Auditory stimulation improves motor function and caretaker burden in children with cerebral palsy- A randomized double blind study

Abstract

AimTo investigate the impact of auditory stimulation on motor function in children with cerebral palsy (CP) and disabling hypertonia.Method9 matched pairs (age: 7y5m, SD 4y1m; 13 boys; gross-motor-functional-classification-scale: median 4; manual-ability-classification-system: median 4) were randomized to receive either auditory stimulation embedded in music (study, n = 9) or music alone (sham, control, n = 9) for at least 10 minutes 4 times a week for 4 weeks. Goal-Attainment-Scale, Care-and-Comfort-Hypertonicity-Questionnaire, Gross-Motor-Function–Measure and Quality-of-Upper-Extremity-Skills-Test (QUEST) were assessed before and 5 months following intervention.ResultChildren receiving auditory stimulation attained more goals than children who listened to music alone (p = 0.002). Parents reported improved care and comfort in children in the study group compared to a slight deterioration in controls (p = 0.002). Upper extremity skills improved in the study group compared to controls (p = 0.006). Similar gross motor function changes were documented in both groups (p = 0.41).One participant reported increased seizure frequency; no other participants with epilepsy reported increased seizure frequency (n = 6/18) and no other adverse events were reported.InterpretationAuditory stimulation alleviated hypertonia and improved fine and gross motor functions.

Effect of music listening on hypertonia in neurologically impaired patients—systematic review

“…In total, data from 171 patients (50 females, 102 males, 19 unknown), of which 30 were diagnosed with stroke (Jeba & Joshi, 2016; Wong, Mak & Mok, 2018), 61 with cerebral palsy (Ben-Pazi et al, 2018; Kvam, 1997; Scartelli, 1982; Wong, Mak & Mok, 2018), 4 with traumatic brain injury (Wong, Mak & Mok, 2018) and 76 patients in a decreased conscious state (Puggina & Da Silva, 2015) were included in this study (Table 1). One hundred and four participants were allocated to the experimental group receiving MLI, while 67 patients were in the control group.…”

“…There was a great variety in outcomes measures used to assess hypertonia. Two studies assessed muscle tone clinically by means of the Modified Ashworth Scale (MAS) (Jeba & Joshi, 2016; Wong, Mak & Mok, 2018), while the other studies used the Care and Comfort Hypertonicity Questionnaire (Ben-Pazi et al, 2018) or Nic Waals muscle test (Kvam, 1997). Hypertonia and muscle activity was biomechanically assessed by either electroneuromyography (ENG) (Puggina & Da Silva, 2015) or EMG (Scartelli, 1982).…”

“…Conventional neurorehabilitation consisted of inhibitory techniques for hypertonia, facilitatory techniques for antagonistic muscles, weight bearing exercises, stretching and rhythmic rotations. Other studies used music listening in comparison to no music (Puggina & Da Silva, 2015) or different music sounds (Ben-Pazi et al, 2018; Wong, Mak & Mok, 2018). The amount of interventions ranged from two to 24 sessions, while therapy time ranged from two minutes to 30 min.…”

“…The amount of interventions ranged from two to 24 sessions, while therapy time ranged from two minutes to 30 min. Four studies (Ben-Pazi et al, 2018; Kvam, 1997; Scartelli, 1982; Wong, Mak & Mok, 2018) investigated long-term effects, ≥4 weeks of therapy, while two studies (Jeba & Joshi, 2016; Puggina & Da Silva, 2015) examined short-term effects, <1 week of therapy.…”

“…The type of music was either predetermined by the study protocol (Jeba & Joshi, 2016; Kvam, 1997; Scartelli, 1982; Wong, Mak & Mok, 2018) or based on the participant’s preferences (Ben-Pazi et al, 2018; Puggina & Da Silva, 2015). Predetermined music was selected by the researchers and consisted of the following musical pieces:…”