Access to and engagement with therapy significantly impacts post-stroke rehabilitation outcomes. Music Therapy (MT), Music-Supported Therapy (MST), and Neurologic Music Therapy (NMT) have all been shown to improve quality of life for stroke survivors. The incorporation of Virtual Reality (VR) into rehabilitation can support motivation to perform exercises through immersion and gamification, improve access to therapeutic tools, and, therefore, increase overall therapy time; all of which can improve physical outcomes post-stroke.

This project couples MST with VR for upper limb stroke rehabilitation. The novel VR app, REFLECT, will deliver music-supported mirror therapy and facilitate music exploration as an accessible musical instrument. REFLECT users create music while performing guided or self-guided therapeutic movements.

A series of co-design sessions were conducted with stroke survivors (n=13) and relevant professionals (n=12). The co-design captured breadth in upper-limb impairment, professional & musical experience, and VR familiarity, which informed the development of REFLECT. Feedback was sought from people with a lived experience of stroke, and the following professions: Occupational Therapy, Music Therapy, Physiotherapy, Academia, and Software Engineering. The participants highlighted personalisation and accessibility as the most important design considerations. Exercises appropriate to the user’s capacity and linked to meaningful, functional goals were therefore prioritised.

Combining music with rehabilitative technology has the following demonstrated benefits: motivates clients to conduct independent rehabilitation, provides additional tools for Registered Music Therapists to incorporate into their practice, and empowers rehabilitation therapists to incorporate MST into their practice.

The feasibility, usability and safety of REFLECT will be assessed via a home-based, self-directed pilot trial, scheduled to commence in late 2025. The pilot trial will employ a single-case experimental design methodology and include 8 weeks of VR therapy with 1- and 3-month follow-up assessments.

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