Optimizing Music-Based Interventions for Stroke Rehabilitation

项目总结：这项研究将解决激励策略的需求，以达到治疗水平 任务重复在卒中后上肢康复中的应用为此，我们正在研究最佳策略 利用音乐增加运动量，改善情绪，增强大脑区域的功能活动 与中风后的运动恢复有关。虽然大多数基于音乐的干预的实证研究都使用固定的 音乐演奏任务，参与者演奏特定的音乐序列，即音乐的临床实践 治疗包括即兴创作，让音乐在瞬间得到调整，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 以音乐为基础的上肢康复干预的即兴表演。在目标1中，我们将描述 成人卒中后偏瘫患者即兴音乐的运动、情感和生理相关性。 我们假设，即兴发挥的增加将与运动活动的增加有关(通过 加速度量学)和增加的影响(通过在每种情况下和 生理唤醒)。在目标2中，我们将使用功能磁共振成像来评估音乐即兴演奏的神经机制。 我们假设，增加的影响和运动输出将得到增加的功能连接的支持 在核心奖赏、动机和情绪相关的皮质下区域和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，该干预措施将利用即兴发挥 最大限度地提高运动恢复率，最大限度地降低磨损率。

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.