Effect of Virtual Reality-Based Music Therapy on Cognitive and Motor Skills in Subacute Stroke Patients

NCT ID: NCT07010536

Last Updated: 2025-06-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-22

Study Completion Date

2025-12-20

Brief Summary

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This clinical trial aims to investigate the effects of immersive virtual reality-based music therapy on cognitive and motor functions in individuals aged 50 to 75 years with subacute stroke (between 2 weeks and 6 months post-stroke). Participants will be randomly assigned to either a control group receiving conventional physiotherapy or an experimental group receiving conventional physiotherapy plus virtual reality-based music therapy.

The study will assess cognitive performance, upper extremity motor skills, stroke impact, balance, and spatial neglect before and after a 6-week intervention. All participants will be treated at Istanbul Aydın University VM Medical Park Hospital. The study has been approved by the ethics committee, and written informed consent will be obtained from all participants.

Detailed Description

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This is a single-center, single bilind, randomized, controlled, prospective clinical trial designed to evaluate the effects of immersive virtual reality (VR)-based music therapy on cognitive functions, upper extremity motor skills, stroke impact, balance, and spatial neglect in patients with subacute stroke. The study targets individuals aged between 50 and 75 years who have experienced a stroke within the previous 2 weeks to 6 months. All participants will be recruited from Istanbul Aydın University VM Medical Park Hospital.

Participants will be stratified based on the side of hemispheric damage (right or left) and randomized into two equal groups (n=15 per group). The control group will receive conventional physiotherapy and rehabilitation 5 days per week for 6 weeks. The experimental group will receive the same conventional physiotherapy program along with additional immersive VR-based music therapy sessions twice a week. These VR sessions involve rhythm-based and music-supported tasks delivered through Oculus Quest 2 applications, including Ocean Rift and PianoVision.

Assessments will be performed at baseline and after the 6-week intervention period. Cognitive function will be assessed using standardized neuropsychological tools, and motor function will be evaluated through established stroke motor recovery scales. The Virtual Reality Sickness Questionnaire (VRSQ) will be administered after the first VR session to monitor adverse effects such as dizziness or nausea.

This trial adopts a stratified randomization method to enhance internal validity by balancing brain hemisphere involvement across groups. A power analysis conducted using G\*Power (version 3.1) determined a sample size of 30 participants based on an effect size reported by Fan et al. (2024), with 95% power and α=0.05. The study protocol has been approved by the Non-Interventional Research Ethics Committee of Üsküdar University (Approval No: 61351342/020-1000, Date: March 27, 2025). Written informed consent will be obtained from all participants before enrollment.

Conditions

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Stroke Subacute Stroke Virtual Reality Immersive Virtual Reality Cognitive Dysfunction Motor Impairment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly assigned to two parallel groups: a control group receiving only conventional physiotherapy, and an experimental group receiving conventional physiotherapy combined with immersive virtual reality-based music therapy. Both groups will receive interventions for 6 weeks, and outcomes will be compared between groups.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Outcome assessors are blinded to group allocation. Participants and care providers are not blinded due to the nature of the interventions.

Study Groups

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Conventional Physiotherapy and Rehabilitation Group

Participants in the control arm will receive conventional physiotherapy and rehabilitation exercises five days per week for six weeks, with sessions lasting approximately 60 minutes. The program includes:

Strengthening exercises for upper and lower extremities

Resistance training

Aerobic exercises

Basic and assisted parallel bar walking

Skill courses on different surfaces

Balance exercises on stable and unstable surfaces

Static and dynamic balance training

Fine motor skill exercises

Weight transfer exercises aimed at improving postural stability

Exercises will be tailored to individual patient capabilities and performed in various positions including standing, sitting, four-point kneeling, supine, and prone. The difficulty level will be adjusted based on patient performance and functional status.

Group Type ACTIVE_COMPARATOR

Conventional Physiotherapy and Rehabilitation

Intervention Type BEHAVIORAL

Participants will receive conventional physiotherapy and rehabilitation exercises as follows:

Upper and lower extremity strengthening exercises

Resistance training exercises

Aerobic exercises

Basic and assisted parallel bar walking

Skill courses on various surfaces

Training on stable and unstable surfaces

Static and dynamic balance exercises

Fine motor skill exercises

Weight transfer exercises to improve postural stability

Exercises will be performed according to the patient's condition in standing, sitting, four-point kneeling, supine, and prone positions.

Exercise difficulty will be adjusted based on the patient's performance and functional level.

Sessions will be 60 minutes long, 5 days per week, for 6 weeks.

VR-Based Music Therapy Group

Participants in the experimental arm will receive conventional physiotherapy and rehabilitation exercises five days per week for six weeks, each session lasting approximately 60 minutes. In addition to this, they will undergo immersive virtual reality (VR)-based music therapy sessions twice a week for 30 minutes per session over the same six-week period.

The VR therapy is administered under the supervision of a licensed physiotherapist using the Oculus Quest 2 headset. The intervention includes three main components:

Rhythm Exercises: Participants will engage in rhythm training by following clapping patterns streamed from the Brooklyn Music Factory YouTube channel, progressing from levels 1 to 4. During these exercises, participants clap their hands on a table to maintain the rhythm, which aims to improve motor coordination and timing.

PianoVision Application: A virtual piano that utilizes hand-tracking technology to allow participants to play without physical controllers. The pian

Group Type EXPERIMENTAL

VR-Based Music Therapy

Intervention Type BEHAVIORAL

VR-Based Music Therapy Protocol:

Participants undergo immersive VR sessions twice weekly for 6 weeks, each lasting 30 minutes, supervised by a physiotherapist. Each session includes three 10-minute activities with 2-minute breaks:

Rhythm Exercises: Participants follow tempo by clapping on a table while watching Brooklyn Music Factory YouTube videos played within the VR headset (levels 1-4), progressing weekly.

Ocean Rift: Exploration of calming underwater environments with marine life to enhance relaxation, attention, and cognition.

PianoVision: Virtual piano exercises using hand tracking with the unaffected hand; difficulty increases from levels 0 to 4.

Conventional Physiotherapy and Rehabilitation

Intervention Type BEHAVIORAL

Participants will receive conventional physiotherapy and rehabilitation exercises as follows:

Upper and lower extremity strengthening exercises

Resistance training exercises

Aerobic exercises

Basic and assisted parallel bar walking

Skill courses on various surfaces

Training on stable and unstable surfaces

Static and dynamic balance exercises

Fine motor skill exercises

Weight transfer exercises to improve postural stability

Exercises will be performed according to the patient's condition in standing, sitting, four-point kneeling, supine, and prone positions.

Exercise difficulty will be adjusted based on the patient's performance and functional level.

Sessions will be 60 minutes long, 5 days per week, for 6 weeks.

Interventions

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VR-Based Music Therapy

VR-Based Music Therapy Protocol:

Participants undergo immersive VR sessions twice weekly for 6 weeks, each lasting 30 minutes, supervised by a physiotherapist. Each session includes three 10-minute activities with 2-minute breaks:

Rhythm Exercises: Participants follow tempo by clapping on a table while watching Brooklyn Music Factory YouTube videos played within the VR headset (levels 1-4), progressing weekly.

Ocean Rift: Exploration of calming underwater environments with marine life to enhance relaxation, attention, and cognition.

PianoVision: Virtual piano exercises using hand tracking with the unaffected hand; difficulty increases from levels 0 to 4.

Intervention Type BEHAVIORAL

Conventional Physiotherapy and Rehabilitation

Participants will receive conventional physiotherapy and rehabilitation exercises as follows:

Upper and lower extremity strengthening exercises

Resistance training exercises

Aerobic exercises

Basic and assisted parallel bar walking

Skill courses on various surfaces

Training on stable and unstable surfaces

Static and dynamic balance exercises

Fine motor skill exercises

Weight transfer exercises to improve postural stability

Exercises will be performed according to the patient's condition in standing, sitting, four-point kneeling, supine, and prone positions.

Exercise difficulty will be adjusted based on the patient's performance and functional level.

Sessions will be 60 minutes long, 5 days per week, for 6 weeks.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Voluntary participation
* Age between 50 and 75 years
* Stroke onset more than 2 weeks and less than 6 months prior
* Diagnosis of unilateral hemiplegic stroke
* Preserved understanding, hearing, and speech abilities sufficient to engage with virtual reality games

Exclusion Criteria

* Medically unstable condition
* Wheelchair use or inability to sit in a chair
* Cognitive impairment preventing comprehension of study procedures
* Hearing loss
* Severe visual impairment
* Refusal to participate in the study
* Epilepsy
* Migraine with aura
* History of motion sickness
Minimum Eligible Age

50 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Suzan Aydın

OTHER

Sponsor Role lead

Responsible Party

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Suzan Aydın

Principal Investigator, Physiotherapist, Lecturer and Ph.D. Candidate in Physical Therapy and Rehabilitation

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Selen GÜR ÖZMEN, Associate Professor

Role: STUDY_DIRECTOR

Bahçeşehir University

Locations

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Istanbul Aydin University VM Medical Park Hospital

Istanbul, Istanbul, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Suzan Aydın, Ph.D. (c)

Role: CONTACT

+90 212 422 44 00

Facility Contacts

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Suzan Aydın, PhD(c)

Role: primary

+90 212 422 44 00

Other Identifiers

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61351342/020-1000

Identifier Type: -

Identifier Source: org_study_id

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