Examining the Effect of Piano Playing Training on Fine Motor Skills in Parkinson's Patients

Study Overview
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Brief Summary
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Piano playing may provide an engaging and accessible setting for finger and wrist movement training. Moreover, it has been found effective for improving manual dexterity and upper-limb function in other neurologic disorders, such as stroke and additionally beneficial for cognitive and psychosocial support in Parkinson's disease. However, no study has examined the effect of piano playing on dexterity in Parkinson's disease. The aim of this study is to test the efficacy of a novel piano-based training program on fine motor function in patients with PD. Participants with Parkinson's disease will take part in an individually tailored 6-week piano training program, combining weekly supervised training sessions (6x60 min altogether), with three independent at-home weekly 30 minutes practice sessions (18x30 altogether). Participants will receive a piano MIDI keyboard for home use during the study.

Official Title
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Examining the Effect of Piano Playing Training on Fine Motor Skills in Parkinson's Patients

Conditions
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Parkinson Disease

Intervention / Treatment
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* Behavioral: Piano


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Idiopathic Parkinson's Disease patients Hoehn and Yahr stages I to III Self-reports of some dexterity difficulties Exclusion Criteria: Participation in an ongoing clinical study or clinical study within 30 days prior to this study Atypical parkinsonian syndrome or secondary parkinsonism (e.g., due to drugs, metabolic neurogenetic disorders, encephalitis, cerebrovascular disease, or other degenerative disease), or other neurologic conditions influencing upper limb movement Significant psychiatric symptoms or history Significant or recent experience in piano playing (participants who are proficient piano players, or had studied piano for more than 3 years in the past, or for shorter periods in the last 5 years) Other significant fine motor skills (e.g., high proficiency in playing another musical instrument, video games, etc.) Mini Mental status examination (MMSE) score below 25 Significant sensory deficits, e.g., hearing or sight impairment Unstable medical disorder Significant postural or action tremor, moderate dyskinesia

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Open label feasibility study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Research group<br>Receives the full piano training | Behavioral: Piano<br>* Receives the piano training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Box and block test | Number of blocks that can be moved over a barrier using the hand / arm in one minute | First meeting, last meeting (after 6 weeks) | 
| 9 Hole peg test | Time taken to insert 9 pegs into holes and then remove them | First meeting, last meeting (after 6 weeks) | 
| Synergy index | Calculated from a force ramp production task using the fingers with force sensors | First meeting, last meeting (after 6 weeks) | 
| Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor parts II (patient questionnaire) - parts 2.4 to 2.7 and III (motor examination) - parts 3.3 and 3.4 | Standard questionnaire used in Parkinson's disease. Higher scores indicate more impairment. Maximum score for each part is 4, so overall for the 6 parts the maximum score is 24. | First meeting, last meeting (after 6 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quantitative Digitography - Average strike duration | Measure of speed and variability of key presses on a piano - mean of the time the key is pressed | First meeting, last meeting (after 6 weeks) | 
| Quantitative Digitography - Coefficient of variation strike duration | Measure of speed and variability of key presses on a piano - coefficient of variation of the time the key is pressed | First meeting, last meeting (after 6 weeks) | 
| Quantitative Digitography - Average interval between strikes (in seconds) | Measure of speed and variability of key presses on a piano - average time between subsequent key presses | First meeting, last meeting (after 6 weeks) | 
| Quantitative Digitography - Coefficient of variation of interval between strikes | Measure of speed and variability of key presses on a piano - coefficient of variation of the time between subsequent key presses | First meeting, last meeting (after 6 weeks) | 
| Quantitative assessment of piano performance progress | Measurement of improvement in playing the piano - the teacher (rater) will give a score (between 0 and 5) for the level of piano playing of the participant, where 0 is no ability to play and 5 is the ability to play the pieces from the workbook (a beginner's level piano book) perfectly. | First meeting, last meeting (after 6 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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piano, dexterity, music