Impact of Non-traditional Guitar Group Instruction on Functional Movement and Well-being in Parkinson's Disease Patients
Condition: Parkinson's Disease
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      This controlled prospective cohort study is designed to assess the feasibility and effect of
      twice-weekly 60 minute non-traditional guitar classes on PD patient's self-reported and
      measurable outcomes including upper extremity function, motor findings, quality of life,
      mood, and cognitive findings. 24-30 individuals with PD will be randomly assigned to an
      early-start and a late-start guitar instruction group. Prior to conducting a larger study,
      this study seeks to assess the possibility that participation in an instrumental performance
      activity in a group setting may improve outcomes in PD patients.
    

Detailed description: 
      PROBLEM STATEMENT: Engagement in musical activities has been found to improve symptoms in
      individuals with Parkinson's disease (PD), and physical therapy and music therapy have been
      demonstrated as viable non-pharmacological intervention methods that improve motor function
      in these individuals. Therapeutic instrumental music performance has the attributes of
      physical, rhythmic and social engagement combined with immediate auditory feedback, and has
      the potential to bring in additional neuro-rehabilitative effects associated with musical
      engagement into a treatment design. However, until now, much of the research has focused on
      the rhythmic aspects of music. Few studies have examined how active and complex engagement
      with music, such as learning to play an instrument, may help PD patients. Finger-style guitar
      instruction has the potential to improve bilateral dexterity in addition to other gains
      reported with music-based interventions in patients with PD.

      PURPOSE: The purpose of this pilot controlled prospective cohort study is to assess the
      feasibility and the effects of non-traditional finger-style guitar classes on the quality of
      life, motor symptoms, upper extremity function, cognition, mood and social participation in
      individuals with PD.

      HYPOTHESIS: The investigators hypothesize that a 6-week bi-weekly finger-style guitar group
      intervention (12 sessions in total) in addition to usual and routine treatment will be a
      feasible intervention in patients with Parkinson's Disease (PD), and both immediate and
      delayed start groups, of PD patients who participate in a twice-weekly non-traditional guitar
      class training for 6 weeks will have unchanged or improved upper extremity function and
      dexterity, improved quality of life and mood.

      IMPORTANCE: The estimated overall prevalence of PD in the world is 315 per 100,000
      individuals overall, and about 2 per 100 individuals 60 years of age or older, with higher
      estimates for older individuals living in North America, Europe and Australia. PD prevalence
      in the United States is projected to rise by 77% between 2010 and 2030. Music and
      rhythm-based interventions are noninvasive, patient-oriented techniques that lack side
      effects. The guitar is the most popular played instrument in the U.S, and it is the principal
      instrument of choice for music therapists. It is affordable and portable, with easy access to
      commercial instruction. Non-traditional engagement in finger-style music making on the guitar
      may have a broad impact on PD by improving the quality of functional upper extremity
      movements, decreasing the amplitude of involuntary movements, increasing social and cognitive
      participation in activities of daily living, and improving quality of life.
    

Intervention name(s): Non-traditional group guitar instruction
Intervention type(s): Other
Intervention description(s): A 6-week curriculum for non-traditional training in finger-style guitar has been developed with rhythmic and goal oriented upper extremity and finger movements. Guitar group intervention will be implemented at the Towson campus of the Peabody Preparatory. Intervention approaches will include rhythmic digital grip with finger isolation, goal directed rhythmic reach on the fret-board and rhythmic alternating tap-like digit and hand movements on the guitar. Participants will be provided with the instruments in the group setting without expectation of practice at home.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will be randomly assigned to early-start or late start guitar groups. Following baseline assessment week, the early-start group will receive twice-weekly non traditional guitar instruction for 6 weeks. The late-start guitar group will receive same intervention after the early-start group complete their 6 week instruction. Study assessments will be conducted during week 7 and week 14. Follow up assessment will be conducted in week 20.
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Parkinson's; Non-traditional guitar instruction; Guitar therapy; Upper extremity motor function; Hand dexterity