The effect of therapeutic instrumental music performance method on upper extremity functions in adolescent cerebral palsy

Abstract

The aim of the study is to investigate the improvement of upper extremity functions with piano training of adolescent cerebral palsy. Nine adolescent cerebral palsy patients admitted to the Pediatric Disability Clinic between 2018 and 2020 and 9 healthy adolescent volunteers as control group were included. Therapeutic Instrumental Music Performance method was applied 2 days a week, 3 months in 40-min sessions. Before/after intervention, MACS, Box Block Test, Nine-Hole Peg Test, Jamar hand dynamometer and key pressing force of fingers were evaluated with Cubase MIDI program. Five of our patients included in the study were spastic hemiplegic and 4 were spastic diplegic cerebral palsy. All measurements made after intervention were found to be statistically significant compared to the measurements made before piano training ( p < 0.05). The fingers that improved the most in the key pressing force of the fingers were found as the right hand 4th, left hand the 4th and 5th fingers ( p < 0.01). A significant strong negative relationship was detected between the Box Block Test and the Nine-Hole Peg Test ( p < 0.001). With therapeutic instrumental music performance method, functional gains can be achieved in the grip strength, strengths of the fingers, gross and fine motor skills of adolescent cerebral palsy patients. Further studies are needed to establish a piano training protocol in neurological music therapy.

Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives

“…Further, these improvements remained stable in a follow-up assessment conducted 16 weeks after treatment was completed. Dogruoz Karatekin and Icagasioglu (2021) reported significant functional gains and improved grip strength, selective strength of the fingers, gross and fine hand motor skills after 3 months of TIMP-based piano intervention in nine adolescents with CP. These findings show promising evidence of the potential of this music-based therapy.…”

The effect of neurologic music therapy in patients with cerebral palsy: A systematic narrative review

“…RAS is a training method that uses external auditory cues to guide movement through anticipated temporal sequence to enhance motor skills by providing rhythmic stimulation to the motor center of the brain ( 24 ). TIMP uses musical instruments to exercise and facilitate functional movement patterns ( 25 ). PSE uses various musical elements, such as rhythmic, melodic, harmonic, and dynamic-acoustical elements, as cues for movement patterns ( 26 ).…”

“…PSE uses various musical elements, such as rhythmic, melodic, harmonic, and dynamic-acoustical elements, as cues for movement patterns ( 26 ). Among these 15 studies, 7 studies were on RAS ( 27 – 33 ), 6 studies were on TIMP ( 7 , 12 , 25 , 34 – 36 ), and 2 studies were on PSE ( 37 , 38 ). Ten studies were conducted on children and adolescents with CP ( 7 , 12 , 25 , 27 , 28 , 32 , 34 , 36 – 38 ) and five studies were conducted on adults with CP ( 29 – 31 , 33 , 35 ).…”

“…Among these 15 studies, 7 studies were on RAS ( 27 – 33 ), 6 studies were on TIMP ( 7 , 12 , 25 , 34 – 36 ), and 2 studies were on PSE ( 37 , 38 ). Ten studies were conducted on children and adolescents with CP ( 7 , 12 , 25 , 27 , 28 , 32 , 34 , 36 – 38 ) and five studies were conducted on adults with CP ( 29 – 31 , 33 , 35 ). The characteristics of the studies, including total number of patients, age, type of CP (if mentioned), type of NMT evaluation tools, treatment duration, follow-up period, and results, are summarized in Table 1 .…”

Neurologic Music Therapy Improves Participation in Children With Severe Cerebral Palsy

“…An increase in the intensity of therapeutic practice has been recommended in neurorehabilitation ( 44 ), and this was intended with the NMT sessions; nevertheless, it was important not to reduce the level of visual contact when increasing the difficulty due to the features of our studied sample ( 6 ). Different studies ( 12 , 31 – 34 , 46 , 47 ) indicate an approximate frequency of intervention sessions of 40 min, twice a week for a period of between 3 or 4 months. However, some authors ( 31 , 32 ) argue that the clinical stage, the severity of the case, the duration of treatment and the dose should be considered individually to better adjust the intervention to the capacity of each individual.…”