Optimizing Music-Based Interventions for Stroke Rehabilitation

优化基于音乐的中风康复干预措施

• 批准号: 10607156
• 负责人: Anna M Palumbo
• 金额: $ 3.41万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10607156
• 关键词: Accelerometer; Adult; Affect; Affective; Animal Model; Area; Arousal; Attention; Behavioral; Brain; Brain region; Brain-Derived Neurotrophic Factor; Clinical; Cognitive; Data; Elements; Emotional; Emotions; Exercise; Fatigue; Foundations; Frequencies; Functional Magnetic Resonance Imaging; Goals; Impairment; Individual; Intervention; Link; Measures; Mental Depression; Molecular; Motivation; Motor; Motor Activity; Motor Cortex; Motor output; Movement; Music; Music Therapy; Neurological outcome; Neuronal Plasticity; Outcome; Participant; Patient Self-Report; Physiological; Play; Population; Prefrontal Cortex; Recovery; Rehabilitation therapy; Reporting; Rewards; Sensory; Social Environment; Specific qualifier value; Stroke; Structure; Surveys; Survivors; Testing; Therapeutic; Upper Extremity; Veins; Work; World Health Organization; chronic stroke; clinical practice; conventional therapy; design; disability; environmental enrichment for laboratory animals; experience; hemiparesis; improved; instrumentation; intrinsic motivation; motor recovery; neural; neural correlate; neuromechanism; pleasure; post stroke; response; social; stroke hemiparesis; stroke intervention; stroke patient; stroke rehabilitation; stroke survivor

Project Summary: This study will address the need for motivational strategies to achieve therapeutic levels of task-repetition in upper extremity rehabilitation post-stroke. To this end, we are investigating optimal strategies for utilizing music to increase motor activity, improve affect and increase functional activity in brain areas related to motor recovery post-stroke. While most empirical studies of music-based interventions utilize fixed music-playing tasks in which participants play a specified music sequence, the clinical practice of music therapy involves improvisation, allowing the music to be adjusted in the moment to reflect the emotional, social and physical needs of participants. We have therefore designed a study to characterize the effect of improvisation within music-based interventions for upper extremity rehabilitation. In Aim 1 we will characterize the motor, affective and physiological correlates of music improvisation for adults with post-stroke hemiparesis. We hypothesize that the increased improvisation will be associated with increased motor activity (measured by accelerometry) and increased affect (measured by self-report surveys following each condition and physiological arousal). In Aim 2 we will assess the neural mechanisms of music improvisation by using fMRI. We hypothesize that increased affect and motor output will be supported by increased functional connectivity between core reward, motivation and emotion-related subcortical regions and cortical motor and frontal areas. These findings will lay the foundation for optimal musi-based interventions that capitalize on improvisation to maximize motor recovery and minimize attrition rate.

项目摘要：这项研究将解决对实现治疗水平的动机策略的需求 中风后上肢康复的任务重复。为此，我们正在研究最佳策略 用于利用音乐来增加运动活动，改善影响并增加大脑区域的功能活动 与运动后的运动恢复有关。虽然大多数基于音乐干预措施的经验研究都使用固定 参与者演奏指定音乐序列的音乐播放任务，音乐的临床实践 疗法涉及即兴创作，可以在此刻进行调整，以反映情感，社交 和参与者的身体需求。因此，我们设计了一项研究，以表征 基于音乐的上肢康复的基于音乐的干预措施。在AIM 1中，我们将描述 中风后偏瘫的成年人音乐即兴演奏的运动，情感和生理相关性。 我们假设即兴创作的增加将与运动活动增加有关（通过 加速度计）和增加的影响（通过每个条件后通过自我报告调查来衡量， 生理唤醒）。在AIM 2中，我们将使用fMRI评估音乐即兴创作的神经机制。 我们假设增加的情感和电动机输出将由功能连通性提高支持 在核心奖励，动机和情感相关的皮层区域以及皮质运动和额叶区域之间。 这些发现将为基于Musi的最佳干预措施奠定基础，这些干预措施利用即兴创作 最大化电机恢复并最小化流失率。