Effect of Incorporating Playing the Piano in Occupational Therapy Treatment to Improve Muscle Strength of Upper Extremity and Hand Dexterity in Stroke

Abstract

This research was a quasi-experimental research to study the effect of incorporating playing the piano in occupational therapy treatment to improve muscle strength of upper extremity and hand dexterity in stroke. Fifty participants with stroke aged between 40-70 years had dominant and weakness of right side, the muscle strength of the weakness side score 4. Without dementia and depression. Patients with stroke were divided into two groups to compare the muscle strength of upper extremity and hand dexterity scores before and after and between groups. The experimental group received playing the piano program of 25 minutes and occupational therapy treatment  program of 25 minutes, (including 50 minutes) 3 days per week for 8 consecutive weeks. The control group received only occupational therapy treatment program of 50 minutes 3 days per week for 8 consecutive weeks, using the Manual Muscle Test (MMT), Grip Strength Test (GST), Pinch Strength Test (PST), gross manual dexterity Minnesota Manual Dexterity Test (MMDT), fine manual dexterity Purdue Pegboard Test (PPT) and Grooved Pegboard Test (GPT). The data were analyzed using Mann-Whitney U Test and Wilcoxon Signed Rank Test

After receiving the incorporating playing the piano in occupational therapy treatment program had improved muscle strength  and dexterity of right hand scores were significantly higher than the control group that received only occupational therapy treatment program as assessed by GST (49.92±5.90 vs 46.44±3.48), PST (10.64±1.35 vs 9.76± .87) , increasing the dexterity and increasing the numbers of pins as assessed by PPT in item Right hand (9.96±1.69 vs 8.96± .84), Both hands (9.88±1.56 vs 8.96± .84), Right, Left, Both Hands (32.24±3.23 vs 30.16±3.05), Assembly (15.36± .86 vs 14.40±1.52), increasing the dexterity and decreasing of time as assessed by MMDT in item  Placing (147.24±5.34 vs 151.48±7.48), Turning (179.36±9.20 vs 184.08±8.66)  and GPT (127.40±3.06 vs 130.44±3.83). When comparing before and after of experimental group was found that the muscle strength and hand dexterity scores were significantly higher than before the experiment. While the score of muscle strength of upper extremity, there is only one test as assessed by MMT (4.00± .00 vs4.00± .00) found that no difference between the groups or before the experiment.