Therapeutic Instrumental Music Training and Sensory-enhanced Motor Imagery in Chronic Post-stroke Upper-extremity Rehabilitation: A Randomized Controlled Trial
Bibliographic record
Abstract
Objectives: To investigate the effectiveness of Therapeutic Instrumental Music Performance (TIMP) training, with or without motor imagery, in upper-extremity rehabilitation for individuals with chronic, post-stroke hemiparesis. Secondary objectives investigate effects of interventions on cognition and affect. Methods: Two baseline assessments, a minimum of one week apart; one final assessment. Nine interventions (3x/wk for 3 wks), facilitated by a qualified Neurologic Music Therapist. Thirty participants were randomized to one of three groups: 45 minutes of active TIMP; 30 minutes of TIMP followed by 15 minutes of metronome-cued motor imagery (TIMP+cMI); 30 minutes of TIMP followed by 15 minutes of motor imagery without cues (TIMP+MI). A selection of acoustic and electronic instruments was used. Results: Thirty participants completed the protocol, ten per arm [14 women; mean age= 55.9; mean time post-stroke= 66.9 months]. Pooled group baseline measures did not significantly differ. There were significant improvements from pre-test 2 to post-test for all groups on the Fugl-Meyer-Upper Extremity (FM-UE) and the Wolf Motor Function Test-Functional Ability Scale (WMFT-FAS), and for TIMP and TIMP+MI on the Motor Activity Log (MAL)-Amount of Use Scale. Comparing percent change differences between groups, TIMP (mean rank = 21.05) scored significantly higher than TIMP+cMI (mean rank = 11.00, p = .032) on the FM-UE. There were no significant percentage change differences between TIMP and TIMP+MI. The TIMP+MI group showed a significant change on the Trail Making Test (TMT)–Part B. The TIMP group showed a significant increase on the Multiple Affect Adjective Checklist (MAACL) Sensation Seeking scale and the Valence and Dominance portions of the Self-Assessment Manikin (SAM); TIMP+cMI showed respective increases and decreases in positive and negative affect on the MAACL, as well as an increase in Valence, Dominance, and Arousal portions of the SAM. There was no statistically significant association between cognitive and affective measures. Conclusions: Implementation of TIMP-based techniques led to significant improvements in paretic arm control. TIMP and TIMP+MI showed greater benefits than TIMP+cMI, suggesting that synchronizing internal and external cues during cMI may pose additional sensory integration challenges. TIMP+MI appeared to increase mental flexibility, while active TIMP interventions appeared to enhance positive affect. Trial Registration: ClinicalTrials NCT03246217
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".