Integration of innovative information technology into music with movement therapy for sustainable implementation to people with dementia

Music with Movement intervention has proven to be a promising intervention to improve the well-being and enhance cognitive performance of old adults with cognitive impairment. Health outcomes are considerably affected by implementation strategies, in which technological innovations are essential to facilitate the delivery of intervention and communication in an effective way.

Notwithstanding the evidence-based effects, Music with Movement intervention encounters barriers in implementation such as intervention fidelity, subjective assessment, unorganised music genres, inflexible training programme and time consuming in documentation. In addressing these challenges for application on traditional community services platform, a stand-alone therapeutic programme empowered by innovative technology is introduced by Dr Daphne Cheung, Associate Professor in School of Nursing at the Hong Kong Polytechnic University and her team to improve adoption and enhance benefits.

Interdisciplinary Collaboration is Vital

Increasing prevalence of dementia is a public health concern amid an increasingly aging population. Multisensory therapy and cognitive stimulation activity such as Music with Movement are applied to improve cognitive functions and health conditions of older adults with cognitive impairment in different settings.

Dr Cheung has conducted research on the effects of Music with Movement intervention on people with cognitive impairment for more than ten years. While research findings have showed promising effects of Music with Movement intervention on people with dementia, the development of a technology enabled intervention protocol for training and implementation is critical.

Interdisciplinary collaboration, empowered by innovation and technology (I&T) for the alignment of people from different discipline and background, can lead to better health outcomes. In the long run, sustainable implementation strategies help caregivers and staffs become competent in both homecare and nursing home environments. Also, training to nursing students on this portable programme would further expand the scale and community research for wider benefits of people with dementia.

Narrowing the Science-to-Service Gap

A research study of Dr Cheng, “A Home-based Dyadic Music-with-Movement Intervention for People with Dementia and Caregivers: A Hybrid Type 2 Cluster-Randomized Effectiveness-Implementation Design” was published on Clinical Intervention in Aging in October, 2022. The research was to evaluate the adoption of Music with Movement intervention with a sustainable approach to improve the psychosocial well-being of people with dementia and their caregivers.

For clinical efficacy, the study found the intervention is effective both in improving anxiety and depressive symptoms of people with dementia and reducing stress level of family caregivers. While for real practice, information and communication technology is identified as an important enabler to support the delivery of integrated and coordinated primary health care. For accelerating the integration of research innovation into real practice, implementation should be culturally appropriate. The study provides practical information on how to design strategies that fit the Asian context.

In the study, it noted working closely with external stakeholders with good communication skills and understanding on cultural perspective and human factors are keys to success. Innovative technology narrows the science-to-service gap through meaningful collaborations among frontline practitioners, administrators, caregivers and researchers.

In Hong Kong, Music with Movement intervention was developed for patient with dementia, and it later came to involve family caregivers as a dyadic intervention. Integrating information and communication technology as implementation strategies builds effective communication and collaboration among various stakeholders.

Dr Cheung said, “ Hope one day, through integrating more advance technology, people living in different geographical locations can participate the music-with-movement intervention and actualize the concept of IoT. Therefore, we collaborate with music therapist and engineers to develop the system.”

Sustainability Enhanced by Innovative Technology

Music with Movement intervention has faced certain barriers for efficient implementation on traditional community services platform. In addressing these challenges, Dr Cheung has led the project “A Stand-alone Therapeutic Music with Movement Programme for Elderly with Cognitive Impairment” for a period of three years in Hong Kong since 2020, with the support of various stakeholders.

Innovation and technology (I&T) is creatively applied to provide customised solutions, with the design of a user-friendly system and interactive platform for the beneficiaries, caregivers and service providers. Smart technology such as AR (Augmented Reality) interactive game, motion sensor and cloud-based data system for analytics are incorporated into music intervention programme.

Optimising with information and communication technology, the project aims to expand programme adoption and sustainability with the development of a stand-alone system and service package for flexible training and support to caregivers and staffs, greater interactive and fun motivation to users and intelligent data management for assessment.

The project has created a stand-alone tablet-based interactive programme, which comprises of training for caregivers on music intervention techniques, wireless music motion-sensing and AR games for users, data management and analytical system for health and engagement reports. Integration of innovative technology such as e-Book for training manual, Android Console Music with Movement system and RFID card for user identification creates substantial solutions for efficient implementation.

Dr Cheung said, “ Interpersonal social interaction is an important factor influencing sense of wellbeing and maintain optimal stimulation of older people with dementia. Music is a medium of communication when verbal community ability diminished. Technology is not for replacing human interaction, but facilitating the implementation of meaningful human-to-human interaction through music activities.”

With integration of I&T elements, the programme builds stronger connection and communication to train, engage and monitor music intervention for sustainability. Extensively, this portable music intervention programme could expand to broader community application for the benefit of people with dementia.