Royal Philharmonic OrchestraSTROKESTRA
In partnership with the Hull Integrated Community Stroke Service.
STROKESTRA® is a stroke rehabilitation programme that uses group creative music-making alongside professional musicians and clinicians to drive patient-led recovery in stroke patients and their carers.
The programme forms part of RPO Resound, the Royal Philharmonic Orchestra’s Community and Education programme.
Royal Philharmonic Orchestra
Target Beneficiaries
Beneficiaries are stroke survivors and their carers, referred by Hull Integrated Community Stroke Service (HICSS) therapists.
The pilot creative music workshops were designed to support a number of outcomes relating to stroke rehabilitation needs, including improved sensation, mobility, strength, flexibility, cognitive function, socialisation, communication and wellbeing. Patients worked with their referring therapist to create a set of individualised goals from the list of possible outcomes to work towards during the project.
Other aims and outcomes related to research and development, training clinical staff, artistic impact and CPD for RPO leaders and musicians.
Delivery
The RPO maintains a five-year concert residency at Hull City Hall in partnership with Hull City Council, including a programme of wider Community and Outreach work. The Hull Health & Wellbeing Board commissioned the RPO to design a programme to support stroke recovery due to a high prevalence rate in the area. HICSS (part of Humber NHS Foundation Trust) were brought in to take the role of clinical partner in planning and delivering the programme.
The RPO and HICSS teams began with a research and design phase followed by a pilot programme delivered in summer 2015. Fifty patients and carers participated in the pilot, with fortnightly participatory sessions led alternately by RPO and HICSS staff. Sessions used a range of instruments and supported participants to listen to, conduct, compose and perform music, with intrinsic rehabilitation benefits built into each activity and tailored to meet individual patient goals.
Participants were also given instruments and musical ‘homework’ to continue practicing at home, and supported to attend an RPO rehearsal. The pilot culminated with a public performance of the pieces devised over the pilot period, with participants, clinicians and RPO musicians performing at Hull City Hall.
The cost of the five-month pilot programme was £32,756 equating to £655 per patient, or £22 per therapy hour.
Impact
50 Patients reported improvements as follows:
Carers reported improvements as follows:
- 100% reported improvements in wellbeing and respite from their role as carer, and improved relationships with their patient.
Clinical staff reported the following impacts:
Artistic impact:
- 76% of patients and 90% of carers stated the project changed the way they listen to music.
- RPO musicians reported marked improvement in the group’s general music abilities.
Wider impacts:
- HICSS staff are using musical techniques and instruments in 1:1 care.
- Patients have purchased their own instruments.
- One patient has begun making cellos, another has returned to calligraphy.
Legacy
A three-year programme is currently being rolled out in Hull with the newly merged Hull & East Riding Community Stroke Service, expanding the model for delivery in both community (as per the pilot) and residential settings (reaching patients earlier in their recovery pathway).
STROKESTRA® currently being piloted in Staffordshire with Midlands Partnership NHS Foundation Trust and Keele University, adapting the model for the local context and including further clinical research opportunities.
Discussions are also underway with partners in Reading and Scunthorpe to devise additional projects in both locations.
Testimonials
“It was the first time he was motivated, it was the first time he had socialised and it was the first time he wanted to do something after – we went out for tea. I think he put his embarrassment to one side. It was the first time I saw him smile in 3 months! ”