Attention, Music Intervention, Rehabilitation Program, Stroke
Conditions
Keywords
Attention, Processing Speed, Home-based Music Rehabilitation Program, Stroke, Malaysia
Brief summary
Stroke often leads to significant cognitive impairment, impacting quality of life. While existing rehabilitation options exist, there's a need for innovative, accessible, and patient-centered solutions. Research suggests music can engage multiple brain networks associated with sensory and motor processes, cognition, and affective regulation, potentially enhancing cognitive functions like attention and processing speed as well. Home-based interventions have also demonstrated positive impacts on rehabilitation adherence and outcomes. Building on this foundation, this study proposes to develop and pilot test a home-based musical rehabilitation program to improve attention and processing speed in Malaysian stroke survivors.
Detailed description
Stroke often leads to significant cognitive impairment, impacting quality of life. While existing rehabilitation options exist, there's a need for innovative, accessible, and patient-centered solutions. Research suggests music can engage multiple brain networks associated with sensory and motor processes, cognition, and affective regulation, potentially enhancing cognitive functions like attention and processing speed as well. Home-based interventions have also demonstrated positive impacts on rehabilitation adherence and outcomes. Building on this foundation, this study proposes to develop and pilot test a home-based musical rehabilitation program to improve attention and processing speed in Malaysian stroke survivors. Using a randomized controlled trial, the program's feasibility and preliminary effectiveness will be evaluated. Participants will undergo cognitive assessments at baseline, post-intervention, and follow-up, complemented by qualitative data collection to understand patient experience. The anticipated outcomes include a culturally relevant, accessible home-based program tailored for Malaysian stroke survivors, preliminary evidence on the program's impact on attention and processing speed, insights into its feasibility and acceptability, and a foundation for a larger-scale randomized controlled trial. This research has the potential to transform stroke rehabilitation in Malaysia by offering an innovative, patient-centered approach that utilizes music therapy to enhance cognitive recovery and improve quality of life.
Interventions
OTHERMusical Home-based Rehabilitation Program
The intervention session will last approximately 40 minutes, comprising: (1) 3-5 minutes of attentional priming; (2) approximately 30 minutes of rhythm-action training; and (3) approximately 5 minutes for rest, feedback and session recording. Participants will complete five sessions per week for four consecutive weeks (20 sessions), consistent with recommendations for intensive, repetitive stroke rehabilitation and previous music-based intervention protocols.⁴¹-⁴³ During rhythm-action training, participants will strike corresponding desk bells in response to visual notation and auditory cues at 60 or 90 beats per minute. Responses will be classified as correct when the appropriate bell is struck within the designated beat interval; errors include incorrect, omitted, additional or mistimed strikes. Task difficulty will be reviewed weekly and adjusted by varying tempo, rhythmic complexity, number of tones or cueing. Participants will progress after achieving ≥80% accuracy across two cons
Participants in both groups will continue usual multidisciplinary stroke rehabilitation at the Department of Rehabilitation Medicine, UMMC. The intervention group will receive the home-based music rehabilitation programme in addition to usual care, while the control group will receive usual care alone. Outpatient rehabilitation is typically provided twice weekly for approximately 45 minutes per session, with frequency and content individualised according to clinical needs. Cognitive rehabilitation may include attention and memory training, executive function exercises, communication and language therapy, and functional cognitive activities integrated into daily living. Therapy type, frequency and duration will be documented throughout the study.
Sponsors
University of Malaya
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
No minimum to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Age \< 75 years 2. First-episode stroke within the last 12 months 3. Montreal Cognitive Assessment (MoCA) of 15- 25, with impairment defined as failure to achieve the prespecified minimum score on the attention-related MoCA items. 4. Sufficient cognitive ability to follow multi-step instructions 5. Functional use of at least one upper limb to perform musical/rhythmic movements 6. Medically stable with the ability to maintain an upright sitting position with good balance
Exclusion criteria
1. Uncontrolled psychiatric or behavioural disorders that may interfere with participation 2. Uncontrolled seizures or epilepsy 3. Significant aphasia or hemispatial neglect 4. Severe visual or visual field deficits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Test of Everyday Attention | 4 months | Test of Everyday Attention (TEA) is designed for adults aged 18 to 80 years. Rather than a single global scale, it evaluates distinct attentional systems through eight separate subtests, yielding individual raw scores, percentiles, and scaled scores converted via age-normed data. |
| Trail Making Test (TMT A and B) | 4 months | Trail Making Tests are tests of speed for attention, sequencing, mental flexibility, visual search, and motor function. |
| Digit Span (Forward and Backward) | 4 months | Forward Digit Span (FDS) assesses short-term, auditory memory, while Backward Digit Span (BDS) tests working memory and central executive processing. |
| Stroop Test | 4 months | The Stroop test assesses a person's ability to inhibit cognitive interference, measure selective attention, and evaluate processing speed. It requires participants to name the ink color of a written word while ignoring the word's actual meaning (such as naming "blue" when the word "red" is printed in blue ink) |
Countries
Malaysia
Contacts
CONTACTMAZLINA BINTI MAZLAN, MBBS
CONTACTNIK SHERINA HAIDI BT HANAFI HANAFI, MBBS
PRINCIPAL_INVESTIGATORWen Fen Beh, PhD
Universitiy of Malaya
Outcome results
None listed