title: The effects of a rhythm and music-based therapy program and therapeutic riding in late recovery phase following stroke: a study protocol for a three-armed randomized controlled trial.
abstract: BACKGROUND
  Stroke represents one of the most costly and long-term disabling conditions in adulthood worldwide and there is a need to determine the effectiveness of rehabilitation programs in the late phase after stroke. Limited scientific support exists for training incorporating rhythm and music as well as therapeutic riding and well-designed trials to determine the effectiveness of these treatment modalities are warranted.
  
  
  METHODS
  A single blinded three-armed randomized controlled trial is described with the aim to evaluate whether it is possible to improve the overall health status and functioning of individuals in the late phase of stroke (1-5 years after stroke) through a rhythm and music-based therapy program or therapeutic riding. About 120 individuals will be consecutively and randomly allocated to one of three groups: (T1) rhythm and music-based therapy program; (T2) therapeutic riding; or (T3) control group receiving the T1 training program a year later. Evaluation is conducted prior to and after the 12-week long intervention as well as three and six months later. The evaluation comprises a comprehensive functional and cognitive assessment (both qualitative and quantitative), and questionnaires. Based on the International classification of functioning, disability, and health (ICF), the outcome measures are classified into six comprehensive domains, with participation as the primary outcome measure assessed by the Stroke Impact Scale (SIS, version 2.0.). The secondary outcome measures are grouped within the following domains: body function, activity, environmental factors and personal factors. Life satisfaction and health related quality of life constitute an additional domain.
  
  
  RESULTS
  A total of 84 participants were randomised and have completed the intervention. Recruitment proceeds and follow-up is on-going, trial results are expected in early 2014.
  
  
  CONCLUSIONS
  This study will ascertain whether any of the two intervention programs can improve overall health status and functioning in the late phase of stroke. A positive outcome would increase the scientific basis for the use of such interventions in the late phase after stroke.
  
  
  BACKGROUND
  Clinical Trials.gov Identifier: NCT01372059.
authors.affiliation: Center for Brain Repair and Rehabilitation, Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Lina
authors.initials: L
authors.lastname: Bunketorp Käll
authors.forename: Åsa
authors.initials: Å
authors.lastname: Lundgren-Nilsson
authors.forename: Christian
authors.initials: C
authors.lastname: Blomstrand
authors.forename: Marcela
authors.initials: M
authors.lastname: Pekna
authors.forename: Milos
authors.initials: M
authors.lastname: Pekny
authors.forename: Michael
authors.initials: M
authors.lastname: Nilsson
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D056147:Equine-Assisted Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009147:Music Therapy; D011788:Quality of Life; D020127:Recovery of Function; D012649:Self Concept; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome