The ‘RePlay’ Study

Due to the ongoing Coronavirus (COVID-19) outbreak, any hospital based trials mentioned in this article are currently postponed. We look forward to continuing this project at Chelsea and Westminster Hospital once it is safe to do so.

According to the Neurological Alliance’s ‘Neuro Number 2019’ report, in England there were 80,000 newly diagnosed incidences of stroke in the year 2016-17. Weakness or paralysis on one side of the body is a common side-effect, with The Stroke Association reporting that over three quarters of stroke survivors have arm weakness. At CW+ we believe that engagement with the arts can help alleviate some of the challenges faced by our patients, and research suggests that this is also the case for stroke patients, with a study in 2013 indicating that piano playing can have benefits in the recovery of upper extremity function.

Since October 2019, CW+ has been collaborating with Queen Mary University of London to create a new musical instrument designed specifically to support upper limb exercises and rehabilitation.  The QMUL ‘Augmented Instruments Lab’ has a track record of using innovative technology to create flexible and accessible new instruments, and, with the support and experience of the CW+ Arts for All team, they are perfectly placed to create a unique and engaging musical therapy tool for neurological patients.

The design of the new instrument evolved through regular meetings with the stroke specialist therapy teams at Chelsea and Westminster Hospital, and was finally developed into a playable prototype. It is played simply by touching the brass rods on the surface, each of which produces a different note. Its size and shape allow it to be accessible to patients with a wide range of upper-limb ability, incorporating full arm extensions and intricate finger work, and it is compliant with hospital infection control protocols.

QMUL instrument for upper limb rehabilitation.
Presenting potential designs to one of the lead OTs on Nell Gwynne ward.

The trials undertaken with patients so far have illustrated the various ways of approaching the instrument, from picking out melodies to strumming the surface like a guitar, but they have also highlighted patients’ appreciation of the instrument’s aesthetic, describing it as ornamental or resembling an old board game.  

Our present study with the instrument is primarily to assess whether the instrument is a tool that patients and clinicians would like to use as part of rehabilitation and exercise. We hope that future research will enable us to assess the potential benefits to patients’ physical and mental wellbeing that use of the instrument might bring.

CW+ and QMUL musical instrument for upper limb rehabilitation.
The finished prototype
Robbie from the QMUL Augmented Instrument Lab preparing the prototype
Robbie from the QMUL Augmented Instrument Lab preparing the prototype

Andrew Hall is a musician, composer, arranger, improviser and researcher. He is currently Music and Sound Research Consultant at CW+.

Twitter @andrewhallmusic
Instagram @doctorandy33