Musical neglect training for unilateral visual neglect in right hemispheric stroke patients
Date
2015
Authors
Kang, Kyurim, author
Thaut, Michael, advisor
LaGasse, Blythe, committee member
Fails, Anna, committee member
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Abstract
The purpose of this study was to examine the immediate and longer-lasting effect of Musical Neglect Training (MNT) on unilateral visual neglect. A single-subject design was used, as participants served as their own control. Two individuals participated in this study. Participants underwent two weekly 30-minute individual sessions over a time period of three weeks, for a total of six MNT sessions for each participant. Two standardized assessments (Albert's and Line Bisection Test) were used. The assessments were administered immediately before and after each of the 6 MNT sessions to assess the immediate effect of MNT. During the training, participants played a set of horizontally arranged tone bars tuned to an ascending triads and scales. At the endpoint of each sequence a cymbal was positioned and played to give a strong audiovisual target in the left visual field for the participants. The experimenter provided a chordal accompaniment on the keyboard to provide harmonic-rhythmic pacing and to cue continuous playing to the end of the sequence. Follow-up testing was done one week after their 6th session to examine the longer-lasting effects of MNT. Paired t-tests were used to test for statistical improvement between pre- and post-test of interventions (immediate effects). Also, nonparametric statistics (Wilcoxon) was also calculated in parallel with the paired t-tests due to the small sample size and possible violations of normal distribution. For the longer-lasting effects, raw data were compared between the average of 6 sessions’ pre-test and follow-up test since there was only one follow-up test. Both participants showed statistical improvement with Albert's Test in the immediate effect (Participant 1: p=.02, Participant 2: p=.01). Results for the immediate effect of MNT on the Line Bisection Test were not significantly different, but means were lower for post-test (Participant 1: M=24.17%, Participant 2: M=9.16%) compared to pre-test (Participant 1: M=25.65%, Participant 2: M=10.39%), indicating positive improvement. Although not statistically significant for the longer-lasting effect, participant 2 had a lower score (score=7) compared to averaged pretest scores of the 6 treatment sessions (M=9.5), indicating a positive outcome, while participant 1 was unchanged at follow-up score (score=14) compared to the pretest average (M=14.5) in the Albert’s Test. Moreover, participant 1 showed increased deviation percentages from the averaged pre-test (M=25.65%) to follow-up test (deviation =27.18%), indicating no positive effect for the longer-lasting effect in the Line Bisection Test. Participant 2 showed a decreased deviation in follow-up score (deviation=7.70%) compared to averaged pre-test score (M=10.39%). The study indicates MNT as a potentially positive intervention for clients with unilateral visual neglect. Future research should employ this music-based intervention with clients in subacute recovery stages post stroke. Furthermore, developing the intervention protocol with increased duration and a higher number of sessions may result in stronger results. Based on the results from this study and previous studies, research focusing on the underlying neural mechanism and tailoring the intervention protocol appropriately to the clinical situation is warranted.
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Subject
cognitive rehabilitation
musical neglect training (MNT)
neurological music therapy (NMT)
right hemisphere stroke
visual neglect