Researchers at Georgia State University are developing a new approach to stroke rehabilitation that uses music and technology to help patients regain movement. The team, which includes faculty from the College of the Arts, Byrdine F. Lewis College of Nursing and Health Professions, and the College of Education & Human Development, has created a digital app called KeyStroke designed for upper-extremity recovery.
Martin Norgaard, a professor of music education and jazz violinist at Georgia State, explained his interest in how music affects the brain: “Music cognition is such a fascinating field,” Norgaard says. “You can go in so many directions, from studying how kids learn to play to looking at brain activity during improvisation or working with health professionals to develop therapies based on music. It’s all driven by this question of how we think through sound and how the brain listens, reacts and creates.”
Norgaard collaborates with Yi-An Chen, assistant professor of occupational therapy, and Rachael Harrington, assistant professor of communication sciences and disorders. Their research focuses on using musical activities as part of stroke rehabilitation. The KeyStroke app guides patients through simple piano melodies using on-screen notes, making repetitive motor exercises more engaging.
“The goal isn’t really to learn to play piano,” Norgaard explains. “It’s to redevelop upper-extremity function. The songs are structured from a developmental and therapeutic perspective, not a musical one.” Chen adds that the design is meant to keep patients motivated: “If you think about traditional rehab exercises, they can be boring, repetitive and often not motivating,” she says. “With KeyStroke, people are engaged. They’re listening, moving and creating all at once.”
A 2025 pilot study showed that patients using KeyStroke completed thousands of rehabilitative movements at home—more than typically achieved in standard therapy sessions. Over two weeks, participants pressed 14,000 keys for about 30 minutes most days, amounting to an average of 1,555 repetitions per session.
“We saw a clear correlation between how much patients used the app and how much their function improved,” Norgaard says. “That told us it wasn’t just about time. It was about the musical training itself.”
The project builds on earlier work where participants used commercial piano-training apps with positive results in motor function improvement. This experience led the researchers to develop their own customized solution for greater patient benefit.
The team is now collaborating with Gil Weinberg at Georgia Tech’s Center for Music Technology to further enhance KeyStroke by adding adaptive features powered by artificial intelligence (AI). These upgrades will allow the app to generate new songs tailored to each user’s progress.
“This idea actually started before the whole AI boom,” Chen says. “We wanted something that could adapt to each person — how they play, how they move — and generate new songs that fit their level. It’s about using technology to make therapy personal.”
Harrington is studying changes in brain connectivity among users through neuroimaging techniques like functional magnetic resonance imaging (fMRI). She reports increased connectivity between regions responsible for motor control and those processing sound and rhythm—a sign of neuroplasticity.
“So far, we’ve seen really interesting changes,” Harrington says. “We’re noticing increased connectivity between regions that handle motor control and those that process sound and rhythm. That’s a marker of neuroplasticity — the brain rewiring itself through practice.”
She notes that music activates both hemispheres of the brain: “Where speech or movement are usually controlled on one side, music engages both,” she says. “So if one hemisphere is damaged, the other can help take over. That bilateral activation seems to support recovery in a way traditional therapy doesn’t always achieve.”
Harrington uses resources at Georgia State’s Center for Advanced Brain Imaging (CABI), which offers advanced equipment for neuroscience research as part of the Georgia Research Alliance’s Core Exchange program.
“CABI is such an incredible resource,” Harrington says. “It’s entirely dedicated to brain imaging and neurobiology research, with everything from a 3T MRI to advanced computing clusters for data analysis. What makes it really special is the supportive staff and the collaborative environment. They help you design experiments, interpret results and connect with other researchers across Georgia State and Georgia Tech.”
Chen emphasizes that making rehabilitation enjoyable increases participation: “Rehabilitation is hard,” she says. “It’s repetitive and exhausting. Most patients don’t get enough therapy after they leave the hospital because insurance only covers so much. We wanted to create something that people want to do.” She shared stories from participants who found joy practicing with family members instead of seeing it as just another exercise routine.
“It’s not about ‘curing’ someone,” Chen says. “It’s about making the process more engaging — more human. Even after stroke, you can still enjoy music. You can still create something beautiful.”
Norgaard connects this work back to his studies on improvisation: “Music is different from other art forms,” he says. “You can’t pause mid-phrase. It unfolds in real time. That means your brain is constantly predicting, correcting and adjusting. Those same motor loops may be what help retrain coordination after a stroke.”
The team plans further research including case studies based on imaging results while seeking additional funding for future development.
