Biomedical and clinical research in music has come a long way especially in the last 10 years to find new and effective ways to help re-educate the injured brain. The use of music has extended from not only including motor therapy, but to the rehabilitation of speech, language, and even cognitive function. Music Therapy or MT is the therapeutic use of music to improve cognitive, sensory, and motor dysfunctions for those with neurological disorders. Treatment techniques are based on scientific data and clinical research using neuroscience models and establishing how music influences the non-musical areas of the brain.
The use of brain imaging techniques to advance the use of music as therapy allows us to better understand the brains plasticity, its ability to change, and find pathways that music activates. The brain areas involved in music are also used in processing language, auditory perception, attention, memory, executive control and motor control. Music effectively and efficiently accesses and stimulates these systems as well as the interaction between them. Music learning changes the brain, and exposure and experience to music therapy can create new and more efficient connections between neurons in the brain, a sort of rewiring process. Active learning and training is found to be the best strategy to help rewire the brain and recover as much lost ability and function as possible.
Timing is significantly important for effective motor learning and skilled motor movements. By using musical rhythms and timing, stroke patients were able to walk faster, with better control on their affected side and the more complex measures of movement control (neuromuscular activation, limb coordination, etc.) became significantly more consistent, smoother and flexible. (6) In Parkinson’s disease patients was shown to quicken their movements, with music as an auditory trigger to keep movements going and prevent freezing. In a study by Thaut, Leins and Rice (2007) the MT group proved to be superior when compared with other standard physical therapy interventions if sustained long term. Music as therapy when grouped with exercise has reported to have many benefits. In a study by Ziv and Lidor (2011), music was able to generate emotion, increase work output, encourage rhythmic movements, even distract from the sensation of fatigue or pain, serve as an exercise stimulant, and enhance acquisition of motor skills. Interestingly, all the improvements were lost in a follow up study after two months. Recommendations of 50-60 minutes of rhythmic and free movements to music can improve the motor and emotional states of patients with Alzheimer’s if sustained long term.
The focus on active music therapy lies on redeveloping functional skills, engaging sensory processes, attention, memory, multisensory integration and social cognition. Active MT has shown improvements in motor abilities and emotional status, with significant improvements in Activities of Daily Living (ADL’s) and quality of life (QoL) for the patients undergoing MT. It is hypothesised that the motor facilitation in response to MT could be based on emotional reactions briefly activating the cortical basal ganglia motor loop, the circuit primarily affected in PD. (9)
A music based movement therapy called The Ronnie Gardiner Rhythm and Music Method (RGRM), focuses on exercises that challenge cognition and sensorimotor control to enhance mobility and coordination in patients with neurological deficiency through the use of rhythm and music. Recommended training is twice weekly for at least 12 weeks. This method compliments other rehabilitation methods and is considered enjoyable, motivating and engaging, which may also help in boosting motivation for rehabilitation. (2)
Evidence suggests that music is considered a higher component of brain function and this form of communication remains intact as dementia progresses. If the use of music has shown to increase participation, this may improve quality of life, by strengthening, allowing range of motion and aerobic interventions to be completed. With the known benefits of exercise in older adults with dementia, the use of music with exercise may help delay their decline in function, as with other neurological disorders. (7)
The use of music in therapy is suggested as an intervention to increase participation and function in exercise programs for those with neurological conditions. Music has shown to provide a number of benefits when it is included in an exercise program. It is suggested for clinicians to add music to their exercise programs when conducting rehabilitation or with clinical populations. Neurologic music therapy meets the standards of evidence based medicine, and should be included in standard rehabilitation care. Please check out the documentary “Alive Inside”. A neurologist by the name of Oliver Sacks helped create it as well as a book called Musicophilia, with both detailing the incredible use of music on neurological conditions.
Luke Bell (B.Sc. – Sport & Exercise Science, B.Sc. – Exercise Science & Rehabilitation) Exercise Consultant – Accredited Exercise Physiologist (AES, AEP)(ESSAM)