Music therapy has been used for many years as a treatment for various conditions, including dementia, strokes, brain injuries, Parkinson's and many more. Music can help patients regain function and cognitive abilities after brain injuries or maximise and retain functions for patients with degenerative neurologic conditions. This is due to the way that music is processed by and interacts with the brain. This is the focus of a specialised branch of music therapy called Neurologic Music Therapy (NMT), which is defined as the "therapeutic application of music to cognitive, affective, sensory, language and motor dysfunctions due to neurologic disease of the human nervous system" (https://nmtacademy.co/key-elements-of-nmt). NMT uses a standardized set of clinical techniques that use music to train and retrain cognitive function in many different areas. This article will explore how NMT works and how it can be used in neurorehabilitation for various conditions.
Why is music therapy effective in this space?
Music is a universal language that can be understood by people of all ages and cultures. It has the ability to communicate emotions, ideas, feelings and thoughts. Music therapy uses this powerful tool to help clients express themselves more fully through the mediums of songwriting, singing, listening, instrument playing and more. Music therapy can be used in the following ways to help neurorehabilitation:
To improve motor functions, such as gait rehabilitation and upper limb function
To improve communication issues, such as aphasia, dysarthria, dyspraxia, dysprosody and dysphonia
To support patients through their emotions during recovery
To improve cognition and executive functions
All of this is possible because music engagement increases neuroplasticity, which is the brains' ability to form or reorganize neural synapses when in the process of learning or repairing. Reorganisation of synaptic pathways allows the brain to either repair what has been damaged or rewire the brain to use different pathways to make up for the damaged areas. Music engagement often utilises every area of the brain, as it coordinates motor movement, cognitive engagement, auditory processing, speech and language, rhythm, melody and it does of all this simultaneously. When all these areas of the brain are activated, it allows neural pathways to be formed and strengthened in damaged areas.
What neurological conditions can be improved through NMT?
Neurologic music therapy has been shown to be effective in the treatment of many neurological conditions, including (but not limited to):
Parkinson's disease
Dementia
Stroke recovery
Traumatic Brain Injury
Coma recovery
Huntington's disease
Multiple sclerosis
Cerebral Palsy
Improving motor skills through NMT
One of the areas of the brain that is often impacted by neurologic conditions is motor skills. Often patients will lose the ability to walk, or move their arms. NMT has been shown to drastically improve the speed, coordination and consistency of gait in patients through the use of a technique called Rhythmic Auditory Stimulation (RAS). This technique uses strong rhythmic pulses, such as a metronome or music with a very strong beat to improve patients gait. This uses the principles of rhythmic entrainment, which is when the motor system and the auditory system work together to improve movement patterns.
Upper limb function and other motor functions can also be improved through the use of strategically placed instruments and the movements involved to play them. This is done through a technique called TIMP - Therapeutic Instrumental Music Performance.
Improving cognitive ability through NMT
NMT also shows great improvement in cognitive ability of those with neurologic deficits. Cognitive areas that can be improved through NMT include attention, arousal, executive function, spatial neglect, memory and more. These benefits often occur with most musical engagement, so a number of interventions may be used, but some of the most common include musical learning, listening to or singing preferred music.
Improving communication skills through NMT
A very common area that is impacted by neurological accident or disease is the speech and language areas of the brain. Many conditions can occur that affect the patients ability to produce speech, understand language, speak coherently or a combination of these issues. While the speech and language areas of the brain may be damaged, often the patient will retain their ability to sing, as singing and music utilise more areas in the brain than just the speech and language areas. NMT uses many interventions to improve communication skills, depending on the particular diagnosis and remaining functions of the patient. Singing techniques can be used to sing phrases and restore communication abilities, and then the singing can be phased out as the speech abilities are restored.
Emotional support through music therapy
Going through a traumatic brain injury or neurologic disease and the debilitating effects it can have on a person can be very distressing and many patients require emotional support as they go through recovery. Music therapy offers this emotional support through many interventions, using the emotional and expressive nature of music and the therapeutic relationship between patient and therapist.
Benefits of music therapy in the recovery plan
As we've already discussed, there are many benefits that music therapy can bring to neurorehabilitation, and therefore it is a valuable aspect of any neurorehabilitation team. Some additional benefits of music therapy include:
Improves mood
Improves sleep
Decreases agitation
Facilitates connections between loved ones
Reduces stress
Reduces the need for medication, therefore avoiding negative side effects such as drowsiness
Music engagement can be continued in the home after recovery to continue positive benefits
Neurologic Music Therapy has proven to be a beneficial and effective therapy in the recovery of neurological injury and in the management of neurological diseases. Music is a universal language that speaks to everyone in some way or another, and the use of it in this field is an exciting development, with so much more potential to be discovered. To learn more, check out the references or leave a comment below. If you'd like to learn more about music therapy for yourself or your loved one, get in touch today to chat and learn how Thrive can help.
Thanks so much for reading, and I'll see you back here next month!
Carolyn
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