Academic journal article Australian Journal of Music Therapy

Music Therapy Services in Neurorehabilitation: An International Survey

Academic journal article Australian Journal of Music Therapy

Music Therapy Services in Neurorehabilitation: An International Survey

Article excerpt

Background

The World Health Organisation (2017a) defines rehabilitation as "a set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment" (p. 1). Neurorehabilitation is a subset of rehabilitation specific to individuals with neurological disorders (Dimyan, Dobkin, & Cohen, 2008; Polgar et al., 1997). Those with neurological disorders demonstrate a variety of sequelae including physical, cognitive, behavioral, and communication impairments, which can lead to psychosocial and daily living difficulties (WHO, 2006). With the broad definition of rehabilitation and the complexity of sequelae in people with neurological disorders, the goals to be addressed in neurorehabilitation are extensive.

Music therapy research in neurorehabilitation has steadily grown since the 1980s and demonstrated potential to address the sequelae of neurological disorders (Baker & Tamplin, 2006). For physical impairments, Weller and Baker (2011) report a number of studies that showed consistent positive and significant outcomes of music therapy interventions (e.g. auditory stimulation, movement to music, active music making) for physical rehabilitation of people with neurological disorders. Music therapy studies have been conducted with people of all ages across a wide range of neurological disorders including stroke, cerebral palsy, Erb's palsy, Parkinson's disease, and Rett syndrome (Freedland et al., 2002; Howe, Lovgreen, Cody, Ashton, & Oldham, 2003; Jeong & Kim, 2007; Kwak, 2007; Luft et al., 2004; Pacchetti et al., 2000; Rahlin, Cech, Rheault, & Stoecker, 2007; Rochester et al., 2005; Schauer & Mauritz, 2003; Schneider, Schonle, Altenmiiller, & Munte, 2007; Thaut et al., 2007; Whitall, McCombe, Waller, Silver, & Macko, 2000; Yasuhara & Suyiyama, 2001). These studies show the diversity of populations with whom physical rehabilitation is addressed across both acquired and degenerative neurological disorders. In particular, there are various dimensions of physical rehabilitation which music therapy can benefit, such as different movement types (e.g. gait, fine and gross motor movements in both upper and lower extremities), and movement qualities (e.g. balance, strength, dexterity, mobility, coordination, range of motion, functional uses) (Magee, Clark, Tamplin, & Bradt, 2017; Tamplin, 2006; Weller & Baker, 2011).

According to the Cochrane review by Magee et al. (2017), studies using music interventions to target cognitive impairments, including memory, attention, executive functioning, and orientation rehabilitation for people with acquired brain injury (ABI) were examined (Pool, 2013; Sarkamo et al., 2008; Mueller, 2013; Baker, 2001). The review shows that orientation was the only outcome that had significant improvements in response to live music listening (Baker, 2001; Magee et al., 2017). In people with disorders of consciousness due to ABI, music therapy has been shown to be effective in stimulating behavioural responses, such as facial expression, blink, and respiratory rate (Fernandes et al., 2014; O'Kelly, 2013). For behavioural problems, music therapy has demonstrated effectiveness in reducing agitation and other challenging behaviours in people with brain injury (Baker, 2001; Hitchen, Magee, & Soeterik, 2010).

For communication impairments, Tamplin (2008) found that singing and vocal exercise improved normative speech production, including speech intelligibility and naturalness, in people with acquired dysarthria. Music therapy has also been reported to improve speech repetition, naming, reading, and verbal fluency in people with acquired aphasia (Jungblut, 2004; Sarkamo et al., 2008; van der Meulen, van de Sandt-Koenderman, Heijenbrok-Kal, Visch-Brink, & Ribbers, 2014). Music therapy thus has potential to address both speech and language aspects of communication impairments. …

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