improve motor functions rehabilitation and can facilitate the integration of auditory and sensory-motor systems[35,36,37] This technique can strengthen and support the damaged proprioceptive system and can make the rehabilitative process more pleasant and stimulating from an emotional and motivational point of view[15,37]. Sonification makes possible the improvement of sensorimotor learning, proprioception, movements planning and execution[37]

Methods

Results

Conclusion