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Publisher Copyright: © 2022 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences. Major advances in music neuroscience have fueled a growing interest in music-based neurological rehabilitation among researchers and clinicians. Musical activities are excellently suited to be adapted for clinical practice because of their multisensory nature, their demands on cognitive, language, and motor functions, and music's ability to induce emotions and regulate mood. However, the overall quality of music-based rehabilitation research remains low to moderate for most populations and outcomes. In this consensus article, expert panelists who participated in the Neuroscience and Music VII conference in June 2021 address methodological challenges relevant to music-based rehabilitation research. The article aims to provide guidance on challenges related to treatment, outcomes, research designs, and implementation in music-based rehabilitation research. The article addresses how to define music-based rehabilitation, select appropriate control interventions and outcomes, incorporate technology, and consider individual differences, among other challenges. The article highlights the value of the framework for the development and evaluation of complex interventions for music-based rehabilitation research and the need for stronger methodological rigor to allow the widespread implementation of music-based rehabilitation into regular clinical practice.

An increased need to explore new methodologies of teaching online emerged due to the COVID-19 pandemic. In this presentation, we share our experiences with organising an international summer course considering students’ perspectives in the course development, as well as some of the challenges we faced. The course has been developed between three partners Universities together with ENOTHE members and SPOTeurope. We hope to create new institutional partnerships to continue developing this course. Using a virtual platform, we delivered a 4-day course for occupational therapy students across Europe (in the summer editions of 2021 and 2022) focusing on digital and community perspectives to bring innovative solutions to occupational therapy practice. Methodologies included lectures following an evidence-based approach, discussion sessions, case-based learning, and supervised project-based learning to enhance students´ learning experience. Students´ feedback pointed out how a virtual environment enhances occupational therapy competencies, including creative and critical thinking, interdisciplinary learning and teamwork skills. Notably, students valued discussions with other students and experts from various European countries. As such, this educational project is innovative since it includes students’ perspectives and international collaboration. These aspects have been fundamental to facilitate invaluable intercultural dialogue sharing practical occupational therapy models and experience in diverse social contexts. DDEUIT

Treball teòric. Introducció: L'adult ingressat a la Unitat de Cures Intensives durant un llarg període de temps pot desenvolupar la síndrome post - UCI, la qual s'associa amb la debilitat muscular adquirida per una immobilitat prolongada. La debilitat muscular adquirida compromet la recuperació de la funcionalitat de la persona afectant de manera significativa l'autonomia i la participació en les activitats de la vida diària. Objectiu: Avaluar l'efectivitat de la Teràpia Ocupacional en la recuperació de la funcionalitat en persones adultes que es troben ingressades en Unitats de Cures Intensives. Mètodes: Es va realitzar una revisió sistemàtica a través de la cerca bibliogràfica d'estudis primaris durant els mesos de desembre i gener del 2020 - 21 en les següents bases de dades: PUBMED, CINAHL, Biblioteca Virtual de Salut, Biblioteca digital de l'Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa. Es van considerar estudis sobre intervencions de Teràpia Ocupacional en les Unitats de Cures Intensives amb adults i es va avaluar la seva qualitat metodològica. Resultats: Es van incloure un total de 10 estudis primaris, entre ells 2 estudis de cas únic, 5 estudis experimentals, 2 assajos clínics aleatoritzats i 1 estudi de cohort. Les intervencions de Teràpia Ocupacional inclouen tècniques basades en la mobilització, canvis posicionals, ferulatge i ortesis, estimulació sensorial i cognitiva, entrenament d'activitats de la vida diària i transferències, adaptació de l'entorn, entre d'altres. Aquestes intervencions redueixen el temps d'ingrés a la Unitat de Cures Intensives i beneficien en el retorn a l'estat funcional previ de la persona. Conclusions: Les intervencions de Teràpia Ocupacional en les Unitats de Cures Intensives d'adults impacten en la reducció del temps d'ingrés en aquestes unitats, promouen una millor recuperació de la independència funcional de la persona i una major participació en les activitats de la vida diària tant a curt com a llarg termini. Introduction: An adult admitted to the Intensive Care Unit for a long period of time may develop post-ICU syndrome, which is associated with muscle weakness acquired by prolonged immobility. Acquired muscle weakness compromises the recovery of a person's functionality by significantly affecting their autonomy and participation in the activities of daily living. Objective: To evaluate the effectiveness of Occupational Therapy in the recovery of functionality in adults who are admitted to Intensive Care Units. Methods: A systematic review was performed through the bibliographic search of primary studies during the months of December and January of 2020 - 21 in the following databases: PUBMED, CINAHL, Virtual Health Library, Digital Library of the University School of Nursing and Occupational Therapy of Terrassa. Studies on Occupational Therapy interventions in Intensive Care Units with adults were considered and their methodological quality was assessed. Results: A total of 10 primary studies were included, including 2 single case studies, 5 experimental studies, 2 randomized clinical trials, and 1 cohort studie. Occupational Therapy interventions include techniques based on mobilization, positional changes, splints and orthoses, sensory and cognitive stimulation, training of activities of daily living and transfers, adaptation of the environment, among others. These interventions reduce the time of admission to the Intensive Care Unit and benefit in the return to the previous functional state of the person. Conclusions: Occupational Therapy interventions in Adult Intensive Care Units impact on the reduction of admission time in these units, promote a better recovery of the functional independence of the person and greater participation in life activities. daily in both the short and long term. Descripció del recurs: juny 2021 DDEUIT

Trabajo teórico. Revisión bibliográfica. La obesidad es una patología cada vez más frecuente en las sociedades modernas, tanto en niños y jóvenes como en adultos, que está vinculada, sobre todo, a los malos hábitos alimentarios y al sedentarismo. Es una enfermedad que puede llegar a tener un gran impacto en la salud física y mental de la persona, y en su participación ocupacional debido a las limitaciones funcionales y sociales y a la estigmatización que provoca. El objetivo principal de este trabajo es evaluar la efectividad de las intervenciones de terapia ocupacional en la mejora del manejo de la salud para la prevención y el tratamiento de las personas con obesidad o riesgo de desarrollarla. Para esto, se ha realizado una revisión bibliográfica de aquellos estudios experimentales en esta disciplina dirigidas a este colectivo. Se ha hallado un total de 8 estudios que cumplieran los requisitos, algunos dirigidos a niños y adolescentes, y otros a adultos; unos en prevención primaria y otros en terciaria. La mayoría de los estudios han obtenido resultados favorables que indican el potencial de la terapia ocupacional en intervenciones con personas con obesidad. Aun así, todos concluyen en que las muestras son demasiado pequeñas para poder extrapolar los resultados y deberían hacerse estudios más extensos. Obesity is a disease every time more frequent in modern societies, in both kids and adults, that is linked, mostly, to bad eating habits and sedentary behaviours. It is a condition that can trigger great repercussions in the person's physical and mental health and can affect their occupational engagement due to functional and social limitations and the stigmatization that this pathology causes. The main objective of this study is to evaluate de effectiveness of Occupational Therapy interventions in the improvement of health's management for the prevention and treatment of people with obesity or risk of developing it. To accomplish this, an article review of experimental studies in this population has been conducted. A total of 8 studies that met the inclusion criteria were found, some of interventions with children and adolescents, others with adults; some in primary prevention, while others in tertiary. Most studies obtained positive results that indicate the potential that Occupational Therapy could have in obesity interventions. Despite this, most of them agree that the samples are too small to generalise the results and that further studies are needed. Descripció del recurs: juny 2021 DDEUIT

Objective: A better understanding of factors influencing breathing weakness in stroke survivors would help in planning rehabilitation therapies. The main objective of this study was to determine whether the location of cerebral infarct is associated with breathing weakness in patients with subacute stroke. Design: Cross-sectional analysis of a prospective cohort. Patients: Consecutive patients admitted to a neurology rehabilitation unit with first-time ischaemic stroke (n?=?170). Methods: Breathing weakness was defined as >?70% reduction in maximal inspiratory and expiratory pressures (PImax and PEmax, respectively) compared with reference values. Computed tomography and magnetic resonance imaging were used to locate stroke lesions, which were classified as cortical, subcortical, cortico-subcortical, brainstem, or cerebellum. The affected cerebrovascular territory was identified to classify stroke subtype. The association between maximal respiratory pressure and affected brain area was studied using median regression analysis. Results: Breathing weakness was detected in 151 (88.8%) patients. Those with cortical and cortico-subcortical stroke location had the lowest PImax and PEmax values (median 33 cmH2O). This value differed significantly from maximal respiratory pressures of patients with strokes located in the brainstem and the cerebellum, with PImax median differences (?) of 16 cmH2O (95% confidence interval (95% CI) 4.1–27.9) and 27 cmH2O (95% CI 7.8–46.2), respectively, and PEmax median differences of 27 cmH2O (95% CI 11.4–42.7) and 49 cmH2O (95% CI 23.7–74.3), respectively, both of which remained significant after adjustments. Conclusion: The prevalence of breathing weakness was very high in stroke patients admitted to a neurorehabilitation ward, being more severe in cortical or cortico-subcortical stroke. Lay Abstract Impaired respiratory muscle function is common in stroke survivors and may increase respiratory complications. This article describes a 2-year project with the aim of assessing breathing weakness in patients with subacute stroke, and studies its potential associations with the cerebral infarct site and affected vascular territory. This is a cross-sectional analysis of a prospective cohort of rehabilitation patients with subacute stroke in which respiratory muscle strength was assessed through maximal respiratory pressures. The results show a very high prevalence of breathing weakness (more than 80%), being more severe when the stroke location was cortical or cortico-subcortical and when total anterior circulation was affected. This research could help to identify patients at risk of respiratory complications who might benefit from specific interventions, such as respiratory muscle training or neuromuscular stimulation. application/pdf DDEUIT

The COVID-19 disease and the systemic responses to it has impacted lives, routines and procedures at an unprecedented level. While medical care and emergency response present immediate needs, the implications of this pandemic will likely be far-reaching. Most practices that the clinical research within neuroscience and music field rely on, take place in hospitals or closely connected clinical settings which have been hit hard by the contamination. So too have its preventive and treatment measures. This means that clinical research protocols may have been altered, postponed or put in complete jeopardy. In this context, we would like to present and discuss the problems arising under the current crisis. We do so by critically approaching an online discussion facilitated by an expert panel in the field of music and neuroscience. This effort is hoped to provide an efficient basis to orient ourselves as we begin to map the needs and elements in this field of research as we further propose ideas and solutions on how to overcome, or at least ease the problems and questions we encounter or will encounter, with foresight. Among others, we hope to answer questions on technical or social problems that can be expected, possible solutions and preparatory steps to take in order to improve or ease research implementation, ethical implications and funding considerations. Finally, we further hope to facilitate the process of creating new protocols in order to minimize the impact of this crisis on essential research which may have the potential to relieve health systems. TS was funded by the Academy of Finland (grant number 299044) and European Research Council (ERC, grant number 803466). DDEUIT

Trabajo de investigación L'ictus és una de les malalties neurològiques més freqüent al nostre entorn, sent una de les principals causes de mortalitat i discapacitat adquirida en persones adultes. Recentment, s'ha desenvolupat la teràpia amb suport musical com un mètode de rehabilitació. Aquesta té com a objectiu millorar la mobilitat i funcionalitat de la persona a través d'exercicis amb instruments musicals. La telerehabilitació es defineix com la capacitat de proporcionar rehabilitació a distància mitjançant la telecomunicació. Hi ha una gran varietat d'estudis sobre la teràpia amb suport musical que evidencien la seva efectivitat en la rehabilitació motora, cognitiva i emocional. Tot i això, hi ha escasses evidències sobre la millora en la qualitat de vida dels participants després de realitzar aquest tipus de teràpia. L'objectiu d'aquest estudi conèixer la qualitat de vida de les persones que han patit un ictus i es troben a la fase crònica de la malaltia prèviament a una intervenció de teràpia amb suport musical. També es pretén saber l'opinió d'aquest col·lectiu envers aquesta teràpia i la telerehabilitació. La mostra és un grup de tres persones procedents de l'Associació Superar l'Ictus de Barcelona. La qualitat de vida i l'opinió sobre les teràpies s'avaluarà mitjançant una entrevista semiestructurada. La metodologia emprada per realitzar l'anàlisi de l'entrevista és qualitatiu. Els resultats obtinguts mostren que la qualitat de vida dels participants és bona si es compara amb la situació que vivien en etapes agudes o subagudes. L'opinió general de la mostra envers la telerehabilitació i la teràpia amb suport musical és positiva. Paraules clau: Teràpia amb suport musical, ictus crònic, qualitat de vida, telerehabilitació Descripció del recurs: juliol 2020 DDEUIT

Introducción: los códigos deontológicos sirven de guía en el ejercicio ético de la profesión. La creciente presencia de terapeutas ocupacionales en Cataluña, así como la necesidad de disponer de un código adaptado a la realidad local, llevaron al Col·legi de Terapeutes Ocupacionals de Catalunya a la creación de un código deontológico propio. Este artículo tiene como objetivo describir la metodología de trabajo para la elaboración del código deontológico del Col·legi de Terapeutes Ocupacionals de Catalunya. Método: a lo largo de un proceso de 43 meses, una comisión delegada de la junta de gobierno del colegio fue la encargada de elaborar el código a través de diferentes etapas: revisión bibliográfica y creación del marco teórico, definición de la estructura del código, redacción de los artículos, redacción del preámbulo, revisión del código, redacción del marco legislativo, aprobación del código en asamblea, edición del documento y presentación del mismo. Conclusión: en la discusión del artículo, se exponen las principales fortalezas y limitaciones en la elaboración del código así como las líneas de trabajo futuro para divulgar y dinamizar el documento. DeCS Ética; Terapia ocupacional; Práctica profesional. Palabras claves Código deontológico; Colegi de Terapeutes Ocupacionals de Catalunya; COTOC; Deontología. Introduction: deontological codes serve as a guide for ethical practices of the profession. The growing presence of occupational therapists in Cataluña, as well as the need to have a code adapted to local circumstances, led the Professional Association of Occupational Therapists of Cataluña to create their own deontological code. The objective of this article is to describe the methodology for elaborating the deontological code of the Professional Association of Occupational Therapists of Cataluña. Methods: along a process of 43 months, a committee delegated by governing board of the association was commissioned to elaborate the code through different stages: a bibliographic review and the creation of a theoretical framework, a definition of the code structure, the drafting of articles, the writing of a preamble, the revision of the code, the drafting of the legislative framework, the approval of the code in assembly, the editing of the document and presentation of the same. Conclusion: the discussion of the article explains the main strengths and limitations during the creation of the code, as well as the lines of future work so as to disseminate the document. info:eu-repo/publishedVersion DDEUIT

[eng] Motor deficits of the upper extremity are present in the majority of stroke patients, having a significant impact on their autonomy and quality of life. The recovery of motor deficits after stroke mainly relies on rehabilitation, which is a patient-centred process aimed at improving and maintaining the individual’s functioning using therapeutic interventions to promote adaptive learning. Recently, music-based interventions have emerged as a promising tool since they can incorporate many principles of stroke motor rehabilitation. Among these interventions, Music-supported Therapy has been developed to enhance the motor function of the paretic upper extremity in stroke patients by playing musical instruments. Previous studies have shown that Music-supported Therapy can improve the functionality of the paretic upper extremity, promote functional neuroplastic changes and enhance the mood and quality of life of subacute and chronic stroke patients. Despite these promising findings, Music-supported Therapy has not been appropriately contrasted with conventional therapy, and still, several aspects of its effectiveness remain unknown. The main aim of this thesis was to study the effectiveness of Music-supported Therapy as a therapeutic intervention in the rehabilitation of upper extremity motor function after stroke. This thesis is composed of four studies that made use of different research designs and measurements at the neural, body functions, activity and participation level. In Study 1, we tested the effectiveness of Music-supported Therapy in treating the hemiparesis of the upper extremity, inducing neuroplastic changes in the sensorimotor cortex and enhancing the quality of life in subacute stroke patients. By using an interventional experimental design, patients were assessed before and after the treatment in an evaluation that comprised standardised clinical motor tests, an assessment of the excitability of the sensorimotor cortex with Transcranial Magnetic Stimulation and a quality of life questionnaire. In Study 2, a randomised controlled trial was conducted to test the effectiveness of adding Music-supported Therapy to a standard rehabilitation program for subacute stroke patients. Participants were randomised into a Music-supported Therapy group or a conventional therapy group in addition to the standard rehabilitation program. Before and after four weeks of treatment, motor and cognitive functions, mood, and quality of life of patients were evaluated. A follow-up evaluation was performed at three months to test the retention of motor gains. In Study 3, a subsample of Study 2 was evaluated with a structural and functional Magnetic Resonance Imaging protocol before and after the intervention. This study aimed to characterise the lesions and white matter damage of patients, test the relationship between corticospinal tract integrity and motor recovery and explore the mechanisms of brain plasticity induced by Music-supported Therapy compared to conventional therapy. In Study 4, a single-case study was conducted to explore the progression of motor improvements throughout the Music-supported Therapy sessions, examine the effects of a second period of training, study the retention of motor gains over time and investigate the generalisation of motor improvements to activities of daily living. An extensive evaluation of the motor function using clinical motor tests and three-dimensional (3D) movement analysis was performed weekly and in a follow-up evaluation. The results of this thesis show that Music-supported Therapy is an effective intervention in the rehabilitation of upper extremity function after stroke. Music-supported Therapy reduces the motor deficits and improves the functionality of the upper extremity of stroke patients in the same manner as conventional therapy, with gains that are generalised to activities of daily living and maintained over time. Moreover, patients treated with Music-supported Therapy have better language abilities, less fatigue and negative emotions, and greater quality of life than those patients treated only with conventional therapy. The pleasure experienced in musical activities is correlated with motor gains in patients treated with Music-supported Therapy, pointing out the importance of motivation in motor skill learning and stroke rehabilitation. Moreover, Music-supported Therapy promotes similar plastic changes than conventional therapy, inducing cortical motor map reorganisation and excitability changes in the sensorimotor cortex in stroke patients although further research is needed to pinpoint the neural plastic changes promoted by the therapy., [spa] Los déficits motores de la extremidad superior están presentes en la mayoría de las personas que han sufrido un ictus, e impactan de manera significativa en su autonomía y calidad de vida. La Terapia con soporte Musical ha sido desarrollada para mejorar la función motora de la extremidad superior parética en el ictus mediante el entrenamiento con instrumentos musicales. Sin embargo, esta intervención no ha sido contrastada adecuadamente con la terapia convencional y todavía se desconocen algunos de los aspectos relacionados con su efectividad. El objetivo principal de la presente tesis doctoral fue estudiar la efectividad de la Terapia con soporte Musical como intervención terapéutica en la rehabilitación de la función motora de la extremidad superior después del ictus. Esta tesis está compuesta por cuatro estudios que utilizaron diferentes diseños y evaluaciones a nivel neuronal, de las funciones del cuerpo, y de la actividad y participación de la persona. A través de diseños experimentales, un ensayo controlado aleatorizado y un caso único se evaluaron los efectos de la Terapia con soporte Musical en mejorar la función motora y calidad de vida de las personas que han sufrido un ictus, así como se estudiaron los mecanismos de plasticidad cerebral inducidos por esta intervención. Considerando los resultados en su conjunto, la Terapia con soporte Musical es una intervención efectiva en la rehabilitación de la función de la extremidad superior después del ictus. La Terapia con soporte Musical reduce los déficits motores y mejora la funcionalidad de la extremidad superior en las personas que han sufrido un ictus de la misma manera que la terapia convencional, con mejoras que se generalizan a las actividades de la vida diaria y se mantienen a lo largo del tiempo. Además, los pacientes tratados con Terapia con soporte Musical tienen mejores habilidades lingüísticas, menos fatiga y emociones negativas, y una mayor calidad de vida que los pacientes tratados solo con terapia convencional. El placer experimentado en las actividades musicales se correlaciona con las mejoras motoras en pacientes tratados con Terapia con soporte Musical, señalando la importancia de la motivación en el aprendizaje motor y en la rehabilitación del ictus. Además, la Terapia con soporte Musical promueve cambios plásticos similares a la terapia convencional, induciendo reorganización del mapa motor cortical y cambios en la excitabilidad de la corteza sensorimotora en personas que han sufrido un ictus.

In the Play&Sing project, we are developing an AI platform to support home-based self-training interventions for chronic stroke patients. A large percentage of patients suffering from this disease show motor deficits that clearly hinder their daily activities and diminish their quality of life. In this project we are proposing and testing a new Music Supported Therapy (MST) to induce upper limb motor recovery. With the help of a tablet-based application and a small musical keyboard, we are developing an AI platform to support home-based MST. Specifically, the role of AI algorithms is to support therapists and to boost user engagement by personalizing the interventions according to patient needs and preferences. AI algorithms will provide the therapists with hindsight and foresight tools. In the proposed MST, patients are performing 30 training sessions of 45 minutes with a frequency of 3 sessions per week. In this paper we present our platform and preliminary experiments conducted at a pilot phase. DDEUIT

The effect of music-supported therapy (MST) as a tool to restore hemiparesis of the upper extremity after a stroke has not been appropriately contrasted with conventional therapy. The aim of this trial was to test the effectiveness of adding MST to a standard rehabilitation program in subacute stroke patients. A randomized controlled trial was conducted in which patients were randomized to MST or conventional therapy in addition to the rehabilitation program. The intensity and duration of the interventions were equated in both groups. Before and after 4 weeks of treatment, motor and cognitive functions, mood, and quality of life (QoL) of participants were evaluated. A follow-up at 3 months was conducted to examine the retention of motor gains. Both groups significantly improved their motor function, and no differences between groups were found. The only difference between groups was observed in the language domain for QoL. Importantly, an association was encountered between the capacity to experience pleasure from music activities and the motor improvement in the MST group. MST as an add-on treatment showed no superiority to conventional therapies for motor recovery. Importantly, patient's intrinsic motivation to engage in musical activities was associated with better motor improvement.

Tesis Doctoral para optar al grado de Doctor en el programa de Doctorado en Biomedicina Motor deficits of the upper extremity are present in the majority of stroke patients, having a significant impact on their autonomy and quality of life. The recovery of motor deficits after stroke mainly relies on rehabilitation, which is a patient-centred process aimed at improving and maintaining the individual's functioning using therapeutic interventions to promote adaptive learning. Recently, music-based interventions have emerged as a promising tool since they can incorporate many principles of stroke motor rehabilitation. Among these interventions, Music-supported Therapy has been developed to enhance the motor function of the paretic upper extremity in stroke patients by playing musical instruments. Previous studies have shown that Music-supported Therapy can improve the functionality of the paretic upper extremity, promote functional neuroplastic changes and enhance the mood and quality of life of subacute and chronic stroke patients. Despite these promising findings, Music-supported Therapy has not been appropriately contrasted with conventional therapy, and still, several aspects of its effectiveness remain unknown. The main aim of this thesis was to study the effectiveness of Music-supported Therapy as a therapeutic intervention in the rehabilitation of upper extremity motor function after stroke. This thesis is composed of four studies that made use of different research designs and measurements at the neural, body functions, activity and participation level. In Study 1, we tested the effectiveness of Music-supported Therapy in treating the hemiparesis of the upper extremity, inducing neuroplastic changes in the sensorimotor cortex and enhancing the quality of life in subacute stroke patients. By using an interventional experimental design, patients were assessed before and after the treatment in an evaluation that comprised standardised clinical motor tests, an assessment of the excitability of the sensorimotor cortex with Transcranial Magnetic Stimulation and a quality of life questionnaire. In Study 2, a randomised controlled trial was conducted to test the effectiveness of adding Music-supported Therapy to a standard rehabilitation program for subacute stroke patients. Participants were randomised into a Music-supported Therapy group or a conventional therapy group in addition to the standard rehabilitation program. Before and after four weeks of treatment, motor and cognitive functions, mood, and quality of life of patients were evaluated. A follow-up evaluation was performed at three months to test the retention of motor gains. In Study 3, a subsample of Study 2 was evaluated with a structural and functional Magnetic Resonance Imaging protocol before and after the intervention. This study aimed to characterise the lesions and white matter damage of patients, test the relationship between corticospinal tract integrity and motor recovery and explore the mechanisms of brain plasticity induced by Music-supported Therapy compared to conventional therapy. In Study 4, a single-case study was conducted to explore the progression of motor improvements throughout the Music-supported Therapy sessions, examine the effects of a second period of training, study the retention of motor gains over time and investigate the generalisation of motor improvements to activities of daily living. An extensive evaluation of the motor function using clinical motor tests and three-dimensional (3D) movement analysis was performed weekly and in a follow-up evaluation. The results of this thesis show that Music-supported Therapy is an effective intervention in the rehabilitation of upper extremity function after stroke. Music-supported Therapy reduces the motor deficits and improves the functionality of the upper extremity of stroke patients in the same manner as conventional therapy, with gains that are generalised to activities of daily living and maintained over time. Moreover, patients treated with Music-supported Therapy have better language abilities, less fatigue and negative emotions, and greater quality of life than those patients treated only with conventional therapy. The pleasure experienced in musical activities is correlated with motor gains in patients treated with Music-supported Therapy, pointing out the importance of motivation in motor skill learning and stroke rehabilitation. Moreover, Music-supported Therapy promotes similar plastic changes than conventional therapy, inducing cortical motor map reorganisation and excitability changes in the sensorimotor cortex in stroke patients although further research is needed to pinpoint the neural plastic changes promoted by the therapy. Los déficits motores de la extremidad superior están presentes en la mayoría de las personas que han sufrido un ictus, e impactan de manera significativa en su autonomía y calidad de vida. La Terapia con soporte Musical ha sido desarrollada para mejorar la función motora de la extremidad superior parética en el ictus mediante el entrenamiento con instrumentos musicales. Sin embargo, esta intervención no ha sido contrastada adecuadamente con la terapia convencional y todavía se desconocen algunos de los aspectos relacionados con su efectividad. El objetivo principal de la presente tesis doctoral fue estudiar la efectividad de la Terapia con soporte Musical como intervención terapéutica en la rehabilitación de la función motora de la extremidad superior después del ictus. Esta tesis está compuesta por cuatro estudios que utilizaron diferentes diseños y evaluaciones a nivel neuronal, de las funciones del cuerpo, y de la actividad y participación de la persona. A través de diseños experimentales, un ensayo controlado aleatorizado y un caso único se evaluaron los efectos de la Terapia con soporte Musical en mejorar la función motora y calidad de vida de las personas que han sufrido un ictus, así como se estudiaron los mecanismos de plasticidad cerebral inducidos por esta intervención. Considerando los resultados en su conjunto, la Terapia con soporte Musical es una intervención efectiva en la rehabilitación de la función de la extremidad superior después del ictus. La Terapia con soporte Musical reduce los déficits motores y mejora la funcionalidad de la extremidad superior en las personas que han sufrido un ictus de la misma manera que la terapia convencional, con mejoras que se generalizan a las actividades de la vida diaria y se mantienen a lo largo del tiempo. Además, los pacientes tratados con Terapia con soporte Musical tienen mejores habilidades lingüísticas, menos fatiga y emociones negativas, y una mayor calidad de vida que los pacientes tratados solo con terapia convencional. El placer experimentado en las actividades musicales se correlaciona con las mejoras motoras en pacientes tratados con Terapia con soporte Musical, señalando la importancia de la motivación en el aprendizaje motor y en la rehabilitación del ictus. Además, la Terapia con soporte Musical promueve cambios plásticos similares a la terapia convencional, induciendo reorganización del mapa motor cortical y cambios en la excitabilidad de la corteza sensorimotora en personas que han sufrido un ictus. DDEUIT

Right hemisphere plays an important role in prosody and music processing with lateralization of function for pitch, meter or melody recognition (among other features). More specifically, a handful of studies explored the role of the functional connectivity between the auditory and inferior frontal cortices and the right arcuate fasciculus(AF) involvement in musical processing Recent studies provided voxel lesion-symptom maps indicating a relationship between right hemispheric damage and the occurrence of amusia. Regarding patients with brain tumors, intraoperative electrical stimulation(ESM) studies have reported that the electrical stimulation applied to the right pars opercularis led to spontaneous singing and stimulation applied at the level of the left superior temporal gyrus and left inferior operculum provoked errors in score reading. DDEUIT

Music is a powerful, pleasurable stimulus that can induce positive feelings and can therefore be used for emotional self-regulation. Musical activities such as listening to music, playing an instrument, singing or dancing are also an important source for social contact, promoting interaction and the sense of belonging with others. Recent evidence has suggested that after retirement, other functions of music, such as self-conceptual processing related to autobiographical memories, become more salient. However, few studies have addressed the meaningfulness of music in the elderly. This study aims to investigate elderly people's habits and preferences related to music, study the role music plays in their everyday life, and explore the relationship between musical activities and emotional well-being across different countries of Europe. A survey will be administered to elderly people over the age of 65 from five different European countries (Bosnia and Herzegovina, Czechia, Germany, Ireland, and UK) and to a control group. Participants in both groups will be asked about basic sociodemographic information, habits and preferences in their participation in musical activities and emotional well-being. Overall, the aim of this study is to gain a deeper understanding of the role of music in the elderly from a psychological perspective. This advanced knowledge could help to develop therapeutic applications, such as musical recreational programs for healthy older people or elderly in residential care, which are better able to meet their emotional and social needs. DDEUIT

Previous studies on body ownership illusions have shown that under certain multimodal conditions, healthy people can experience artificial body-parts as if they were part of their own body, with direct physiological consequences for the real limb that gets 'substituted.' In this study we wanted to assess (a) whether healthy people can experience 'missing' a body-part through illusory ownership of an amputated virtual body, and (b) whether this would cause corticospinal excitability changes in muscles associated with the 'missing' body-part. Forty right-handed participants saw a virtual body from a first person perspective but for half of them the virtual body was missing a part of its right arm. Single pulse transcranial magnetic stimulation was applied before and after the experiment to left and right motor cortices. Motor evoked potentials (MEPs) were recorded from the first dorsal interosseous (FDI) and the extensor digitorum communis (EDC) of each hand. We found that the stronger the illusion of amputation and arm ownership, the more the reduction of MEP amplitudes of the EDC muscle for the contralateral sensorimotor cortex. In contrast, no association was found for the EDC amplitudes in the ipsilateral cortex and for the FDI amplitudes in both contralateral and ipsilateral cortices. Our study provides evidence that a short-term illusory perception of missing a body-part can trigger inhibitory effects on corticospinal pathways and importantly in the absence of any limb deafferentation or disuse. DDEUIT

In the last decade, important advances in the field of cognitive science, psychology, and neuroscience have largely contributed to improve our knowledge on brain functioning. More recently, a line of research has been developed that aims at using musical training and practice as alternative tools for boosting specific perceptual, motor, cognitive, and emotional skills both in healthy population and in neurologic patients. These findings are of great hope for a better treatment of language-based learning disorders or motor impairment in chronic non-communicative diseases. In the first part of this review, we highlight several studies showing that learning to play a musical instrument can induce substantial neuroplastic changes in cortical and subcortical regions of motor, auditory and speech processing networks in healthy population. In a second part, we provide an overview of the evidence showing that musical training can be an alternative, low-cost and effective method for the treatment of language-based learning impaired populations. We then report results of the few studies showing that training with musical instruments can have positive effects on motor, emotional, and cognitive deficits observed in patients with non-communicable diseases such as stroke or Parkinson Disease. Despite inherent differences between musical training in educational and rehabilitation contexts, these results favor the idea that the structural, multimodal, and emotional properties of musical training can play an important role in developing new, creative and cost-effective intervention programs for education and rehabilitation in the next future. Financial support for the present project has been received by the Spanish government (Ministry of Economy and Competitiveness [MINECO] Grant PSI2011-29219 to AF) and from the Fyssen Foundation to CF (http://www.fondationfyssen.fr/).