A Cross-over Pilot Study on the Effects of Classical Guitar Instruction on Motor and Non-Motor Symptoms in People with Parkinson's Disease

Abstract

Background: A previous randomized pre-post cross-over study with 26 participants found positive changes in motor and non-motor symptoms in people with Parkinson's disease (PwPD) after six weeks of group classical guitar sessions but not customary and usual treatment.

Objective: To determine if a six-week group classical guitar instruction program improved motor function, mood, and quality of life for PwPD in comparison to a six-week group exercise program in a non-randomized cross-over pilot study.

Methods: Eighteen PwPD were enrolled and 15 completed the study. Group 1 (N = 10) received a six-week group guitar instruction program, and then a six-week group exercise program. Group 2 (N = 8) received a six-week group exercise program, and then a six-week guitar instruction program. Assessments were at baseline, six weeks, and 12 weeks. The groups were combined for analysis by two-tailed paired t-tests due to the low sample size. Assessments included the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor sub-section, Hoehn and Yahr scale, Parkinson's Disease Questionnaire-39 (PDQ-39), Apathy Evaluation Scale-Self (AES-S), and Beck Depression Inventory II (BDI-II).

Results: MDS-UPDRS mean motor scores decreased compared to pre-test scores with group guitar instruction (-5.3 points, P < .001), but not group exercise (-0.47 points, P = .85). BDI-II mean scores decreased by 2.13 (P = .08) and 1.87 points (P = .02) with group guitar instruction and group exercise, respectively. PDQ-39 mean scores decreased by 1.93 (P = .02) and 2.52 (P = .02) points with group guitar instruction and group exercise, respectively. AES-S mean scores decreased with group exercise (-2.40 points, P = .03) but not group guitar instruction (-2.4 points, P = .26).

Conclusions: Group guitar instruction could potentially help with both motor and non-motor symptoms in PwPD. There appears to be a specific effect of group guitar instruction on MDS-UPDRS motor scores that is not due to regular meetings and general exercises. This unfunded study was registered at ClinicalTrials.gov (NCT05917704).

Keywords: MDS-UPDRS; Parkinson’s disease; apathy; depression; guitar-based treatment; music-based treatment; non-motor symptoms; rhythm-based treatment.

Figure 1.

Consort diagram for participant screening and enrollment.

Figure 2.

Combined analysis by intervention immediately after intervention compared to before the intervention for MDS-UPDRS motor scores (a), BDI-II scores (b), AES-S scores (c), and PDQ-39 index scores (d). ***P < .001. *P < .05.