The Case for Musical Instrument Training in Cerebral Palsy for Neurorehabilitation

Abstract

Recent imaging studies in cerebral palsy (CP) have described several brain structural changes, functional alterations, and neuroplastic processes that take place after brain injury during early development. These changes affect motor pathways as well as sensorimotor networks. Several of these changes correlate with behavioral measures of motor and sensory disability. It is now widely acknowledged that management of sensory deficits is relevant for rehabilitation in CP. Playing a musical instrument demands the coordination of hand movements with integrated auditory, visual, and tactile feedback, in a process that recruits multiple brain regions. These multiple demands during instrument playing, together with the entertaining character of music, have led to the development and investigation of music-supported therapies, especially for rehabilitation with motor disorders resulting from brain damage. We review scientific evidence that supports the use of musical instrument playing for rehabilitation in CP. We propose that active musical instrument playing may be an efficient means for triggering neuroplastic processes necessary for the development of sensorimotor skills in patients with early brain damage. We encourage experimental research on neuroplasticity and on its impact on the physical and personal development of individuals with CP.

Development and evaluation of a novel music-based therapeutic device for upper extremity movement training: A pre-clinical, single-arm trial

“…There is growing evidence that music-based interventions are a promising therapeutic approach for the restoration of upper extremity functional abilities in neurologic conditions including stroke [30,31], cerebral palsy [32], and Parkinson's Disease [28,33]. For instance, there is extensive research on the effectiveness of therapeutic techniques such as Music-supported Therapy and Therapeutic Instrumental Music Performance in rehabilitating arm paresis after stroke through musical instrument playing [30,[34][35][36][37][38][39][40].…”

Music‐supported therapy in the rehabilitation of subacute stroke patients: a randomized controlled trial

“…These techniques are designed to improve not only motor deficits but also other relevant aspects, including motivation, treatment adherence, and mood, all of which are known to contribute to the success of the rehabilitation process . For instance, music practice as a therapy for stroke patients is an enjoyable activity that includes complex and coordinated movements while placing a high demand on cognitive functions, such as attention and working memory, as well as modulating mood . Music performance facilitates auditory–motor coupling, increases the adherence to physical exercises, and promotes social bonding during group performance .…”

“…11,12 For instance, music practice as a therapy for stroke patients is an enjoyable activity that includes complex and coordinated movements while placing a high demand on cognitive functions, such as attention and working memory, as well as modulating mood. [13][14][15][16][17] Music performance facilitates auditory-motor coupling, 18 increases the adherence to physical exercises, 19 and promotes social bonding during group performance. [20][21][22] Some of these positive aspects could be partly mediated by the dopaminergic reward system, which is known to be highly responsive to music and involved in learning, memory, and the modulation of synaptic plasticity.…”

Development and Evaluation of a Novel Music-based Therapeutic Device for Upper Extremity Movement Training

“…There is growing evidence that music-based interventions are a promising therapeutic approach for the restoration of upper extremity functional abilities in neurologic conditions including stroke [30,31], cerebral palsy [32,33], and Parkinson's Disease [28,34]. For instance, there is extensive research on the effectiveness of Therapeutic Instrumental Music Performance in rehabilitating arm paresis after stroke through musical instrument playing [35][36][37][38][39][40][41][42][43][44].…”

“…For instance, there is extensive research on the effectiveness of Therapeutic Instrumental Music Performance in rehabilitating arm paresis after stroke through musical instrument playing [35][36][37][38][39][40][41][42][43][44]. Similarly, active musical instrument playing (i.e., piano) also seems to improve manual dexterity and nger and hand motor function in individuals with cerebral palsy [33,[45][46][47]. Furthermore, consistent evidence indicates that interventions using rhythmic auditory cues or rhythmically-enhanced music [34,48,49] are effective to increase muscle activation symmetry [50], improve range of motion and isometric strength [51,52], enhance spatiotemporal motor control [53], and decrease compensatory reaching movements [50].…”