PM&R News   •   March 2020

New research from Addenbrooke’s hospital in Cambridge has shown promising results with the use of music therapy in treatment of patients with acute CVAs. A 2-year study performed on 177 patients who underwent 675 sessions was recently reported for improvements in patient’s mood and thus possibility of increased patient engagement with rehabilitation sessions.

Prior studies have shown that depression amongst those affected by CVAs, particularly aphasia, is high. The impact that music therapy has on improved mood could also affect rehabilitation participation, depression scales, and ultimately rehabilitation outcomes.  The use of music therapy is not novel and has shown to allow for copious practice, tactile/auditory feedback for neuroplasticity, and the ability to create novel frameworks within the brain to aid in anticipating and timing of movements.  The study hypothesizes that the effects of music therapy are correlated with the reward and learning/activity plasticity centers in the brain lending to its effectiveness.

Music therapy treatment was performed on a single cohort (no controls due to purpose of assessing NMT feasibility within this particular population) over a 24-month timespan at 2x/week on a 26-bed CVA rehab unit. Feedback on NMT and Visual Analogue Mood Scale (t-scores based on this) were conducted. Sensorimotor treatment included: sit to stand and UE/LE movements via hand percussion, drums, and keyboard with touchscreen tablets. Exercises targeting cognitive training and executive function utilized drums and percussions requiring patients to mimic intricate rhythmic patterns, internal feedback, and extrinsic feedback to allow for progression with attention and executive function. Exercises for speech focused on “articulation, breath control, speech rate, speech fluency, and/or word retrieval”. This was completed via singing, filling in missing lyrics, melodic intonation therapy, and rhythmic speech cueing.  Exercises were specific for each patient and developed with the patient and rehabilitation team along with psychologists.

Significant limitations existed with data collection due to inability of patients to complete questionnaires (usually related to aphasia and/or early discharge). Overall the studies aim was accomplished in determining the feasibility of carrying out NMT in the acute setting (though recommendations are made to reproduce this in another facility for generalizability). Improvements in patient moods and movements were noted both by patients, relatives, and the care teams involved.

*Further studies on patients affected by acute CVAs can be found here: arm function, non-fluent aphasia, gait, and cognition,as well as a recent Cochrane review on the sub-acute setting.

References:

1. https://www.tandfonline.com/doi/full/10.1080/10749357.2020.1729585
2. https://www.sciencedaily.com/releases/2020/03/200305203539.htm

Photo by Spencer Imbrock on Unsplash