title: Music-supported motor training after stroke reveals no superiority of synchronization in group therapy.
abstract: BACKGROUND
  Music-supported therapy has been shown to be an effective tool for rehabilitation of motor deficits after stroke. A unique feature of music performance is that it is inherently social: music can be played together in synchrony.
  
  
  OBJECTIVE
  The present study explored the potential of synchronized music playing during therapy, asking whether synchronized playing could improve fine motor rehabilitation and mood.
  
  
  METHODS
  Twenty-eight patients in neurological early rehabilitation after stroke with no substantial previous musical training were included. Patients learned to play simple finger exercises and familiar children's songs on the piano for 10 sessions of half an hour. Patients first received three individual therapy sessions and then continued in pairs. The patient pairs were divided into two groups. Patients in one group played synchronously (together group) whereas the patients in the other group played one after the other (in-turn group). To assess fine motor skill recovery the patients performed standard clinical tests such as the nine-hole-pegboard test (9HPT) and index finger-tapping speed and regularity, and metronome-paced finger tapping. Patients' mood was established using the Profile of Mood States (POMS).
  
  
  RESULTS
  Both groups showed improvements in fine motor control. In metronome-paced finger tapping, patients in both groups improved significantly. Mood tests revealed reductions in depression and fatigue in both groups. During therapy, patients in the in-turn group rated their partner as more sympathetic than the together-group in a visual-analog scale.
  
  
  CONCLUSIONS
  Our results suggest that music-supported stroke rehabilitation can improve fine motor control and mood not only individually but also in patient pairs. Patients who were playing in turn rather than simultaneously tended to reveal greater improvement in fine motor skill. We speculate that patients in the former group may benefit from the opportunity to learn from observation.
authors.affiliation: Institute of Music Physiology and Musicians' Medicine, University of Music, Drama, and Media Hanover Hanover, Germany ; Lyon Neuroscience Research Center, CNRS-UMR 5292, INSERM U1028, University Claude Bernard Lyon-1 Lyon, France.
authors.forename: Floris T
authors.initials: FT
authors.lastname: Van Vugt
authors.affiliation: Institute of Music Physiology and Musicians' Medicine, University of Music, Drama, and Media Hanover Hanover, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Ritter
authors.affiliation: BDH-Klinik, Institute for Neurorehabilitational Research (InFo), Teaching Hospital of Hanover Medical School Hessisch Oldendorf, Germany.
authors.forename: Jens D
authors.initials: JD
authors.lastname: Rollnik
authors.affiliation: Institute of Music Physiology and Musicians' Medicine, University of Music, Drama, and Media Hanover Hanover, Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Altenmüller
keywords: mood; motor improvement; music therapy; shared experience; social; stroke rehabilitation; synchronization