Music-supported therapy in the rehabilitation of subacute stroke patients: A randomized controlled trial

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Introduction/Background: Music-supported therapy (MST) has been developed as a tool in neurorehabilitation to restore hemiparesis of the upper extremity after a stroke based on the ability of music training to promote brain plasticity. However, the effects of MST have not been appropriately contrasted with conventional therapy. The aim of this trial was to test the effectiveness of adding MST to a standard rehabilitation program in subacute stroke patients. Material and method: A two-arm, parallel-group controlled trial was conducted where 40 patients in the first 6 months from the stroke onset were randomly allocated to conventional treatment (CT-group, n=20) or MST treatment (MST-group, n=20) in addition to the rehabilitation program. Before and after 4 weeks of treatment, patients were evaluated on four domains: motor functions, cognitive functions, mood and quality of life, and brain plasticity assessed with functional Magnetic Resonance Imaging (fMRI). A follow-up at 3 months was conducted to examine the evolution of the motor gains. Results: Both groups significantly improved their motor function, and no differences between groups were found. The only difference between groups was observed in the language domain for quality of life. Importantly, an association was encountered between the capacity to experience pleasure from music activities and the motor improvement in the MST-group. A pattern of intrahemispheric reorganization in motor-related areas was observed in both groups, being more prominent in the MST-group. Conclusion: MST as an add-on treatment showed no superiority to conventional therapies for motor recovery with a similar pattern of plastic changes. Importantly, patient's intrinsic motivation to engage in musical activities was associated to better motor improvement. Trial registration NCT02208219.