OBJECTIVES

With the aim of adapting the treatment for its application in the address of the person, the University of Barcelona together with the Institute of Research in Intelligence Artificial of the CSIC work to design an application for electronic tablets that allow:

PROPOSAL

  • The personalization of the exercises, adjusting their difficulty to the needs and the progress of the person.
  • The continuous monitoring of the exercises performed by the person.
  • Incorporation of positive feedback and gamification strategies as a mechanism for improve patient adherence and learning.
  • The incorporation of positive feedback and gamification strategies as a mechanism for improving learning and adherence to treatment.
  • Empowering people to self-regulate treatment sessions.

CAPACITIES

PREDICTIVE

  • Calculate an estimation from the initial participant exploration.
  • Check the prediction, incorporating the performance information from the last session and highlights the session change to the therapists.
  • Combines Case Reasoning (CBR) with regression.

PRESCRIPTIVE

  • Select a subset of the suitable exercises by using a CBR system that, by measuring the clinical and performance similarities, classifies activities according to previous experience.
  • Weighs each activity according to its previous effectiveness.
  • Finally, a linear optimizer is used to generate proposed sessions.
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ACHIEVEMENTS

Project starts

Co-Design

Pilot

Pilot with controls

Controlled study starts


+ 400.000 notes played

+ 500 sessions

+ 35 participants

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PROJECT IMPACTS

Impact on health and social

People who carry out the treatment of Music Support Therapy support can improve their autonomy and participation in the community as well as their quality of life.

Creating knowledge

Researchers on basic neuroscience, neurorehabilitation, and occupational therapy and artificial intelligence work together to create an innovative tool that allows to perform the treatment of Musical Supported therapy at the person's home.

Evidence-based therapy

Efforts to validate this treatment based on scientific studies can be consolidated using the Music Supported Therapy as a cost-effective and easy-to-use tool in the home rehabilitation in people who have suffered stroke.

Ability to build

The constant interaction between researchers of different profiles can increase the participation in new projects and, in particular, promote the training of PhD students and health professionals.

Economic benefits

Facilitate the clinical recommendation of these protocols (based on evidence) by the health, as well as the technology transfer from current protocols to products merchants for neurorehabilitation purposes

STROKE IMPACT

One of the main disability causes

Stroke is one of the most common neurological diseases in our environment and one of the most common main causes of mortality and disability. About 80% of people who suffer stroke have motor problems in the upper limb. These movement problems have impact directly on the person's autonomy to perform daily life activities, affecting the participation in the community and diminished his quality of life.

The motor problems recovery and the person autonomy depend on the rehabilitation, which is defined as a process aimed at allowing people with some disability reach and maintain their functional physical, sensory, intellectual, psychological and social benefits, providing them with tools to achieve independence and self-determination [1]. The rehabilitation after the stroke is a process complex and long in time. In the chronic phase of the disease different studies have been shown that the person needs to carry out activities in order to maintain their own functionality and continue improving [2]. In this sense, there is one increasing need to design and validate new therapeutic interventions that may be perform the chronic phase and be based on scientific evidence.

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THE POTENTIAL REHABILITATOR OF MUSIC

Listening to music, playing an instrument, singing or dancing are musical activities that are present in our daily life. The therapeutic role of these leisure activities is based on the ability to music to provoke emotions and regulate mood. In addition, these activities require precise movements and the perception and integration of auditory, visual, tactile and motor information. At the throughout history, music has been used in the treatment of different diseases. It has been shown that musical activities can:

  • Improve mood [3].
  • Facilitate communication [4].
  • Stimulate cognitive processing [5].
  • Inducing functional and structural plastic changes in different brain related areas auditory processing, movement and cognition [6].

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MUSIC-SUPPORTED THERAPY

Therapy with musical support was developed in 2007 in the laboratory of Dr. Altenmüller at Hanover University of Music, Drama and Media (Hanover, Germany). This therapy aims improve upper limb mobility in people who have suffered a stroke through Do exercises with different musical instruments. The exercises are performed following a protocol of exercises that increase in difficulty and allow the individualization of the treatment taking into account the capabilities of the person. Music support therapy is based on the principles of:

  1. Massive repetition of finger and hand movements.
  2. Audio-motor integration, reinforcing the movement made from the sound.
  3. Treatment individualization and modeling.
  4. Emotional and motivational effects.

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SCIENTIFIC STUDIES ON MUSIC-SUPPORTED THERAPY

Previous studies have shown that Music-Supported Therapy can improve functionality of the upper limb, promote brain plasticity changes and improve mood and quality of life of people who have suffered a stroke. In our country, since 2007, the laboratory of Dr. Rodríguez-Fornells at the University of Barcelona and assigned to IDIBELL investigates the effectiveness of Music-Supported Therapy in the stroke rehabilitation. More than a decade of research in collaboration with the Service of Neurology of the University Hospital of Bellvitge and the Service of Physical Medicine and Rehabilitation of Hospitals of the 'Mar' and 'Esperanza' are included in the following investigations:

  1. Grau-Sánchez J, Duarte E, Ramos-Escobar N, et al. Music-supported therapy in the rehabilitation of subacute stroke patients: a randomized controlled trial. Ann N Y Acad Sci. 2018;1423(1):318-328. doi:10.1111/nyas.13590
  2. Grau-Sánchez J, Ramos N, Duarte E, Särkämö T, Rodríguez-Fornells A. Time course of motor gains induced by music-supported therapy after stroke: An exploratory case study. Neuropsychology. 2017;31(6):624-635. doi:10.1037/neu0000355
  3. Ripollés P, Rojo N, Grau-Sánchez J, et al. Music supported therapy promotes motor plasticity in individuals with chronic stroke. Brain Imaging Behav. 2016;10(4):1289-1307. doi:10.1007/s11682-015-9498-x
  4. François C, Grau-Sánchez J, Duarte E, et al. Musical training as an alternative and effective method for neuro-education and neuro-rehabilitation. Front Psychol. 2015;6:475. doi:10.3389/fpsyg.2015.00475
  5. Amengual JL, Rojo N, Veciana de las Heras M, et al. Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation. PLoS One. 2013;8(4):e61883. doi:10.1371/journal.pone.0061883
  6. Grau-Sánchez J, Amengual JL, Rojo N, et al. Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study. Front Hum Neurosci. 2013;7:494. doi:10.3389/fnhum.2013.00494
  7. Rodriguez-Fornells A, Rojo N, Amengual JL, Ripollés P, Altenmüller E, Münte TF. The involvement of audio-motor coupling in the music-supported therapy applied to stroke patients. Ann N Y Acad Sci. 2012;1252(1):282-293. doi:10.1111/j.1749-6632.2011.06425.x
  8. Rojo N, Amengual J, Juncadella M, et al. Music-supported therapy induces plasticity in the sensorimotor cortex in chronic stroke: a single-case study using multimodal imaging (fMRI-TMS) . Brain Inj. 2011;25(7-8):787-793. doi:10.3109/02699052.2011.576305
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CONTACT

AI Learning System Department Group: arcos@iiia.csic.es

Brainvitge Music Therapy Group: brainvitge.musictherapy@gmail.com