Invited: Brain and Music: Piano-like Skill Learning for Stroke Rehabilitation

Stroke is one of the most common causes of physical disability worldwide and the majority of people with stroke experience impairment of movement. Lesions to the motor cortex and the corticospinal tract areas following a stroke cause deficits in generating isolated finger movements and thus limiting basic daily functions. Unfortunately, conventional rehabilitation strategies fail to improve hand dexterity in the chronic stage of the stroke. In my talk, I’ll show and discuss how novel motor skill training might help restore the ability to improve finger dexterity in people with chronic stroke.

People with chronic stroke first underwent baseline assessments of hand function, impairment and hand dexterity. Then, participants were trained for 5 consecutive days on a piano chord-like task in which they simultaneously pressed two or three digits while keeping all other fingers at rest. Task’s difficulty was individualized for each patient based on the baseline performance. We used reinforcement strategies to insure high level of motivation. To test retention and generalization following training, participants underwent post-training assessments one day and one week after finishing training.

Our data show that chronic strokes could significantly improve finger individuation. We have found enhanced clinical hand function, and that this improvement was correlated with improved finger individuation. The generalization to motor hand functions, like pinch precision, suggests that training improved movement quality rather than task-specific improvement. Our finding suggests a novel training protocol that could be used clinically to help improve finger dexterity and reduce abnormal flexion synergy in people with chronic stroke.