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. 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.

Inclusion criteria

• Diagnosed with ischemic or haemorrhagic stroke confirmed by CT scan
• 18 to 70 years old
• Duration of stroke within the first one year
• Ability to provide informed consent
• Understands Bahasa Melayu or English with basic communication abilities to follow instructions during therapy sessions
• Mild to moderate cognitive impairments with MoCA score of 10-25, with incomplete score for the attention sections
• Availability of caregiver (formal or informal) who can assist in the music therapy, monitor and give feedback during the music therapy sessions at home
• Have one normal functioning hand to perform the movements during the music therapy rehabilitation program
• Have good balance and able to sit upright

Exclusion criteria

• Severe aphasia
• Significant uncorrected hearing or visual impairments preventing engagement in music therapy.
• Severe or unstable medical conditions (e.g., uncontrolled hypertension or diabetes).
• Medications that significantly impair cognition or motor function (e.g., high-dose sedatives).
• History of neurological diseases other than stroke (eg, Parkinson's disease).