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Minghetti A, Widmer M, Viehweger E, Roth R, Gysin R, Keller M. Translating scientific recommendations into reality: a feasibility study using group-based high-intensity functional exercise training in adolescents with cerebral palsy. Disabil Rehabil 2024; 46:4787-4796. [PMID: 38042988 DOI: 10.1080/09638288.2023.2290204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/04/2023]
Abstract
PURPOSE To examine the feasibility and effects of a functional high-intensity exercise intervention performed in a group-setting on functionality, cardiovascular health and physical performance in adolescents with cerebral palsy (CP). METHODS Ten adolescents with a diagnosis of CP (2 females; 16.6 ± 3.4 years; GMFCS: I-II) participated in a 12-week training intervention, containing progressive resistance training using free weights and high-intensity workouts twice a week. The six-minute walking test, arterial stiffness and physical performance (strength and power tests) were measured before and after the intervention. RESULTS No adverse events were reported. We measured small increases in the six-minute walking test (Δ = 28.8 m, 95% CI [-1.78;52.7]; g = 0.34 [-0.04;0.72]) and a small reduction in arterial stiffness (Δ = -4.65% [-10.90;1.25]; g = -0.46 [-1.36;0.21]). All measures of physical performance increased (0.24 ≤ g ≤ 0.88). CONCLUSION Functional training with free weights in high-functioning adolescents with CP is safe and effective in increasing parameters of physical performance and cardiovascular health. Positively influenced indicators of everyday independence (i.e. strength parameters) showed a transfer into movements of daily life. Concerns about adverse events through high-intensity training in adolescents with CP appear unjustified when training is performed progressively, following basic training principles.
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Affiliation(s)
- Alice Minghetti
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Michèle Widmer
- Neuroorthopaedics and Motion Analysis Unit, Department of Orthopaedics, University Children's Hospital beider Basel, Basel, Switzerland
| | - Elke Viehweger
- Neuroorthopaedics and Motion Analysis Unit, Department of Orthopaedics, University Children's Hospital beider Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Ralf Roth
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Martin Keller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Adar S, Keskin D, Dündar Ü, Toktaş H, Yeşil H, Eroğlu S, Eyvaz N, Beştaş E, Demircan A. Effect of Robotic Rehabilitation on Hand Functions and Quality of Life in Children With Cerebral Palsy: A Prospective Randomized Controlled Study. Am J Phys Med Rehabil 2024; 103:716-723. [PMID: 38320248 DOI: 10.1097/phm.0000000000002430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE This study aimed to examine the impact of robotic hand rehabilitation on hand function and quality of life in children with cerebral palsy. DESIGN Children with cerebral palsy aged 7-16 yrs were divided into robotic rehabilitation ( n = 9) or conventional rehabilitation ( n = 10) groups for hand rehabilitation of 30 sessions. The primary outcomes were the Fugl-Meyer Assessment for Upper Extremity and Box and Block Test. The secondary outcomes were the Manual Ability Classification System, modified Ashworth scale, hand grasp and finger strengths, ABILHAND-Kids, Functional Independence Measure for Children, and PedsQL Quality of Life Inventory-CP Module. RESULTS In the robotic rehabilitation group, a significant improvement was found in all parameters after treatment ( P < 0.05), except for the Functional Independence Measure ( P = 0.081). In the conventional rehabilitation group, there was significant improvement after treatment in the modified Ashworth scale, Fugl-Meyer Assessment for Upper Extremity, hand grasp strength, Box and Block Test, ABILHAND-Kids, and PedsQL Quality of Life Inventory-CP Module ( P < 0.05). Before and after treatment, all outcome parameters in the groups were similar ( P > 0.05). CONCLUSIONS Robotic hand rehabilitation is effective in improving motor function, manual dexterity, spasticity, and quality of life in children with cerebral palsy. However, it was not demonstrated to be superior to conventional rehabilitation.
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Affiliation(s)
- Sevda Adar
- From the Department of Physical Medicine and Rehabilitation, School of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey (SA, DK, ÜD, HT, HY, SE, NE, EB); and Department of Ataturk Vocational School of Health Services, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey (AD)
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Urbina J, Abarca VE, Elias DA. Integration of music-based game approaches with wearable devices for hand neurorehabilitation: a narrative review. J Neuroeng Rehabil 2024; 21:89. [PMID: 38811987 PMCID: PMC11134927 DOI: 10.1186/s12984-024-01379-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Restoring hand functionality is critical for fostering independence in individuals with neurological disorders. Various therapeutic approaches have emerged to address motor function restoration, with music-based therapies demonstrating notable advantages in enhancing neuroplasticity, an integral component of neurorehabilitation. Despite the positive effects observed, there remains a gap in the literature regarding implementing music treatments in neurorehabilitation, such as Neurologic Music Therapy (NMT), especially in conjunction with emerging fields like wearable devices and game-based therapies. METHODS A literature search was conducted in various databases, including PubMed, Scopus, IEEE Xplore, and ACM Digital Library. The search was performed using a literature search methodology based on keywords. Information collected from the studies pertained to the approach used in music therapy, the design of the video games, and the types of wearable devices utilized. RESULTS A total of 158 articles were found, including 39 from PubMed, 34 from IEEE Xplore, 48 from Scopus, 37 from ACM Digital Library, and 35 from other sources. Duplicate entries, of which there were 41, were eliminated. In the first screening phase, 152 papers were screened for title and abstract. Subsequently, 89 articles were removed if they contained at least one exclusion criterion. Sixteen studies were considered after 63 papers had their full texts verified. CONCLUSIONS The convergence of NMT with emerging fields, such as gamification and wearable devices designed for hand functionality, not only expands therapeutic horizons but also lays the groundwork for innovative, personalized approaches to neurorehabilitation. However, challenges persist in effectively incorporating NMT into rehabilitation programs, potentially hindering its effectiveness.
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Affiliation(s)
- Javier Urbina
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, 15008, Lima, Peru
| | - Victoria E Abarca
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, 15008, Lima, Peru.
| | - Dante A Elias
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, 15008, Lima, Peru
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Kang K, Stenum J, Roemmich RT, Heller NH, Jouny C, Pantelyat A. Neurologic music therapy combined with EEG-tDCS for upper motor extremity performance in patients with corticobasal syndrome: Study protocol for a novel approach. Contemp Clin Trials 2023; 125:107058. [PMID: 36549380 DOI: 10.1016/j.cct.2022.107058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Corticobasal syndrome (CBS) is an atypical parkinsonian disorder that involves degeneration of brain regions associated with motor coordination and sensory processing. Combining transcranial direct current stimulation (tDCS) with rehabilitation training has been shown to improve upper-limb performance in other disease models. Here, we describe the protocol investigating whether tDCS with neurologic music therapy (NMT) (patterned sensory enhancement and therapeutic instrumental music performance) enhances functional arm/hand performance in individuals with CBS. METHODS Study participants are randomly assigned to six 30-min sessions (twice per week for 3 weeks) of NMT + either sham tDCS or active tDCS. We aim to stimulate the frontoparietal cortex, which is associated with movement execution/coordination and sensory processing. The hemisphere contralateral to the more affected arm is stimulated (total stimulation current of 2 mA from 5 dime-sized electrodes). Individualized NMT sessions designed to exercise the upper limb are provided. Participants undergo gross/fine motor, cognitive and emotional assessments at baseline and follow-up (one month after the final session). To investigate the immediate effects of tDCS and NMT training, gross /fine motor, affective level, and kinematic parameter measurements using motion sensors are collected before and after each session. Electroencephalography is used to collect electrical neurophysiological responses before, during, and after tDCS+NMT sessions. The study participants, neurologic music therapist and outcome assessor are blinded to whether participants are in the sham or active tDCS group. CONCLUSION This noninvasive and patient-centered clinical trial for CBS may provide insight into rehabilitation options that are sorely lacking in this population.
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Affiliation(s)
- Kyurim Kang
- School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America; Center for Music and Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America
| | - Jan Stenum
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States of America; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Ryan T Roemmich
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States of America; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Nathan H Heller
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
| | - Christophe Jouny
- School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America
| | - Alexander Pantelyat
- School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America; Center for Music and Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America.
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Kim SJ, Shin YK, Jeong E, Cho SR. Movement-specific keyboard playing for hand function in adolescents and young adults with acquired brain injury. Front Neurol 2023; 13:1062615. [PMID: 36698898 PMCID: PMC9868739 DOI: 10.3389/fneur.2022.1062615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/02/2022] [Indexed: 01/11/2023] Open
Abstract
Background Patients with acquired brain injury (ABI) suffer from deficits in fine motor function in hands which affect independent self-care function in daily life. This study aimed to examine the effects of movement-specific keyboard playing for improved hand function in adolescents and young adults with ABI. Method A total of 23 patients with ABI participated in this study. Twelve were assigned to the intervention group and eleven to the control group. The intervention group engaged in movement-specific keyboard playing three to four times a week for 3 weeks in addition to standard care, while the control group received only standard care. Results The results of a mixed model of repeated measures ANOVA showed that the time effects were significant in the functional independence measure, key-pressing force, and most of the hand function tests measured. In terms of the interaction effect between group and time, a significant effect was found only in the checker-stacking task as a subtest of the Jebsen-Talyor Hand Function Test. Discussion These results indicate that the specified movements required to play the keyboard may involve more precise and dexterous manipulation with hands and fingers. These results also suggest that movement-specific keyboard playing has potential in optimizing the intervention effect of keyboard playing while maximizing the benefits of music for motivating young patients with ABI.
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Affiliation(s)
- Soo Ji Kim
- Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul, Republic of Korea,Arts Education Therapy Institute, Ewha Womans University, Seoul, Republic of Korea,*Correspondence: Soo Ji Kim ✉
| | - Yoon-Kyum Shin
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eomhyeong Jeong
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-Rae Cho
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea,Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea,Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea,Sung-Rae Cho ✉
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Yang S, Suh JH, Kwon S, Chang MC. The effect of neurologic music therapy in patients with cerebral palsy: A systematic narrative review. Front Neurol 2022; 13:852277. [PMID: 36176557 PMCID: PMC9514322 DOI: 10.3389/fneur.2022.852277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022] Open
Abstract
Background Cerebral palsy (CP) is one of the most common causes of disability in children. It is characterized by impairment in motor function and coordination and difficulties in performing daily life activities. Previous research supports that neurologic music therapy (NMT) was effective in improving motor function, cognition, and emotional wellbeing in patients with various neurologic disorders. However, the benefit of NMT in patients with CP have not yet been thoroughly investigated. The aim of this review was to investigate the potential effect of NMT motor rehabilitation techniques for patients. Materials and methods We searched articles published up to May 24, 2022 in PubMed, Embase, Scopus, Cochrane library, Web of science, and Ovid MEDLINEdatabases. We included studies that investigated the effect of NMT in patients with CP. Results After search, 4,117 articles were identified using the search terms. After reading the titles and abstracts, 4,089 articles that did not meet our inclusion criteria were excluded. The remaining 28 articles which were assessed for eligibility. Finally, 15 studies were included in this systematic review. Among 15 studies that investigated the effect of NMT on patients with CP, 7 studies were on rhythmic auditory stimulation (RAS), 6 studies were on therapeutic instrumental music performance (TIMP), and 2 studies were on patterned sensory enhancement (PSE). Conclusions Various techniques of NMT brings beneficial effects for gross and fine motor improvements in patients with CP. NMT techniques, such as RAS, TIMP, and PSE, may be a potential alternative rehabilitation strategy to enhance gross and fine motor skills for patients with CP.
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Affiliation(s)
- Seoyon Yang
- Department of Rehabilitation Medicine, College of Medicine, Ewha Woman's University, Seoul, South Korea
| | - Jee Hyun Suh
- Department of Rehabilitation Medicine, College of Medicine, Ewha Woman's University, Seoul, South Korea
| | - SuYeon Kwon
- Department of Rehabilitation Medicine, College of Medicine, Ewha Woman's University, Seoul, South Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea
- *Correspondence: Min Cheol Chang
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Santonja-Medina CS, Marrades-Caballero E, Santonja-Medina F, Sanz-Mengibar JM. Neurologic Music Therapy Improves Participation in Children With Severe Cerebral Palsy. Front Neurol 2022; 13:795533. [PMID: 35356462 PMCID: PMC8959457 DOI: 10.3389/fneur.2022.795533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Positive effects after neurologic music therapy (NMT) have been described regarding the motor function of children with severe cerebral palsy (CP). This study aimed to quantify improvements in participation, as well as complexity on task-related manual activities in children with severe bilateral CP. This analytic quasi-experimental study exposed 17 children with severe cerebral palsy to 13 NMT sessions to improve motor learning through therapeutic instrumental music performance (TIMP), using principally percussion musical instruments. Hoisan software video recording was used to quantify participation involved in creating music. In addition, the number of active movements performed in each NMT session was quantified. Significant improvements were found in the participation variables “visual contact,” “motor participation” and “motor participation repetitions.” Significant differences were also found in the subcategory “reaching and stroke,” “hitting with the hand” and “grasping and hitting.” The use of therapeutic of TIMP in children with severe CP improves participation during manual activities utilizing percussion instruments, therefore increasing the intensity of the psychomotor intervention.
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Affiliation(s)
| | | | - Fernando Santonja-Medina
- Faculty of Medicine and Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
- Department of Traumatology, V. de la Arrixaca University Hospital, Murcia, Spain
- *Correspondence: Fernando Santonja-Medina
| | - Jose Manuel Sanz-Mengibar
- Faculty of Medicine and Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
- Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, United Kingdom
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Braun Janzen T, Koshimori Y, Richard NM, Thaut MH. Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives. Front Hum Neurosci 2022; 15:789467. [PMID: 35111007 PMCID: PMC8801707 DOI: 10.3389/fnhum.2021.789467] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022] Open
Abstract
Research in basic and clinical neuroscience of music conducted over the past decades has begun to uncover music’s high potential as a tool for rehabilitation. Advances in our understanding of how music engages parallel brain networks underpinning sensory and motor processes, arousal, reward, and affective regulation, have laid a sound neuroscientific foundation for the development of theory-driven music interventions that have been systematically tested in clinical settings. Of particular significance in the context of motor rehabilitation is the notion that musical rhythms can entrain movement patterns in patients with movement-related disorders, serving as a continuous time reference that can help regulate movement timing and pace. To date, a significant number of clinical and experimental studies have tested the application of rhythm- and music-based interventions to improve motor functions following central nervous injury and/or degeneration. The goal of this review is to appraise the current state of knowledge on the effectiveness of music and rhythm to modulate movement spatiotemporal patterns and restore motor function. By organizing and providing a critical appraisal of a large body of research, we hope to provide a revised framework for future research on the effectiveness of rhythm- and music-based interventions to restore and (re)train motor function.
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Affiliation(s)
- Thenille Braun Janzen
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil
| | - Yuko Koshimori
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, CAMH, Toronto, ON, Canada
| | - Nicole M. Richard
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Faculty of Music, Belmont University, Nashville, TN, United States
| | - Michael H. Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- *Correspondence: Michael H. Thaut,
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Tramontano M, De Angelis S, Mastrogiacomo S, Princi AA, Ciancarelli I, Frizziero A, Iosa M, Paolucci S, Morone G. Music-based techniques and related devices in neurorehabilitation: a scoping review. Expert Rev Med Devices 2021; 18:733-749. [PMID: 34162284 DOI: 10.1080/17434440.2021.1947793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction:The music as a powerful, and versatile stimulus for the brain, is at the date sometimes used in neurorehabilitation and proposed as a promising complementary strategy provided in combination with other therapy in individuals with neurological disorders. Different techniques and devices have been developed in the field of the music-based neurorehabilitation.Areas covered:This scoping review analyzes the current scientific literature concerning the different techniques and devices used in the music-supported neurorehabilitation, also focusing on the devices used in music-based therapies in patients with neurological disorders: 46 studies met the inclusion criteria and were included.Expert opinion:Included studies, highlight the potentiality and the versatility of the music-based therapy in the rehabilitation of neurological disorders. The variety of existing techniques allow to applied the music-based therapy in different situations and conditions. Moreover, the wide range of used devices that ranging from the simple musical instruments to the more advanced technologies, allows to develop customized exercises based on the needs of the patient. This review may be considered as a starting point to better design future RCTs that would investigate the effectiveness of music therapy on neurological disorders.
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Affiliation(s)
| | | | | | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy.,Department of Psychology, University of Rome La Sapienza, Rome, Italy
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