Healing Is Music To Our Ears
Elizabeth Stegemöller is an assistant professor in kinesiology researching how music facilitates movement in people with neurological disorders. Stegemöller is a board certified music therapist with a Ph.D. in neuroscience. Her research has demonstrated that singing training can significantly improve swallowing and respiratory functions, often major impairments in people with Parkinsons disease. This research has resulted in two outreach programs in Ames, IA: a singing group and a music and movement group.
Each program meets for one hour once a week.
Benefits Of Singing For People With Parkinson’s
There are physical benefits of singing to the general population as well as to those suffering from PD. It is considered exercise. It can improve your posture and breathing when using correct technique. Singing can strengthen your immune system and is a natural anti-depressant. It works by releasing chemicals, including endorphins, which can make you happy and reduce stress. Because singing is social, it can also help you improve your confidence and make friends.
Loss of vocal strength is a common side effect of Parkinsons. Some people experience difficulty with articulation, as their speech becomes slurred. Muscle and motor issues, like difficulty controlling tongue movement, could cause this. Others experience a decrease in vocal volume that could be influenced by poor breath support.5 Singing can help by reinforcing vocal enunciation and sustaining breath support. People can build strength through song.3,6
According to Elizabeth Stegemöller, an assistant professor of kinesiology at Iowa State University, singing uses the same muscle groups used for swallowing and breathing.
Study Design And Procedures
The study aimed to explore and discover the rehabilitation and training needs of patients with PD, as well as the needs and requirements of their therapists and relatives. These would be later used to design a system, as a useful solution for daily remote training of PD. With this objective, a series of co-creation workshops were planned, with a maximum duration of 3h each and the following structure.
After a short welcome, the involved research team and participants were briefly introduced, together with an explanation of the purpose and nature of the session. This introduction included an interactive short presentation of the first version of a mobile application prototype , developed before conducting the study. During the demonstration, the functionalities of the rehabilitation program as well as the acceptance and usability of the proposed solution were discussed with the participants in the workshop. This discussion was driven by a guide, prepared by the research team prior to each workshop, that integrated a set of components to assist the debate among participants. This guide was updated after each session and considered the results of previous workshops and the characteristics of the participants.
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Effects Of Music Therapy On The Cognitive Sphere
Spina detected a beneficial effect of music therapy on cognition. There was an improvement at the end of the program in tests that examine frontal lobe function in a pilot study conducted on Parkinsons patients, which suggests that the music-based intervention could improve frontal function by acting as a training ground for these cognitive skills since it stimulates attention and executive functions such as planning, flexible thinking, and execution. Although, according to the authors, this effect tends to disappear after the music therapy program is stopped, so it should be continued for a longer period.
However, another study led by Dalla Bella shows how patients with relatively moderate rhythmic abilities are the most likely to benefit from rhythmic auditory signals. These can be enhanced with the use of technological devices such as cell phones and tablets, among others, which can help to generate, apart from rhythm, the correction of cognitive functions of speech and language. This applies not only to people with PD but to patients such as children and adults with neurodevelopmental disorders.
Clinical Trials For Complementary Therapies In Pd
Just like they do for medications, clinical trials are also done for complementary therapies. Trials that test complementary therapies in PD can be conducted in a variety of ways, some more rigorous than others. Typically, patients are assessed for different outcome measures depending on the treatment. For example, a study of massage investigated the change in pain level as an outcome measure, whereas studies of acupuncture looked at changes in sleep and depression as outcome measures. The different types of treatments have not been compared to each other, so there is little way of knowing if one edges out the others in terms of effectiveness on any given measure.
In general, however, these modalities are low-risk and typically demonstrate improvement in either a motor or a non-motor symptom. Additional research with larger and more rigorous trials is needed, but it is exciting to realize that there are many possible therapeutic avenues to explore. It is also important to note that complementary therapies are typically not covered by insurance, so they may be out of financial reach for many people with PD. Increased research demonstrating the efficacy of these modalities is the first step in convincing insurance providers that these services are worth covering.
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Music Helps Movement Mood In Parkinson’s Patients
This is the first time that music therapy’s effect on Parkinson’s has been objectively studied, the Italian researchers say, and their results appear in the latest issue of the journal Psychosomatic Medicine.
Parkinson’s disease is a progressive, incurable nervous system disease that is characterized by difficulties walking, moving, and by uncontrollable tremors. It’s caused by a decrease in brain cells that create dopamine, a chemical that is important for regulating body movement. Often, improving patients’ ability to move and walk can help improve their well-being.
Thirty-two Parkinson’s patients with mild to moderate disability participated in the study. They were divided into two equal groups — one group went through three months of weekly physical therapy sessions the other had weekly music therapy sessions. The latter consisted of listening to music, creating it on instruments, and moving to it rhythmically.
The researchers noted that physical therapy improved stiffness — but did not have a significant effect on overall daily performance. Music therapy did. Patients reported improved ability to do such tasks as cut food and get dressed, and said they were less likely to fall or experience the sudden freezing-up of muscles that occurs with Parkinson’s. Also patients with Parkinson’s sometimes have trouble initiating movement, and music therapy improved this problem — possibly because of its rhythmical quality, the authors suggest.
Music Therapy Interventions In Parkinsons Disease: The State
Parkinsons disease is a neurological disorder involving the progressive degeneration of the dopaminergic system, which gives rise to movement-related dysfunctions as well as other symptoms, mainly of cognitive and psychological nature. In the latter case, mood disorders prevails frequently causing anxiety and depression in all phases of the disease, sometimes even before the motor symptoms occur.
Aarsland and colleagues report that 35% of the patients affected by PD present depression, whereas Richard states that anxiety is to be found in 40% of the cases.
The literature shows that playing and listening to music may modulate emotions, behaviors, movements, communication, and cognitive factors, modifying the activity of the brain areas involved in the perception and regulation of these aspects .
Music can produce substantial effects on movement-related symptoms as well as psychological ones in PD treatment. Concerning the first aspect, rhythm has a crucial role in rehabilitation, enhancing connections between the motor and auditory systems .
Literature showed how a rhythmic auditory cues-based training can produce a compensation of the cerebello-thalamo-cortical network leading to beneficial effects, for example, improving not only speed and step length but also perceptual and motor timing abilities .
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Research Objectives And Comparators
The central goal for this study is to investigate the underlying networks used during TIMP and test the rehabilitative power of TIMP techniques for fine motor control in PD. Specifically, the study aims to demonstrate whether the use of musical instruments to specifically promote fine motor function allows differential mobilization of neuronal networks when they are combined with external rhythmic cueing. To allow for an accurate clinical comparator, a standardized OT research protocol will be tested as well.
Statistical Methods And Sample Size
We will address our clinical research question by determining whether there is a significant change in fine motor skills following TIMP-RHY, TIMP-NR, and OT due to fine motor training compared to the non-therapy condition. We predict that TIMP-RHY will decrease mean GPT scores to a higher extent than the TIMP-NR and the OT groups. We will use an ANOVA F-test model to test this prediction on the mean GPT score change as well as pairwise contrasts with Tukey-Kramer correction for multiple comparisons to assess where the differences are. We do not expect such changes in the waitlist group due to the absence of fine motor strengthening. Given the large effect size of 0.8 sd/mean seen in other PD studies using the GPT grooved pegboard test as main outcome , we anticipate that our sample size of 25 per group will allow us to determine a group difference of 15% decreased time using the dominant hand and to be comparable to published data . We will also perform exploratory analyses using regression modeling to assess whether sex, age, or disease severity and cortical motor beta power changes are correlated with fine motor tests performance.
We will address our QOL research question by assessing changes in the PDQ-39 and CGI-I scales. As fine motor skills may improve, we expect a decrease in mean total scores after a 5-week TIMP-RHY session and to a lower extent after OT or TIMP-NR sessions. We do not expect a change of QOL mean scores in the waitlist group.
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Feel The Rhythm: Music Therapy And Parkinsons Disease
Every year, the top Parkinsons experts from around the world who treat people with Parkinsons at a Parkinsons Foundation-designated Center of Excellence convene to discuss the latest Parkinsons research and treatments. This article summarizes the 2018 Center Leadership Conference presentation on music therapy led by Concetta M. Tomaino, DA, LCAT, MT-BC, Executive Director and Co-Founder of the Institute for Music and Neurologic Function in New York City. Read the articles covering some of the other topics discussed: intimacy issues, art therapy, new therapies in trial and oral health.
Music therapists are professionals who are academically trained and board certified to improve the everyday lives of their patients. More specifically, when people with Parkinsons disease work with a music therapist they see improvements in movement symptoms, speech, cognitive issues and mental health. Through dance programs, choirs and drumming programs, music therapy helps people with PD maintain function, express creativity and experience a better quality of life.
Music therapy can help someone with PD with:
Music therapy uses rhythm, melody and preferred movement to address issues that commonly affect people with PD, such as bradykinesia .
For more information about music therapy or where to find a music therapist near you, contact the Parkinsons Foundation toll-free Helpline at 1-800-4PD-INFO or .
Bringing Harmony To The Brain: The Neuroscience Of Music And Parkinsons Disease
As anyone who has heard their song can attest, the right music has the power to make you move. Now healthcare providers are trying to harness this power to help patients with a neurological motor disorder, Parkinsons disease .
Over the past three decades, researchers have begun to uncover the neural basis of musics effect on the brain with an eye toward treating diseases like PD. A growing body of research reveals that the influence of music is far-reachingshaping connections in the brain, improving our senses and movement, and enhancing our mood.
The Many Disharmonies of Parkinsons Disease
As the second-most common neurodegenerative disease following Alzheimers, Parkinsons disease affects more than 10 million people worldwide and is projected to afflict almost 1 million Americans by 2020.
At its core, PD is marked by a host of movement-related problems, including tremor, rigidity of muscles, slowness of movement, and postural instability. The disease can affect the patients throat muscles, resulting in softer or slurred speech, as well as the muscles in their limbs. Patients often describe challenges with everyday tasks that require fine motor control, like writing or buttoning their clothing. As the disease progresses, patients may develop a slow, shuffling gait and experience challenges with maintaining their balance. With less mobility and daily autonomy, patients quality of life can take a nosedive.
Imperfect Treatments for a Complex Disease
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Music To Ones Ears: Familiarity And Music Engagement In People With Parkinsons Disease
- 1St. Charles Hospital, Port Jefferson, NY, United States
- 2School of Health Technology and Management, Stony Brook University, Stony Brook, NY, United States
- 3Consortium for Digital Arts, Culture, and Technology, Stony Brook University, Stony Brook, NY, United States
- 4Department of Biomedical Informatics, Stony Brook University, New York, NY, United States
- 5Department of Music, Stony Brook University, Stony Brook, NY, United States
- 6School of Medicine, Stony Brook University, Stony Brook, NY, United States
About Music Therapy & Wmts
Music Therapists are credentialed healthcare professions who use music and musical elements to help clients live healthy and fulfilled lives.
Music Therapy sessions involve the application of music therapy interventions within the context of a therapeutic relationship, a relationship that is developed through music-based, verbal, and/or non-verbal communication. Certified MTAs use music to address human needs within cognitive, communicative, emotional, musical, physical, social, and spiritual domains. They conduct client assessments, develop treatment plans, implement therapy processes, and evaluate progress.
For more information about Music Therapy in Canada, check out the Canadian Association for Music Therapists and The Music Therapy Association of Ontario. You can also find more information through the American Music Therapy Association and the World Federation of Music Therapy.
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Ethics Approval And Consent To Participate
Informed consent will be obtained from all subjects participating in this study. Ethical approval was approved by the Colorado Multiple Institutional Review Board . All research procedures will be performed in a confidential setting, and all documents generated by this study, including consent, will be stored in a locked filing cabinet in the locked office of the PI. Electronic data will be de-identified with the exception of a correlational spreadsheet including demographic information and study IDs for scheduling and safety contact purposes. This, and all other research data, will be stored on a password protected network drive and backed-up on the hard-drive of the PI. Identifying information will not be shared outside of the research team or regulatory bodies . Subjects have the right to request their personal health information as well as the results of the different research measures from the investigator, although they will be notified that these do not have any clinical value.
Music Therapy To Help Manage Parkinson’s Symptoms
When a doctor suggests singing, it can be a recommendation for music therapy. A clinical and evidence-based science, according to the American Music Therapy Association the use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. can improve quality of life for those with medical or psychological conditions. The Association promotes the benefits of music therapy and seeks to increase access to quality music therapy services used in healthcare and educational settings.1
Parkinsons disease is a chronic, degenerative, neurological disorder it is frequently characterized by a loss of motor function, yet it has serious non-motor symptoms as well. Cognitive and psychological decline may in fact appear before the motor symptoms. Speech and communication deficits often progress with the disease.
Music therapy has been demonstrated to be effective for people with PD. A review of music therapy programs in the scientific literature shows that playing and/or listening to music may have an effect on emotions, behaviors, movement, communication, and cognitive factors.2 The impact can modify brain activity. Studies have shown that the effects of music can result in changes to both psychological and movement-related symptoms in those being treated for PD.
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Music Therapy Can Be Just What The Doctor Ordered
I never realized the benefits of music until I was diagnosed with Parkinsons disease.
Early in my diagnosis, I met Alexander Pantelyat, MD, co-director of the Johns Hopkins Center for Music and Medicine, who introduced me to both music and dance. Together with boxing and other exercises, music and dance are important tools in my Parkinsons toolbox.
Recently, Pantelyat offered a webinar titled Music as Medicine.
According to Pantelyat, Music has been an integral part of the human experience as long as humanity has been around. Its been intuitively felt to have healing properties, but now we are in a position to study the mechanisms and optimize music-based interventions.
Sarah Hoover, DMA, who also co-directs the center, added: Its fascinating and powerful to think that music, something that has been floating around in our environment forever, that this natural, omnipresent human activity has demonstrable benefit as treatment.
Getting Creative And The Road To A Standardized Therapy
Another component of the neurologic music therapy sessions whether or not they use externally driven movements, is a period of time where patients can improvise at the piano.
We dont really know why or how, but theres a big emotional contentment component that comes with producing music. It seems to increase quality of life for some people, she says. A lot of people feel very uncomfortable improvising at the beginning, but by the end, theyre very much liking it.
Buard and her team plan to collect data throughout the study, measuring finger dexterity through a grooved pegboard test that requires a series of 25 pegs to be rotated into certain positions to be placed correctly. They will measure quality of life and anxiety and depression levels as well.
The mechanistic data collected may inform future research leading to treatment and rehabilitative interventions for patients with Parkinsons and other basal ganglia disorders, and possibly other neurologic diseases, Buard says it may also further knowledge of the neural processes utilized by music.
For patients with Parkinsons, she hopes the study eventually leads to a standardized musical intervention to help improve fine motor skills.
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