Kinematic Accelerometry Assessment Of Music-Based Motor Training in Stroke Rehabilitation

Abstract

<h3>Research Objectives</h3> To use a novel limb acceleration measure to reveal mechanisms of improved paretic limb control following music-based rehabilitation. <h3>Design</h3> A consecutive sample. <h3>Setting</h3> A music and health research facility in Toronto, CA. <h3>Participants</h3> 30 community dwellers aged 30-79 years in the chronic stroke phase with minimal volitional control of the affected limb. <h3>Interventions</h3> Nine training sessions thirty-minutes in length were administered three times per week by a Neurologic Music Therapist. The music-based training incorporated mapping rhythmically cued functional arm movements onto digital sonification touch tablets. The paretic limb's acceleration profile was recorded at 1000 Hz from a wrist-worn accelerometer. <h3>Main Outcome Measures</h3> Estimates of power-spectral-density were obtained with an approximately 1-s sliding window and a 50% window overlap across the entire training session. The power-spectral-density was computed as the median of all the windows within each trace. The dominant peak in the function was then identified and quantified as the height of the peak (i.e., peak-power). Peak-power was then used to quantify functional changes in limb control across sessions. <h3>Results</h3> Repeated-measures ANOVA for peak-power revealed a main effect of session (p < .001) and follow-up trend analyses revealed a significant linear trend, highlighting continuous motor improvement across all sessions. T-tests were then used to determine that movements of the paretic limb increased in peak power (p = .001; 95% CI = -.0002, - .0007) from session 1 (M = .00004) to session 9 (M = .0002) with peak-power being localized within the lower frequency spectrum (i.e., 4.4 Hz). <h3>Conclusions</h3> Peak-power increases within the lower frequency spectrum indicates improved volitional motor control and intentionality of paretic arm movements. Such functional changes in limb acceleration represent a mechanism underlying improved motor outcomes in music-based stroke interventions. <h3>Author(s) Disclosures</h3> The authors have nothing to disclose.