Archive for category Music/Music therapy
Karen Nolan, PhD, of Kessler Foundation, is site investigator for a multi-site trial of a music-based digital therapeutic device with the potential to improve mobility after stroke
East Hanover, NJ. September 16, 2020. Karen Nolan, PhD, of Kessler Foundation, received a grant from MedRhythms to test the company’s investigational digital therapeutic device, the Stride Plus, in individuals striving to recover mobility after stroke. Dr. Nolan, a senior research scientist in the Center for Mobility and Rehabilitation Engineering Research, specializes in the study of new technologies with potential applications in rehabilitation research for deficits in gait and balance that impair mobility.
Kessler Foundation is one of six sites participating in the randomized controlled study, “Post-stroke walking speed and community ambulation conversion: A pivotal study.” The other sites are the Shirley Ryan AbilityLab in Chicago, The Mount Sinai Hospital in New York, Spaulding Rehabilitation Hospital in Boston, Boston University Neuromotor Recovery Laboratory, and Atrium Health in Charlotte, North Carolina.
The study’s objective is to help individuals whose walking ability is affected by stroke to improve their walking speed and advance from limited community ambulation to community ambulation. The data collected from the six sites will support MedRhythm’s application for FDA approval of the device, which received Breakthrough Device Designation from the FDA in June 2020.
The Stride Plus device, which relies on internet connectivity, includes: 1) mobile device that provides rhythmic auditory stimulation in the form of music and rhythmic cues to facilitate the speed and quality of walking; 2) sensors that attach to each shoe to measure biomechanics; and 3) headphones that deliver the auditory cues. Feedback from the sensors is used to augment the music to encourage stable gait patterns and faster walking speed. The sensors also allow for monitoring and recording of the individual’s progress.
A total of 78 participants, including stroke survivors and controls, will be randomized to treatment and control groups. The treatment group will train in the Stride Plus three times a week for five weeks.
“Loss of mobility after stroke exerts a huge toll on individuals, their caregivers, our healthcare system, and society,” said Dr. Nolan, site investigator for the Kessler site. “Stroke rehabilitation is an area where we need to test new technologies to change the outlook for recovery. Applying digital therapeutics is a promising approach for restoring lost mobility,” she noted, “which may foster greater independence and better quality of life in this population.”
As stroke survival rates increase and the population ages, the population of stroke survivors in the U.S. is growing, according to Brian Harris, founder and CEO of MedRhythms. “Progress in stroke rehabilitation has lagged the needs of this growing population. Randomized controlled trials like this pivotal study will help us determine the potential for digital therapeutics in filling these unmet needs for rehabilitation that improves outcomes,” Harris added. “We are encouraged by the FDA’s Breakthrough Device Designation for Stride Plus, which supports our efforts to raise the standard of care for chronic stroke.”
[ARTICLE] The Use of Therapeutic Music Training to Remediate Cognitive Impairment Following an Acquired Brain Injury: The Theoretical Basis and a Case Study – Full Text
Cognitive impairment is the most common sequelae following an acquired brain injury (ABI) and can have profound impact on the life and rehabilitation potential for the individual. The literature demonstrates that music training results in a musician’s increased cognitive control, attention, and executive functioning when compared to non-musicians. Therapeutic Music Training (TMT) is a music therapy model which uses the learning to play an instrument, specifically the piano, to engage and place demands on cognitive networks in order to remediate and improve these processes following an acquired brain injury. The underlying theory for the efficacy of TMT as a cognitive rehabilitation intervention is grounded in the literature of cognition, neuroplasticity, and of the increased attention and cognitive control of musicians. This single-subject case study is an investigation into the potential cognitive benefit of TMT and can be used to inform a future more rigorous study. The participant was an adult male diagnosed with cognitive impairment as a result of a severe brain injury following an automobile accident. Pre- and post-tests used standardized neuropsychological measures of attention: Trail Making A and B, Digit Symbol, and the Brown– Peterson Task. The treatment period was twelve months. The results of Trail Making Test reveal improved attention with a large decrease in test time on both Trail Making A (−26.88 s) and Trail Making B (−20.33 s) when compared to normative data on Trail Making A (−0.96 s) and Trail Making B (−3.86 s). Digit Symbol results did not reveal any gains and indicated a reduction (−2) in free recall of symbols. The results of the Brown–Peterson Task reveal improved attention with large increases in the correct number of responses in the 18-s delay (+6) and the 36-s delay (+7) when compared with normative data for the 18-s delay (+0.44) and the 36-s delay (−0.1). There is sparse literature regarding music based cognitive rehabilitation and a gap in the literature between experimental research and clinical work. The purpose of this paper is to present the theory for Therapeutic Music Training (TMT) and to provide a pilot case study investigating the potential efficacy of TMT to remediate cognitive impairment following an ABI.
An acquired brain injury (ABI) can result in impairment in a variety of domains including motor, speech, emotional, and cognitive. Cognitive impairment is the most common sequelae following an ABI [1,2,3,4] and is a result of deficit in one or more areas of cognition such as the various forms of attention, working memory, memory, executive function, or processing speed [5,6,7,8,9,10,11]. An individual with cognitive impairment may experience challenge to suppress distraction, remain on task, shift between tasks, follow directions, organize and initiate a response, or have difficulties with memory. Cognitive impairment can impact participation and progress in rehabilitation therapies for any of the above domains due to reduced attention, poor executive functioning, or impaired memory. The inability to attend to instructions of the therapist, to cognitively plan and organize a response, or to remember rehabilitation objectives outside the therapy session can potentially disqualify an individual from participation in rehabilitative programs or may impede progress in them. Furthermore, cognitive impairment is reported by family and caregivers as a significant source of stress [8,12,13,14]. Addressing cognitive impairment should be a priority in patient treatment following an acquired brain injury. Therefore, it is important to have on-going research into potentially effective cognitive rehabilitation tools.Music training has been noted in the literature to impact areas of non-musical functioning including phonological awareness , speech processing , listening skills , perceiving speech in noise  and reading [19,20]. Of significance to the theory of Therapeutic Music Training, the literature demonstrates the impact of music training on cognitive abilities including attention and executive functioning [21,22,23,24,25,26,27].Therapeutic Music Training (TMT) is a music therapy model in which the use of music training, specifically learning to play the piano, is used to address and remediate cognitive impairment following an acquired brain injury . TMT is informed by clinical work and is grounded in literature. The hypothesis of the efficacy of TMT to remediate cognitive impairment is supported by literature regarding the influence of music training on cognition [23,24,25,29], musician’s enhanced abilities in attention, working memory, and cognitive control , theories of attention [30,31,32,33,34,35] and the neuroplasticity of the brain, including following injury [36,37,38,39,40]. Because of the engagement of the prefrontal cortex and the demands placed on working memory and attention during TMT, it can be an effective tool to address cognitive impairment. Although functionally interconnected, specific aspects of cognition such as working memory, attention, executive function, and memory are targeted in TMT tasks. TMT is a remedial approach to cognitive rehabilitation, that is, the goal is to drive, strengthen, and improve the underlying neural processes involved in the target cognitive areas. This is in contrast to a compensatory approach to cognitive rehabilitation, in which the goal is to provide the individual with strategies and accommodations to deal with the outcomes of cognitive impairment. The tangible outcome of producing a song provides motivation for the client to engage in cognitive rehabilitation and to remain in the rehabilitative process for an extended period of time as is required to stimulate a neuroplastic response and for the remediation of neural processing to take place.TMT is distinct from modified music education in that the goal of TMT is the remediation of cognitive processes rather than music performance. Tasks involved in learning to play the piano are designed with the goal of placing demands on the various components of cognition. The sequencing and pacing of tasks are determined by the cognitive goals with consideration to target cognitive processes and the time required to drive and strengthen the networks involved. Novelty and the gradual increase in complexity of tasks are utilized to place on-going demands on attention networks and to gradually benefit higher cognitive processes. This is in contrast to modified music education, in which the primary goal is the acquisition of musical abilities and performance.TMT is distinct from other models of music therapy in that it uses music training as the intervention for rehabilitative purposes. TMT contrasts from other music therapy models which use music primarily for expressive purposes, lack corrective feedback from the therapist, or use isolated music tasks which are not intended as music training. TMT is distinct from Neurologic Music Therapy (NMT)  in addressing cognitive goals as NMT does not use music training in its music-based rehabilitative interventions. Bruscia highlighted the importance of the music therapist’s “non-judgemental acceptance of what the client does musically”  (p. 3). While the TMT therapist would express empathy and support to the client, s/he would also provide constructive and corrective feedback as required in the learning to play an instrument. As in other models of music therapy, the therapist’s use-of-self and the role of the client–therapist relationship are important contributors to the success of the therapy.Remarkably, much of cognitive rehabilitation is not grounded in the literature [36,43,44,45]. This may be due in part to the fact that rehabilitation therapy used to address cognitive impairment is most often based on a compensatory approach, accommodating or supporting the impairment, rather than attempting to remediate the cognitive processes that have been impaired. While the use of music and instrument playing for motor rehabilitation has been widely investigated [41,46,47,48], there is sparse literature investigating the potential efficacy of music-based cognitive rehabilitation interventions. This paper provides a brief introduction to the theory for TMT. This case study investigates the hypothesis of the potential effectiveness of therapeutic music training, TMT, to remediate cognitive impairment and serves as a pilot project to inform future, more rigorous studies. This investigation can contribute to the literature regarding music-based cognitive rehabilitation and inform clinical practice. There is a gap between cognitive experimental research and treatment applications . The hypothesis for TMT has been informed by clinical work and this study can help fill in the gap between experimental research and clinical application. […]
Continue —-> https://www.mdpi.com/2227-9032/8/3/327/htm
Scientists from Italy conducted a study, during which they established the beneficial effects of Mozart’s piano music on people’s mental health. They proved that the works of the composer help with epilepsy.
The “Mozart effect” has been known since the end of the last century. However, until recently, no research has provided convincing evidence of its existence, and therefore doctors are skeptical about it. Scientists from the University of Pisa carried out scientific work, during which they carried out a detailed analysis of 147 published articles devoted to this phenomenon. After reviewing all the materials, Dr. Federico Sicca and Gianluca Sesso chose the 12 most accurate. They compared the results obtained by experts working independently of each other, revealing patterns. In their opinion, listening to classical works of Mozart daily can have a significant impact on health. The number of seizures with epilepsy among fans of such music decreases from 31% to 66%. Even a one-time listening has a positive impact. Probably, the effect is due to special rhythmic structures, but the therapeutic effect can be revealed when listening to compositions by other authors.
Their colleague from the Lithuanian University of Medical Sciences Vesta Steiblienė agrees with them. In her opinion, interest in non-invasive methods of brain stimulation is growing and is increasingly being practiced by doctors, but for widespread use and acceptance of recommendations, such neurostimulation should be studied more carefully and accurately. Since it is already obvious now that Mozart’s music really has an effect, but it is not clear at the expense of what exactly.
• Music-based interventions integrate most of the principles of motor training and multimodal stimulation.
• The use of music in rehabilitation can improve motor and cognitive functions of subacute and chronic stroke patients.
• Music-based interventions lead to better mood and quality of life in stroke patients than conventional approaches.
• Future studies should better address methodological aspects to improve the level of evidence of these interventions.
Music-based interventions have emerged as a promising tool in stroke motor rehabilitation as they integrate most of the principles of motor training and multimodal stimulation.
This paper aims to review the use of music in the rehabilitation of upper extremity motor function after stroke. First, we review the evidence supporting current music-based interventions including Music-supported Therapy, Music glove, group music therapy, Rhythm- and music-based intervention, and Musical sonification. Next, we describe the mechanisms that may be responsible for the effectiveness of these interventions, focusing on motor learning aspects, how multimodal stimulation may boost motor performance, and emotional and motivational aspects related to music.
Then, we discuss methodological concerns in music therapy research related to modifications of therapy protocols, evaluation of patients and study designs. Finally, we highlight clinical considerations for the implementation of music-based interventions in clinical settings
[Abstract] The effect of music therapy on physiological parameters of patients with traumatic brain injury: A triple-blind randomized controlled clinical trial
Traumatic brain injury (TBI) is known as a silent epidemic and leading cause of death and disability. .
Hospitalization in the ICU is stressful for TBI patient and can lead to an increase in their physiological Parameter.
Auditory stimulation with a familiar voice is one of the non-pharmacological interventions for stress control.
The result of this study showed that familiar auditory stimulation can control and reduce SBP, DBP, HR, and respiration. .
Familiar auditory stimulation did not have a significant impact on temperature and O2 saturation.
This study aims to investigate the effect of music therapy integrated with family recollection on physiological parameters of patients with traumatic brain injury who are admitted to Intensive Care Units.
Sixty patients were selected through convenience sampling and were then randomly assigned to the intervention group and control group. In the intervention group and for 6 consecutive days, the patients received a combination of music and auditory stimulation twice a day for 15 minutes. The patients’ physiological parameters were measured before the intervention, and then 10 minutes and finally 30 minutes after the intervention. The data were analyzed using multilevel modeling method through MLwiN version 2.27.
The results showed that there was no significant difference between the two groups in terms of demographic factors and the duration of coma. However, the results of the two-level multiple linear models which were performed for 6 consecutive days indicated a significant decrease in systolic blood pressure, diastolic blood pressure, respiratory rate and heart rate for the patients in the intervention group as compared to the patients in the control group (P < 0.0001). Nevertheless, no significant difference was observed in temperature and oxygen saturation (P > 0.05).
Integration of music therapy with family recollection can moderate physiological parameters. Therefore, it is recommended to use this cost-effective treatment along with the routine treatments, especially for patients with traumatic brain injury.
Posted by Debbie Overman
Homebound stroke patients practicing piano therapy at home demonstrated positive motor performance results, according to a pilot study conducted by Georgia State University researchers.
The stroke survivors, who had impairment of upper extremity motor function and the ability to follow instructions, participated in the 3-week study using a portable electric piano and a commercial iPad app, Yousician. Participants were encouraged to play the piano assisted by the app for at least 1 hour per day. At the end of the study, the participants showed good training compliance and gave positive feedback, according to a media release from Georgia State University.
The study, led by Dr. Yi-An Chen, assistant professor of occupational therapy in the Byrdine F. Lewis College of Nursing and Health Professions, and Dr. Martin Norgaard, associate professor of music education in the School of Music, may help improve outcomes in homebound patients.
Chen and Norgaard shared their initial findings via a conference abstract in the American Journal of Occupational Therapy. The researchers found participants enjoyed the piano therapy, and when interviewed, 80% said they were motivated for rehabilitation by playing the piano. Also, 40% indicated they wanted to keep playing, if possible. Chen and Norgaard will present further results and details in a poster session at the Georgia Occupational Therapy Association virtual conference in October, the release continues.
“We are pleased with the positive results of this pilot study, which demonstrate the feasibility and the effects of in-home piano therapy using a mobile app for individuals with stroke.”
— Dr Martin Norgaard, associate professor of music education, School of Music, Georgia State University
According to Chen, the team is applying for additional grants to test the therapy and app with a larger group of stroke survivors and to examine opportunities to extend the therapy to other types of patients such as those with Parkinson’s disease or multiple sclerosis. The researchers also want to create a training app specifically for this project.
“We are currently working on applying for a few different grants to develop our own app, which will allow us to better tailor the rehab piano training for patients, allow telecommunication between patients and therapists, and will be more patient-friendly.”
— Dr Yi-An Chen, assistant professor of occupational therapy in the Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University
[Source: Georgia State University]
Music can restore some of the cognitive functions, sensory and motor functions of the brain after a traumatic injury.
June 10, 2020. Source: University Health Network
A new clinical research study has found that a Mozart composition may reduce seizure frequency in patients with epilepsy.
A new clinical research study by Dr. Marjan Rafiee and Dr. Taufik Valiante of the Krembil Brain Institute at Toronto Western Hospital, part of University Health Network, has found that a Mozart composition may reduce seizure frequency in patients with epilepsy.
The results of the research study, “The Rhyme and Rhythm of Music in Epilepsy,” was recently published in the international journal Epilepsia Open. It looks at the effects of the Mozart melody, “Sonata for Two Pianos in D Major, K. 448” on reducing seizures, as compared to another auditory stimulus — a scrambled version of the original Mozart composition, with similar mathematical features, but shuffled randomly and lacking any rhythmicity.
“In the past 15 to 20 years, we have learned a lot about how listening to one of Mozart’s compositions in individuals with epilepsy appears to demonstrate a reduction in seizure frequency,” says Dr. Marjan Rafiee, lead author on the study. “But, one of the questions that still needed to be answered was whether individuals would show a similar reduction in seizure frequency by listening to another auditory stimulus — a control piece — as compared to Mozart.”
The researchers recruited 13 patients to participate in the novel, year-long study. After three months of a baseline period, half of the patients listened to Mozart’s Sonata once daily for three months, then switched to the scrambled version for three months. The others started the intervention by listening to the scrambled version for three months, then switched to daily listening of Mozart.
Patients kept “seizure diaries” to document their seizure frequency during the intervention. Their medications were kept unchanged during the course of the study.
“Our results showed daily listening to the first movement of Mozart K.448 was associated with reducing seizure frequency in adult individuals with epilepsy,” says Dr. Rafiee. “This suggests that daily Mozart listening may be considered as a supplemental therapeutic option to reduce seizures in individuals with epilepsy.”
Epilepsy is the most common serious neurological disorder in the world, affecting approximately 300,000 Canadians and 50 million people worldwide.
Many experience debilitating seizures. The treatment is often one or more anti-seizure medications. But for 30 per cent of patients, the medications are not effective in controlling their seizures.
“As a surgeon, I have the pleasure of seeing individuals benefit from surgery, however I also know well those individuals for whom surgery is not an option, or those who have not benefitted from surgery, so, we are always looking for ways to improve symptom control, and improve quality of life for those with epilepsy,” says Dr. Taufik Valiante, senior author of the study and the Director of the Surgical Epilepsy Program at Krembil Brain Institute at UHN and co-Director of CRANIA.
“Like all research, ours raises a lot of questions that we are excited to continue to answer with further research and support from the epilepsy community.”
While these results are promising, the next step is to conduct larger studies with more patients, over a longer period of time.
- Marjan Rafiee, Kramay Patel, David M. Groppe, Danielle M. Andrade, Eduard Bercovici, Esther Bui, Peter L. Carlen, Aylin Reid, Peter Tai, Donald Weaver, Richard Wennberg, Taufik A. Valiante. Daily listening to Mozart reduces seizures in individuals with epilepsy: A randomized control study. Epilepsia Open, 2020; 5 (2): 285 DOI: 10.1002/epi4.12400