Sensomotorische Reintegration nach Schlaganfällen durch Klavierspiel

Ausführlicher englischer Informationstext:

Previous studies have shown that only three weeks of piano training can induce neuronal representations of skilled finger movements activated by auditory stimulation (Bangert & Altenmüller, 2003; Bangert et al., 2006). This study investigated whether or not such a cross-modal mechanism for auditory sensorimotor integration can be employed in the rehabilitation of motor functions following a stroke (Schneider et al., submitted).

We evaluated a music-supported training program designed to induce an auditory sensorimotor co-representation of movements in stroke patients. Patients without any previous musical experience participated in an intensive step-by-step training that began with the paretic extremity and was followed by training of both extremities. Training was applied 15 times over 3 weeks in addition to conventional treatment. Fine as well as gross motor skills were addressed by using either a MIDI-piano or electronic drum pads. Other stroke patients undergoing exclusively conventional therapies were recruited as a control group. Behavioral pre- and post-treatment motor functions were monitored using a computerized movement analysis system and an established array of motor tests. To investigate the activity of cortical regions in the control of movement, we studied event-related desynchronization/synchronization (ERD/ERS) and event-related coherences from all patients performing self-paced movements of the right index finger (MIDI-piano) and of the whole arm (drum pads).

Patients displayed significant improvement after training with respect to speed, precision, and smoothness of movements as shown by 3D movement analysis and clinical motor tests. Furthermore, compared to the control patients, motor control in everyday activities improved significantly. Neurophysiological data showed a significantly larger decrease of EEG signal (power) before time of movement onset in the music-supported training group in the post-training register, which is associated with increased corticospinal excitability, whereas there were almost no differences in the control group. The music-supported training group presented a pronounced enhancement of the coherences after the training compared to the control group, especially in using the drum pads. This innovative therapeutic strategy is an effective approach for the motor skill neuro-rehabilitation of stroke patients.