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NCT Number: NCT07522463

Enhancing Attention and Processing Speed Through Home-based Music Rehabilitation Program After Stroke in Malaysia

Stroke often leads to significant cognitive impairment, impacting quality of life. While existing rehabilitation options exist, there's a need for innovative, accessible, and patient-centered solutions. Research suggests music can engage multiple brain networks associated with sensory and motor processes, cognition, and affective regulation, potentially enhancing cognitive functions like attention and processing speed as well. Home-based interventions have also demonstrated positive impacts on rehabilitation adherence and outcomes. Building on this foundation, this study proposes to develop and pilot test a home-based musical rehabilitation program to improve attention and processing speed in Malaysian stroke survivors.

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Key information

Conditions

Stroke Attention Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Music Intervention Nervous System Diseases Rehabilitation Program Vascular Diseases

Age range

Up to 75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Stroke often leads to significant cognitive impairment, impacting quality of life. While existing rehabilitation options exist, there's a need for innovative, accessible, and patient-centered solutions. Research suggests music can engage multiple brain networks associated with sensory and motor processes, cognition, and affective regulation, potentially enhancing cognitive functions like attention and processing speed as well. Home-based interventions have also demonstrated positive impacts on rehabilitation adherence and outcomes.

Building on this foundation, this study proposes to develop and pilot test a home-based musical rehabilitation program to improve attention and processing speed in Malaysian stroke survivors. Using a randomized controlled trial, the program's feasibility and preliminary effectiveness will be evaluated. Participants will undergo cognitive assessments at baseline, post-intervention, and follow-up, complemented by qualitative data collection to understand patient experience.

The anticipated outcomes include a culturally relevant, accessible home-based program tailored for Malaysian stroke survivors, preliminary evidence on the program's impact on attention and processing speed, insights into its feasibility and acceptability, and a foundation for a larger-scale randomized controlled trial. This research has the potential to transform stroke rehabilitation in Malaysia by offering an innovative, patient-centered approach that utilizes music therapy to enhance cognitive recovery and improve quality of life.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age < 75 years
  • First-episode stroke within the last 12 months
  • Montreal Cognitive Assessment (MoCA) of 15- 25, with impairment defined as failure to achieve the prespecified minimum score on the attention-related MoCA items.
  • Sufficient cognitive ability to follow multi-step instructions
  • Functional use of at least one upper limb to perform musical/rhythmic movements
  • Medically stable with the ability to maintain an upright sitting position with good balance

Exclusion criteria

  • Uncontrolled psychiatric or behavioural disorders that may interfere with participation
  • Uncontrolled seizures or epilepsy
  • Significant aphasia or hemispatial neglect
  • Severe visual or visual field deficits

Treatment and study plan

Musical Home-based Rehabilitation Program

Other

The intervention session will last approximately 40 minutes, comprising: (1) 3-5 minutes of attentional priming; (2) approximately 30 minutes of rhythm-action training; and (3) approximately 5 minutes for rest, feedback and session recording. Participants will complete five sessions per week for four consecutive weeks (20 sessions), consistent with recommendations for intensive, repetitive stroke rehabilitation and previous music-based intervention protocols.⁴¹-⁴³ During rhythm-action training, participants will strike corresponding desk bells in response to visual notation and auditory cues at 60 or 90 beats per minute. Responses will be classified as correct when the appropriate bell is struck within the designated beat interval; errors include incorrect, omitted, additional or mistimed strikes.

Task difficulty will be reviewed weekly and adjusted by varying tempo, rhythmic complexity, number of tones or cueing. Participants will progress after achieving ≥80% accuracy across two cons

Control Group (Standard Care)

Other

Participants in both groups will continue usual multidisciplinary stroke rehabilitation at the Department of Rehabilitation Medicine, UMMC. The intervention group will receive the home-based music rehabilitation programme in addition to usual care, while the control group will receive usual care alone. Outpatient rehabilitation is typically provided twice weekly for approximately 45 minutes per session, with frequency and content individualised according to clinical needs. Cognitive rehabilitation may include attention and memory training, executive function exercises, communication and language therapy, and functional cognitive activities integrated into daily living. Therapy type, frequency and duration will be documented throughout the study.

Primary outcomes

  1. Test of Everyday Attention

    Time frame: 4 months

    Test of Everyday Attention (TEA) is designed for adults aged 18 to 80 years. Rather than a single global scale, it evaluates distinct attentional systems through eight separate subtests, yielding individual raw scores, percentiles, and scaled scores converted via age-normed data.

  2. Trail Making Test (TMT A and B)

    Time frame: 4 months

    Trail Making Tests are tests of speed for attention, sequencing, mental flexibility, visual search, and motor function.

  3. Digit Span (Forward and Backward)

    Time frame: 4 months

    Forward Digit Span (FDS) assesses short-term, auditory memory, while Backward Digit Span (BDS) tests working memory and central executive processing.

  4. Stroop Test

    Time frame: 4 months

    The Stroop test assesses a person's ability to inhibit cognitive interference, measure selective attention, and evaluate processing speed. It requires participants to name the ink color of a written word while ignoring the word's actual meaning (such as naming "blue" when the word "red" is printed in blue ink)

Study contacts

Contact information is provided by the study sponsor or research team.

MAZLINA BINTI MAZLAN, MBBS

CONTACT

[email protected]

+60379675181

NIK SHERINA HAIDI BT HANAFI HANAFI, MBBS

CONTACT

[email protected]

+60379492802

Sponsors and collaborators

Lead sponsor

University of Malaya

Other

Registry information

Official study title

Enhancing Attention and Processing Speed Through Home-based Music Rehabilitation Program After Stroke in Malaysia: A Feasibility Random Controlled Study

Acronym: HMRPAS

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Apr 13, 2026
Registry last updated
Aug 19, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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