The feasibility study results can be found in clinical rehabilitation and the protocol in Fromtiers in human neuroscience: just search 'home-based neurological music therapy for arm rehabilitation......'
Sounds interesting Alex! What are you after exactly in terms of collaboration?
I have a PhD student about to commence an upper limb rehab study with stroke patients. But she is using an ipad-based music therapy intervention.
Hello Alex, I might me interested in collaborating. I would like to know more about your ideas. Best, Camila
Hi, I would like to know any ideas you might have too, once you know a bit more about what i am thinking.
At the moment I am thinking of recruiting and allocating people with stroke into two groups in a RCT pilot study (so n=60 would be acceptable for a pilot). The comparison of music based interventions with CIMT was discussed at the Boston music and neuroscience conference and is proposed in order to ensure a clear comparison, as you know standard rehab can vary considerably.
Recruitment could occur at point of discharge from in-patient to home. Group A=30, constraint induced movement therapy plus music therapy, Group B=30 music therapy. MT for both groups would be twice weekly for 6 weeks, but this is what needs discussion with a CIMT practitioner, as the dosage needs to be in-keeping with current protocols. Some studies have looked at wearing the mitt for 6 hours every day for four weeks. We also need to ensure that participants can tolerate the MT on top of the CIMT, which I think would be fine. I am speaking to a colleague in Glasgow (Satu Bayan) tomorrow and hopefully can begin to gather more information, she know of a community stroke team near her that delivers CIMT. What are your thoughts?
With regard to your student Jeanette, if the iPad exercises are set out as a reproducible protocol (i.e. instructions could be written out and given to any music therapist to deliver) then i suppose if we had a study up and running then we could pool the data; or it could be pooled with any study provided the outcome measures are the same in both, i.e. ARAT and 9HPT in mine.
Hello Alex,
we have CIMT protocols for stroke in and out patients in subacute care at the hospital, but no home-based treatments or follow-ups (which could be wonderful to develop). Although it is very interesting to think about a home-based RCT protocol including CIMT, it seems challenging at the same time and that it might be simpler to run this in an institutional frame (?) instead of a home-based program? For example, an occupational therapist could help control the CIMT....just a thought that you certainly already have considered. I certainly can find out for you the length and intensity of CIMT being applied at the hospital. I know that the team recently published a paper on this.
My email is [email protected], if it makes communication easier.
Best, Camila
We have transferred CIMT principles to an autonomous Virtual Reality-based setup, through what we call Reinforcement-Induced Movement Therapy (RIMT):
Ballester, B. R., Maier, M., Mozo, R. M. S. S., Castañeda, V., Duff, A., & Verschure, P. F. (2016). Counteracting learned non-use in chronic stroke patients with reinforcement-induced movement therapy. Journal of neuroengineering and rehabilitation, 13(1), 74.
We have also validated the setup at home with hemiparetic stroke patients. If you are interested in integrating our method to merge it with music augmented training please let us know.
Regards,
Oh! That sounds interesting. Thank you, I will have a look at the paper.
alex.
Belen RIMT sounds amazing! What a wonderful, clinically informed idea, to enhance users' movements in this way, countering any negative experience they might (and do!) have through not achieving affected arm use. I wonder whether such an approach would work in speech (aphasia, dyspraxia).
Do you have any plans to trial RIMTat an earlier stage post-stroke?
Hi Alex, sorry I just saw this now. Thanks so much for your comment! For the moment we are not planning any longitudinal trial at the acute stage, I'm not sure the same principle (massed practice) would be beneficial, there is not a clear consensus in the literature, but we are very interested in exploring the RIMT dosage-chronicity issue.
Good point! Yes, we are already considering transferring the same principle to aphasia rehab. Klaudia Grechuta is leading that work in our lab.
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