Since the 1990s, a strong body of research evidence has set the foundation for the use of rhythm and music as important tools in the development, rehabilitation, and maintenance of sensorimotor function, particularly in the treatment of neurologic disorders. This chapter examines the connection between music and sensorimotor function, and the underlying neurological principles and mechanisms behind music perception, production, and cognition as they relate to motor function. The role of neurologic music therapy to facilitate functional movement is discussed with a variety of populations and movement disorders including: Parkinson’s disease, stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, autism and healthy elderly. The chapter is divided into sections related to acquired movement disorders, degenerative diseases, and developmental disorders.
BACKGROUND: Traumatic brain injury has multiple impacts on gait including decreased speed and increased gait variability. Rhythmic auditory stimulation (RAS) gait training uses the rhythm and timing structure of music to train and ultimately improve slow and variable walking patterns. OBJECTIVE: To describe the feasibility of RAS gait training in community-dwelling adults with traumatic brain injury (TBI). A secondary objective is to report changes in spatiotemporal gait parameters and clinical measures of balance and walking endurance. METHODS: Two individuals with a TBI participated in nine sessions of gait training with RAS over a 3-week period. At baseline, post-training and 3-week follow-up, spatiotemporal parameters of walking were analyzed at preferred pace, maximum pace and dual-task walking conditions. Secondary outcomes included the Community Balance and Mobility Scale and the 6-Minute Walk Test. Feasibility was assessed using reports of physical fatigue, adverse event reporting, and perceived satisfaction. RESULTS: Both participants completed all 9 planned intervention sessions. The sessions were well tolerated with no adverse events. Participant 1 and 2 exhibited different responses to the intervention in line with the therapeutic goals set with the therapist. Participant 1 exhibited improved speed and decreased gait variability. Participant 2 exhibited reduced gait speed but less fatigue during the 6MWT. CONCLUSIONS: RAS was found to be a safe and feasible gait intervention with the potential to improve some aspects of gait impairments related to gait speed, gait variability, dynamic balance and walking endurance. Further investigation including a pilot randomized controlled trial is warranted.
This chapter examines the connection between music and speech, and points out areas of intersection relative to the mechanisms guiding their practice, application, and execution. This work also investigates the role of neurologic music therapy as a developmental, remedial, and rehabilitative protocol in the area of speech and language. In order to operationalize findings, the chapter is divided into sections by speech and language disorder: dysarthria, apraxia of speech, aphasia, fluency, sensory deficits, voice disorders, and dyslexia. Literature is provided hereafter outlining the premise for music prescription relative to the aforementioned areas, as well as areas of speech and language therapy wherein music discernibly exists as a fundamental construct in various therapeutic protocols; the practice of singing being a main area of concentration. The review provides an overview of related research and outlines areas in preliminary stages of investigation.
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