Parkinson’s And Music Therapy
April is Parkinsons Awareness Month. Since people with Parkinsons Disease are a population Maine Music & Health often works with, I thought I would share some of the ways music therapy can help these patients and some resources for you.
Parkinsons is a neurodegenerative disorder that affects movement. Symptoms, which can progress gradually, include tremors, stiffness and slowing of movements that often affect a persons ability to walk, produce clear speech and sometimes swallow.
Typical music therapy goals for adults with PD are to improve motor function, which can include gait, or walking stride, and speech.
These goals are addressed by using rhythm, melody and movement techniques. For example, rhythmic auditory cueing is a technique in which rhythm is used to facilitate movement and improve gait. This is done by providing a uniform beat that acts as an external cue to guide a patients movements and has been shown to benefits gait, walking speed and stride length.
Why is rhythm so effective? Rhythm becomes a template for organizing a series of movements, as well as combat cognitive issues that affect movement function, such as attention and focus. Rhythm helps coordinate movement, stimulate attention spans and induce relaxation. Parkinsons.org
Improved speech can be targeting with vocal exercises like singing, humming and vocal warmups. This can have carry over effects on swallowing function and strength.
Researching The Connection Between Music And Movement
With both Music Therapy Awareness month and Brain Awareness Week taking place in March, we explore the conjunction between music, Parkinsons and the brain through research on the effects of music on movement, specifically the symptoms experienced by people living with Parkinsons.
Dr. Jessica Grahn is a cognitive neuroscientist, an associate professor in the Brain and Mind Institute and the Department of Psychology at Western University. She also runs the Music and Neuroscience Lab and was funded by Parkinson Canadas National Research Program, researching how music and sound affect movement.
Dr. Grahn: We do know that music has the effect of transforming their movements for some people. But we still dont know very much about the mechanisms of how it affects activities in anyones brain, whether they have Parkinsons or not.
One thing thats clear is that music promotes powerful responses in our motor systems, even if youre not moving to the music. A lot of the research is around why these motor areas are responding. The applied side of this research would be how to harness this understanding for people with movement problems, including people living with Parkinsons.
Im excited about this because I think it will help us figure out what is going on in the brain by looking at different groups of people and figuring out the mechanism of what happens when they move to music. Then the next step will be figuring out whose brains will respond positively and why.
It Improves Mood And Emotional Status In Parkinsons Disease
Listening to music can have a rewarding effect. When you listen to a song that you like or a song sung by an artist whose voice seems mesmerizing to you, you do tend to experience a sense of elation.
A study published in World Journal of Psychiatry, 2015 reveals that music therapy can alleviate depressive symptoms and improve mood in various neurological disorders.
Pacchetti et al. conducted a study where Parkinsons patients were treated with active music therapy. The therapy involved choral singing, voice exercises and rhythmic as well as free body movements.
Improvement in bradykinesia was observed. Also, music therapy brought about improvement in emotional well being, daily activities and quality of life.
Researchers state that group singing may benefit in Parkinsons by increasing connectedness and flow of social and biological rhythms.
A recent study published in Disability and Rehabilitation, 2016 demonstrated that group singing helped patients manage consequences of their disorder such as low mood, social isolation and communication problems.
Quick Gist: Music therapy can help elevate mood and reduce depressive symptoms in Parkinsons disease patients. Group therapy can help alleviate consequences of the disease such as social isolation.
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How Does Music Therapy Help In Parkinsons Disease
Parkinsons disease involves progressive dysfunction of dopaminergic neurons resulting in impairment of movement.
Also, there are psychological symptoms such as anxiety and depression that occur in this disorder. Music can have significant effects on gait, emotions, communication, etc. which makes it therapeutic for such conditions.
The prime focus of music therapy is rehabilitation or to improve motor function and gait. Internal timing is the mechanism that coordinates and times the movement of our body with our thoughts.
This internal timing is disturbed in Parkinsons disease patients. The irregular timing affects gait, coordination and causes freezing in patients.
Music provides an external audible stimulus that serves as a rhythm that coordinates body movements with beats. This rhythm compensates for the internal timing disturbance.
The therapy involving the use of rhythms as a stimulus to coordinate movement is known as Rhythmic Auditory Stimulation.
Thaut et al. were the first to prove that rhythm can help improve gait in Parkinsons and this study dates back to 1996.
Beats in music can be perceived as pulses for a response to patterns. Beats that form rhythm help establish a pattern and once this pattern is established, the individual remembers the rhythm even if the music is not played.
This phenomenon of learning the rhythm and coordinating movement with it is referred to as entrainment.
Effects Of Music Therapy On The Social And Communication Sphere
Impaired communication is one of the most common symptoms in PD, significantly affecting the persons quality of life. In a study by Tamplin et al. , they consider that singing shares many of the neural networks and structural mechanisms used during speech and therefore has the potential for therapeutic application to address speech disorders. They therefore set out to explore the effects of an interdisciplinary singing-based therapeutic intervention on voice and communication in people with PD, concluding that ParkinSong is an attractive intervention with the potential to increase volume and respiratory function in patients with this condition.
Hypokinetic dysarthria during the disease was analyzed with regard to communication skills as predominant factors in daily life, with the same immediately influencing decreased competence in communication, thereby increasing frustration and a loss of confidence, regardless of the degree of symptoms. Regarding the feasibility and outcome measures, they concluded that there is initial evidence to warrant further study of the protocol. On the other hand, in a narrative review, the role of music therapy in improving aphasia and other neurological disorders was described, underlying the reasons why this tool could be effective in rehabilitation settings, especially in people affected by stroke , in maintaining vocal skills, and in delaying the vocal deterioration that often accompanies PD .
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Dancing Helps Manage Depression
Dancing is one of the most potent ways to connect your mind and body. In recent years, dance-based therapy programs have been used to help improve symptoms of neurological disorders such as Parkinsons, dementia, and depression.
Fortunately for most of us, it doesnt matter how well you move, so long as youre trying to move with the beat. Dancing can take many forms seated, standing, arms-only, etc. However you choose to move, you will feel the benefits!
If you need some guidance, try this seated dancing warm-up from our Victory Summit® Omaha online event.
Music Aids Neuroplasticity Which Enables The Brain To Heal
We used to think MS-damaged brains could not heal. Now we know they can, thanks to a process called neuroplasticity, in which undamaged parts take over for damaged parts, and different parts of the brain learn to work together better.
Music aids neuroplasticity. Harris says, Music globally activates our entire brain. Thats why its applicable to all these illnesses.
Neuropsychiatrist Jon Lieff, MD, writes that music training improves capacities related to perception, performance, and language. He says learning, playing, or singing music increases brain efficiency, with fewer neuronal units needed to encode information.
He says different aspects of music are processed in different parts of the brain. For example, timing is organized in the cerebellum. Pitch is processed in different areas throughout the brain. Musical imagery is analyzed in the frontal lobe, and singing is mostly in the right frontal lobe. Music can get the whole brain working together.
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Getting Back Into The Rhythm
Music therapy may be one promising option that can address many symptoms of PD. Therapeutic music performance, such as prescribed dance classes or group drumming sessions, can improve gross and fine motor skills through a process called rhythmic entrainment, which sets body movements to the beat of music.
In a series of seminal studies, researchers provided a rhythmic beat to PD patients and instructed them to walk. Typically, PD makes it difficult to produce and maintain the rhythmic movement required for walking. But the rhythmic beats in these studies provided a metronome to help patients sync their steps, leading to improvements in gait speed and cadence.
A systematic review conducted in 2018 of previous research studies found that rhythmic auditory stimulation improves walking speed and increases the length of each stride in PD patients. Based on these results, the authors recommend early incorporation of rhythmic auditory cueing for gait performance in PD patients. In the real world, research-backed programs that take advantage of the rhythm of music, such as Dance for PD, have helped improve movement and quality of life for PD patients in 25 countries worldwide.
Music Therapy For Ms: How Rhythm Can Help With Movement And Memory
Music and rhythm can improve the brains ability to function and the bodys ability to move.
Have you found yourself clumsier or less coordinated since you developed multiple sclerosis ? Is your walking affected?
One approach that may give you your rhythm back is music therapy a type of therapy that uses music to address physical, emotional, cognitive, or social needs of individuals.
How can music help with MS? Barbara Seebacher, PhD, a physiotherapist based in Innsbruck, Austria, explains:
There are three different brain centers responsible for the timing of movement: the motor cortex, the basal ganglia, and the cerebellum. One or another of these can be damaged by stroke, Parkinsons disease, or multiple sclerosis.
Music can often supply the timing that has been damaged, helping your body to work more smoothly.
Neurological music therapist Brian Harris, a founder of MedRhythms in Boston, says, When you hear a rhythm, a song, or a metronome, it activates the auditory system, which activates the motor system at a subconscious level.
This process is called entrainment. Harris says, The rhythm is telling your brain to tell your body to move. For people who have damage to the brain, using rhythm can engage undamaged areas to help people move. We have quantifiable data on this. People walk faster they have longer strides. You can see the changes on neurological imaging.
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Music Therapy For Improved Walking
Dr. Seebacher has studied the effects of music therapy in people with MS and documented the benefits of imagined walking combined with music or metronome cues for walking with MS. Her trials, conducted within the department of neurology at the Medical University of Innsbruck in Austria, as part of her PhD program at the University of Brighton in the United Kingdom, included a total of 217 people with mild to moderate MS, some of whom were using canes or crutches, and some who used no walking aids.
Seebacher had study participants listen to music and imagine walking. The participants imagined feeling themselves walking to music or to a metronome beat. The imagination part is called motor imagery, and the music or metronome is called rhythmic cueing or rhythmic auditory stimulation.
A control group did the motor imagery without the rhythmic cueing.
All groups showed improvement in their actual walking, but the music group improved more and had greater improvement in their fatigue levels and quality of life.
A Brain Shaped By Music
Music may be uniquely suited to address the different challenges people with PD face in ways more traditional medical interventions cannot.
The brain is not a static object. It is malleable and plastic, able to change its connections and activity based on a persons experience.
Engaging with music requires a multifaceted set of skillskeeping a rhythm, hitting the correct notes, or coordinating specific body parts, for exampleand may make it particularly effective in activating and reshaping many parts of the brain affected by PD.
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Listening To Music Can Be Both A Solo And Social Activity
Even when songs have deep personal meaning for you, you can listen to and enjoy them with an entire community. In this way, music is arguably the most beautiful and universal experience there is.
Try turning on the radio to your favorite channel and, when the music is playing, close your eyes and think about the thousands of other people who are listening to the same song at that very same time. Or create a sharable playlist on YouTube, Spotify, or your favorite music platform and share it with your closest friends so you can all enjoy it together. Take it a step further and hop on the phone to chat about what memories or feelings the songs bring up for you.
Music Sets Emotions In Motion
Music is more than just a beat: it can also stir up powerful feelings, which can help PD patients.
Listening to and producing music is associated with increased activity in brain areas involved with reward and emotion and increased release of dopamine. By naturally increasing the brains dopamine levels, music may partially counteract the loss of dopamine neurons from the progression of PD. As an added benefit, music is intrinsically motivating, which means music therapy is more effective and easier to keep up with compared to other training regimens, like conventional physical therapy.
Recent studies conducted by neurologist Alexander Pantelyat of Johns Hopkins University found that regular choir, guitar, or drum sessions helped patients with Parkinsons disease improve their movement and coordination as well as their mood.
The group music sessions also provide a social benefit, establishing a community for PD patients who may otherwise find themselves isolated and lonely. Allowing PD patients to experience camaraderie and develop social bonds likely benefits their mood and quality of life.
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Effects Of Music Therapy On The Emotional Sphere
PD is a complex diagnosis commonly associated with motor dysfunction, but it is also known to encompass cognitive, psychiatric, and mood disorders. Music has been successfully used to address motor and non-motor symptoms. Morris administered two surveys to 19 people with PD and 15 people without PD to assess their subjective impressions and appraisals of music. They concluded that people with Parkinsons may perceive less of an automatic connection between music and activity than their healthy peers. In addition, those with PD may receive more pleasure and value from music than they anticipate. Taken together, these results suggest that people with PD may require encouragement to participate, as well as to the ability to choose familiar selections to better access music-based interventions and the benefits they may offer. This may facilitate adherence to therapy, as music is engaging and enjoyable , improves mood, depressive syndromes , and thus improves the quality of life for people with PD .
How Can Music Therapy Help People With Parkinsons Disease
Music is used to promote healing all over the world. Music can be used as a form of therapy to help revive the sensory, fine, and gross motor skills in clients. There are many ways that music therapy can benefit someone with Parkinsonâs. According to the Parkinsonâs Foundation, it helps in a variety of ways. Music therapy can improve a client’s balance, communication, cognition, mental health, and social isolation.
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How Music Therapy Repairs Skills In Those With Parkinson’s
Music therapy is used to help restore the motor skills in people diagnosed with Parkinsonâs Disease.
Nearly one million Americans suffer from Parkinsonâs Disease per year according to the Michael J. Fox Foundation. Approximately six million people suffer from it worldwide. It is becoming one of the worldâs most widespread diseases.
Feel The Rhythm: Music Therapy And Parkinsons Disease
Every year, the top Parkinsons experts from around the world who treat people with Parkinsons at a Parkinsons Foundation-designated Center of Excellence convene to discuss the latest Parkinsons research and treatments. This article summarizes the 2018 Center Leadership Conference presentation on music therapy led by Concetta M. Tomaino, DA, LCAT, MT-BC, Executive Director and Co-Founder of the Institute for Music and Neurologic Function in New York City. Read the articles covering some of the other topics discussed: intimacy issues, art therapy, new therapies in trial and oral health.
Music therapists are professionals who are academically trained and board certified to improve the everyday lives of their patients. More specifically, when people with Parkinsons disease work with a music therapist they see improvements in movement symptoms, speech, cognitive issues and mental health. Through dance programs, choirs and drumming programs, music therapy helps people with PD maintain function, express creativity and experience a better quality of life.
Music therapy can help someone with PD with:
Music therapy uses rhythm, melody and preferred movement to address issues that commonly affect people with PD, such as bradykinesia .
For more information about music therapy or where to find a music therapist near you, contact the Parkinsons Foundation toll-free Helpline at 1-800-4PD-INFO or .
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Imperfect Treatments For A Complex Disease
As a neurodegenerative disease, PD involves the progressive loss of dopamine-producing neurons. This loss leads to irregular activity and connections in the surviving brain cells, impacting movement coordination. It may also account for non-motor symptoms in PD related to emotion and mood.
Traditionally, physicians prescribe medications that target the dopamine system to compensate for the patients lost dopamine production surgical interventions, such as deep brain stimulation, can also help and are believed to mitigate some of the aberrant brain activity caused by the disease.
Unfortunately, these medications and surgeries become increasingly ineffective with extended treatment in most patients. To address PD and all its complexities, healthcare providers are exploring different treatment strategies to complement more traditional interventions.