Efficacy of music-based telerehabilitation after stroke: protocol description of a randomised controlled trial.

introductionWith the rapid ageing of the population, the prevalence and public health burden of stroke continue to rise. Many patients are left without sufficient access to multidisciplinary rehabilitation that addresses the complexity of stroke symptoms, including deficits in motor, cognitive and verbal functioning as well as emotional well-being. Several music-based rehabilitation methods, such as instrument playing, rhythm exercises, singing and music listening, have shown promising effects across these domains. In addition, interest in stroke telerehabilitation has grown as a way to improve accessibility and efficiency of rehabilitation when healthcare resources are limited. However, the effectiveness and usability of a multidimensional, music-based telerehabilitation programme for stroke recovery have not yet been systematically investigated. In the present project, we (1) developed a novel music-based telerehabilitation programme for patients who had a stroke, which combines different music-based rehabilitation methods (singing, playing, rhythmic movement, music listening); (2) evaluate whether the programme can enhance verbal, motor, cognitive and emotional recovery and induce structural and functional neuroplasticity changes in patients who had a stroke; and (3) explore how patients' clinical and demographic factors, musical background and current post-stroke musical skills affect the programme's efficacy. METHODS AND ANALYSIS: In this parallel-group randomised controlled trial, 100 patients who had a stroke recruited from Southern Finland receive either the music-based telerehabilitation programme (10 weeks, 5 days/week, 60 min/day) or standard care and rehabilitation. Participants in the music intervention group are assigned according to lesion laterality either to singing-based (left-hemisphere stroke) or playing-based (right-hemisphere stroke) training. Both subgroups receive rhythm-based training targeting cognitive deficits and music listening targeting emotional well-being. Efficacy is assessed over a 6-month follow-up period using standardised verbal, motor and neuropsychological tests; questionnaires on mood, daily functioning and quality of life; and structural and functional MRI. Clinical and demographic background information as well as musical abilities are assessed at baseline. ETHICS AND DISSEMINATION: Ethical approval has been obtained in Finland 12/24. Results will be presented in international and national conferences and published in international scientific journals and in journals for clinical professionals and patient associations in Finland. TRIAL REGISTRATION NUMBER: NCT06804304.