物理治疗与身体康复杂志

Sonification-based Exercise as an Add-on Therapy for Upper Limb Motor Recovery in the Acute Phase of Stroke

Abstract

Danilo Spada1*, Chiara Megliani2, Matteo Sozzi3, Andrea Cornaggia4 and Andrea Salmaggi3

Music- and sonification-assisted rehabilitation is being increasingly investigated in motor recovery after stroke, but only few studies have thus far involved patients in the acute phase of the disease.

In this quasi-experimental study (no randomization has been applied), patients with motor deficit of the upper limb fulfilling predefined inclusion criteria were sequentially enrolled onto a program of sonification-based exercises through a serious game, id est. an adapted piano-keyboard as an add-on to standard rehabilitation treatment. Based on the potential efficacy of the auditory-motor networks, the aim was to further stimulate the patient on tactile stimulation, limb lifting and finger motor individualization. Starting 2 to 7 days after stroke onset and for an overall 21-day duration, the experiences were performed in the hospital. After the enrollment of 13 patients as experimental group, 12 more patients were enrolled as control group and underwent standard physiotherapy treatment.

For all patients, the Action Research Arm Test (ARAT) was administered at T0 (prior to therapy), T1 (after 10 days) and T2 (end of treatment) while the quality of life, as assessed by the SF-36 scale, was evaluated at T0 and T2.

For the ARAT, statistical analyses were performed by Student’s T test for paired and unpaired samples, respectively. In both groups, ARAT scores significantly improved from T0 to T1, but the sole experimental group displayed a significant motor improvement from T1 to T2.

Again, only in the case of the experimental group quality of life showed a significant improvement in the perception of physical health.

Overall, add-on treatment with sonification exercises was feasible in the acute phase of stroke, leading to recovery which tended to be more lasting than in the control group. Motor recovery of upper limb function paralleled an improvement in the perception of physical health.

These results are the basis for a future randomized controlled study on the effect of sonification add-on therapy in the acute phase of stroke.