title: Improving hand functional use in subjects with multiple sclerosis using a musical keyboard: a randomized controlled trial.
abstract: OBJECTIVE
  Playing an instrument implies neuroplasticity in different cerebral regions. This phenomenon has been described in subjects with stroke, suggesting that it could play a role in hand rehabilitation. The aim of this study is to analyse the effectiveness of playing a musical keyboard in improving hand function in subjects with multiple sclerosis.
  
  
  METHODS
  Nineteen hospitalized subjects were randomized in two groups: nine played a turned-on musical keyboard by sequences of fingers movements (audio feedback present) and 10 performed the same exercises on a turned-off musical keyboard (audio feedback absent). Training duration was half an hour per day for 15 days. Primary outcome was the perceived hand functional use measured by ABILHAND Questionnaire. Secondary outcomes were hand dexterity, measured by Nine-Hole Peg Test, and hand strength, measured by Jamar and Pinch dynamometers. Two-way analysis of variance was used for data analysis.
  
  
  RESULTS
  The interaction time × group was significant (p = 0.003) for ABILHAND Questionnaire in favour of experimental group (mean between-group difference 0.99 logit [IC95%: 0.44; 1.54]). The two groups showed a significant time effect for all outcomes except for Jamar measure.
  
  
  CONCLUSIONS
  Playing a musical keyboard seems a valid method to train the functional use of hands in subjects with multiple sclerosis.
authors.affiliation: Department of Neurorehabilitation, San Raffaele Hospital, Milan, Italy.|School of Physiotherapy, Vita-Salute San Raffaele University, Milan, Italy.|Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gatti
authors.affiliation: Department of Neurorehabilitation, San Raffaele Hospital, Milan, Italy.|School of Physiotherapy, Vita-Salute San Raffaele University, Milan, Italy.|Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tettamanti
authors.affiliation: Department of Neurorehabilitation, San Raffaele Hospital, Milan, Italy.|School of Physiotherapy, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Lambiase
authors.affiliation: Department of Neurorehabilitation, San Raffaele Hospital, Milan, Italy.|Brissago Rehabilitation Centre, Hildebrand Clinic, Brissago, Switzerland.
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossi
authors.affiliation: Department of Neurorehabilitation, San Raffaele Hospital, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Comola
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D056228:Feedback, Sensory / Q000502:physiology; D005260:Female; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D053581:Muscle Strength Dynamometer; D009146:Music; D009147:Music Therapy / Q000295:instrumentation*; D026741:Physical Therapy Modalities; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: ADL; hand function; multiple sclerosis; music therapy