Optimizing Music-Based Interventions for Stroke Rehabilitation

项目概述：本研究将解决激励策略的需要，以达到治疗水平， 任务重复在脑卒中后上肢康复中应用为此，我们正在研究最佳策略 利用音乐来增加运动活动，改善情绪，增加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干预的实证研究使用固定的 音乐演奏任务，其中参与者播放指定的音乐序列，音乐的临床实践 治疗涉及即兴创作，允许音乐在瞬间进行调整，以反映情感，社会 参与者的身体需求。因此，我们设计了一项研究，以描述 即兴在音乐为基础的干预上肢康复。在目标1中， 中风后轻偏瘫成人音乐即兴的运动、情感和生理相关性。 我们假设即兴创作的增加与运动活动的增加有关（通过测量 加速度计）和增加的影响（通过每种条件下的自我报告调查测量， 生理唤醒）。在目标2中，我们将使用功能磁共振成像评估音乐即兴创作的神经机制。 我们假设情感和运动输出的增加将得到功能连接增加的支持 核心奖励、动机和情绪相关的皮层下区域与皮层运动区和额叶区之间的联系。 这些发现将为最佳的基于音乐的干预奠定基础，这些干预利用即兴创作， 最大化运动恢复和最小化磨损率。

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.