Published February 2023
After having a stroke, many people don’t feel like themselves because they’ve lost so much of what they used to be able to do. Lisa Rodio, from the Royal Philharmonic Orchestra, runs STOKESTRA®, a unique music-making group that combines music and rehabilitation in a way that makes stroke recovery fun, effective and confidence-boosting.
STROKESTRA® is unique, helping people with all aspects of their stroke recovery in one placeLisa Rodio, STROKESTRA® Project Manager
The Royal Philharmonic Orchestra (RPO) is no stranger to the power of music changing lives. We’ve seen a growing body of research showing that music can particularly support the recovery and rehabilitation of people who have had a stroke. From helping patients to walk more evenly, improve arm and fine motor movement, to having a positive mood and better quality of life.
Shortly after the RPO set up residency in Hull City Hall, the local authority asked us what we could do to help the high number of stroke patients in Kingston upon Hull and the surrounding region. Teaming up with Hull Integrated Community Stroke Service (HICSS), we developed STROKESTRA®, a unique programme that uses group creative music-making alongside professional musicians and clinicians to support recovery for stroke patients and their carers.
A holistic approach to stroke recovery
We did a lot of research and development to unpick exactly how group music-making could support stroke recovery. Working in a multidisciplinary team of stroke clinicians, physiotherapists, occupational therapists, speech and language therapists, clinical psychologists and nurses, we designed sessions that would encourage patients to practise rehabilitation exercises in a fun, music-led environment.
When testing our ideas through a pilot, we found that group music-making made it possible to bring together the physical, cognitive, speech, and social rehabilitation activities that patients usually have to work through separately. We also designed STROKESTRA® around patients’ families and carers who can choose to join in or use the sessions to take a break from their caring responsibilities.
After a welcome cup of tea and chitchat, sessions cover a range of fun music-making exercises which are all linked to the goals set by the patients. We jam together using a wide range of instruments we bring, such as drums, guitars, keyboard, where everyone can make a noise which is pulled together into a tune by the RPO musicians improvising.
We’re seeing patients self-manage better because they have something to work towards
Participants can also conduct the musicians who interpret their movements – for example, changing the pitch when someone lifts their arm higher or lower, or playing long or short notes depending on what arm actions are being made. We also work on singing and songwriting based on what people might have said over tea.
When we weren’t able to meet in-person during COVID, we made STROKESTRA® at Home videos and ran online sessions over Zoom so people could still make music using every-day objects like pans, coffee cups and spoons.
Our online sessions and videos helped keep patients gently active whilst stuck inside, and offered familiar faces and activities during a time when many felt socially isolated. The sessions were really popular, with one participant even making a glockenspiel out of different sized wrenches!
Motivation through music making
STROKESTRA® is unique, helping people with all aspects of their stroke recovery in one place.
Our pilot studies showed that STROKESTRA® generates significant impact to patients and carers. For example, 86% of patients get relief from symptoms, 71% show physical improvements in walking, standing or upper arm strength, 91% report having better relationships and communication skills, and 86% saw their memory and concentration improve, as well as feeling more confident and having a renewed sense of self.
What surprised us the most is the level of motivation the patients get by taking part. Every session has rehabilitation elements built-in but we’re seeing people working harder in their rehabilitation outside of STROKESTRA® as well. They’re practising more because they want to do well in the group, whether that’s working on their memory so they can get the song right or doing more arm exercises so they can play an instrument for longer.
We’re seeing patients self-manage better because they have something to work towards. One patient who uses a wheelchair worked so hard on her mobility in-between sessions that she was able to walk several steps into the session hall after months of being pushed in, and even play instruments standing up for short periods of time.
The clinicians, therapists and nurses involved in the sessions are also motivated by the music. They often take a back seat at first, especially if they don’t see themselves as musical. But quickly they see the benefits for patients and also their own wellbeing. A number have gone on to set up staff choirs and music groups, or taken back up instruments they used to play.
With The Dunhill Medical Trust’s (DMT) funding we’re now in the third year of this STROKESTRA® rollout, delivering six-month programmes for up to 50 people, each ending with a final live performance. These events are really fun and celebratory, especially because for a lot of patients this might be the first time they’ve done something in public since having a stroke.
Next we’re creating a follow-on ensemble that will be run by Hull music students who worked with us to deliver STROKESTRA®. While it won’t have the same amount of clinical support as STROKESTRA®, this ensemble will allow previous participants to continue their music-making and work towards joining other community groups, musical or otherwise, in the future.
The DMT are really great to work with and generous in their support – they’re one of our favourite funders. They also put us in touch with other groups working with music or in similar areas and funded our partnership with Plymouth Music Zone. This meant we could learn from each other, with me travelling to Plymouth to see how they deliver singing sessions for people with Parkinson’s and one of their team coming to sit in on a STROKESTRA® session. It’s really valuable to work with a funder that provides time and resources to prioritise this learning.