Enhancing motivation through music therapy in subacute stroke rehabilitation: a within-subject crossover study

Objective This study examined motivation as a possible working mechanism for music therapy in stroke rehabilitation. We hypothesised that music therapy would lead to increased motivation for rehabilitation and explored its potential association with improvements in motor and/or functional and subjective (measures of) recovery. Methods Using a randomised within-subject crossover design, sixteen subacute stroke survivors received either Neurologic Music Therapy (NMT) plus standard care, followed by standard care only, or vice versa. The NMT intervention consisted of 6-9 half-hour sessions using Therapeutic Instrumental Music Practice and Music in Attention and Concentration Training. Motivation was assessed using the Brain Injury Rehabilitation Trust Motivation Questionnaire, alongside functional motor, cognitive, and quality of life measures. Results and Conclusions Music Therapy significantly increased motivation (p = .041), with an average increase of 8.72 in motivation scores during NMT plus standard care, while showing a 4.43 decrease during standard care alone. No significant association was found between motivation changes and cognitive or motor outcomes. Despite limitations due to missing data, the study suggests that NMT enhances motivation for rehabilitation in the subacute phase after stroke. Larger-scale studies are needed to evaluate the impact of music therapy-related increases in motivation on recovery.