Sunday, August 7, 2022

Singing And Parkinson’s Disease

Improvements On The Participants After Eight Weeks

Singing could help millions with Parkinson’s

Stegemöller study was published in the journals Disability and Rehabilitation and Complementary Therapies in Medicine. The study resulted in the following:

  • The patients with Parkinson’s disease show an improved muscle activity that is associated with swallowing.
  • Through the group therapeutic singing, the clinical measures of Parkinsons have improved as evaluated using the Unified Parkinsons Disease Rating Scale .
  • Group therapeutic singing can be utilized as an early intervention for swallow impairment in people with Parkinsons disease.

Singing As Therapy: How It Helps People With Parkinsons Disease

For a person diagnosed with Parkinsons disease, their mobility and movement control ability is impaired, such that they will develop tremors. Moreover, getting dressed, eating, writing, brushing teeth, and driving becomes more challenging. Family members of a patient with Parkinsons disease also know the difficulties that come while living with it. Acceptance may even be difficult. Parkinsons currently has no cure, but with proper treatment and early diagnosis, the symptoms can be controlled.

How Does It Work

Scientists are still trying to pinpoint how, exactly, singing is benefiting people with Parkinsons.

They theorize that cortisol, a stress hormone, may be lowered because of the social aspect of singing and the positive mood changes after a session. The study not only involved singing and exercising, but interacting with each other as a group.

Further research will look into oxytocin, a hormone that is associated with bonding, and measuring heart rate/heart rate variability will tell researchers exactly how much the body is relaxed after singing, which could also help explain its therapeutic benefits.

Parkinsons Foundation reports that at least 50% of people diagnosed with Parkinsons disease will experience depression, and 40% will experience an anxiety disorder. Dietary modifications have been shown to help improve depression and anxiety.

Treatment for the mental and emotional symptoms of Parkinsons is just as crucial as treatment for the physical ones. Unlike standard physical therapy, singing provided fun along with a physical working of muscles. Though it may be cliché, it is true that one should never underestimate the power of fun.

An elevated mood after spending time doing an activity that you love with new friends can reduce stress and reinvigorate you. Theres also the sense of community that is so important, as Parkinsons patients dont feel like theyre alone and can be part of a group going through a similar experience.

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Parkinson’s Disease And Music Therapy: How Can One Heal

According to UCB Canada, nearly one in every five hundred people are diagnosed with Parkinsons disease in Canada this amounts to approximately 6,600 new cases each year. Due to the fact that it is a progressive and degenerative neurological disease, it is one that can have numerous life-altering consequences in all parts of life and the everyday experience for those affected. However, several treatments are believed to enhance the quality of life and mitigate the symptoms and effects of this disease, including music therapy through this endeavour, patients may see improvements in cognition, movement, speech, and mental health, as stated by the Parkinson’s Foundation. It can truly be a revolutionizing experience.

Image is courtesy of Verywell Mind.

Effects Of Music Therapy On The Emotional Sphere

Singing away the symptoms: how carrying a tune can help ...

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 .

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Testimonies From The Participants

Jackie Manatt had been diagnosed with Parkinson’s thirteen years ago. She learned about the study through an email and immediately signed up to join. She believed that the therapy has helped how she projects and her voice grows stronger.

“I don’t have much volume in my voice, which is very normal with Parkinson’s to have the voice go,” Manatt said. “I just keep thinking I would probably have even less volume by now if I hadn’t taken this singing class.”

L.K. Jordening joined the Ames group handles by Stegemöller. She said that through the singing exercises, her ability to project her voice had improved and she can now breathe easier.

Jordening said that when she is stressed, she can immediately find calmness through deep breathing through the nose while exhaling using the mouth. She also stated that she can now hold her breath stronger and her range is so much better. Aside from the personal improvements the two participants observed after joining the therapy, they both agreed that because of the therapy, their social life had gotten better. They found new friends, their support group has increased, and their coping for having the disease has improved. Other benefits reported to Stegemöller by patients, their families, and caregivers include improvements in mood, stress, and depression.

After A Researcher Approached A Group Of Parkinson’s Patients To Start An Experimental Choir A Series Of Small Miracles Unfolded

When Wendy Driscoll was diagnosed with in 2003, she felt robbed of a lifelong love: singing. “I’d been a choral singer all my life. It got to the point where I couldn’t sing to the end of a long phrase or note,” recalls Driscoll, 75, a resident of Westborough, MA. Disheartened by her weaker voice and decreased breath control, which made it difficult for her to talk, let alone sing, Driscoll didn’t necessarily want help. She was wary of support groups.

Eventually, though, her symptoms became so severe that she felt she needed to talk to someone. She went to hear a featured speaker at a support group in Worcester, MA, and began attending the monthly group on a regular basis. But she still felt she needed something more. So last year, when Kelly Richardson, PhD, a speech-language pathologist and associate professor in the department of communication disorders at the University of Massachusetts Amherst’s School of Public Health and Health Sciences, approached the group and asked if members would be interested in participating in an 11-week experiment involving weekly singing sessions, Driscoll jumped at the chance. “I was all over it,” she remembers.

Addressing Vocal Problems

She recruited Shelly Roberts, an accomplished, energetic choir director, to provide vocal and breathing warm-ups as part of the experiment. Ten people from the support group, including Driscoll, joined the study.

Seeds of Change

Stronger Through Song

Climatic Concert

Post-Concert Effect

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Complementary Therapies For Pd

Complementary therapies are healing practices, performed in addition to standard treatments, with the goal of improving quality of life. My previous blog on art therapy and its use in Parkinsons disease introduced the concept of complementary therapies. Today, I will discuss complementary therapies more generally and also concentrate on music, dance and singing therapies that are used for PD.

As I have mentioned, some of the complementary therapies that are in use for PD include exercise/movement therapies such as boxing, yoga, and Tai chi, mindfulness techniques such as meditation, manual practices such as acupuncture and massage, and creative pursuits such as singing, music therapy, dance therapy, theater and art therapy.

Most of these complementary therapies have been formally studied in PD patients in some manner, although usually only in small groups of people. Dont see your therapy of choice mentioned? Dont worry the above list is not meant to be comprehensive and does not include every complementary therapy which has been studied in PD patients.

Singing May Reduce Stress Improve Motor Function For People With Parkinson’s Disease

Parkinson’s Disease Wellness: Sing Out Loud
Date:
Iowa State University
Summary:
Singing may provide benefits beyond improving respiratory and swallow control in people with Parkinson’s disease, according to new data. The results from the pilot study revealed improvements in mood and motor symptoms, as well as reduced physiological indicators of stress.

Singing may provide benefits beyond improving respiratory and swallow control in people with Parkinson’s disease, according to new data from Iowa State University researchers.

The results from the pilot study revealed improvements in mood and motor symptoms, as well as reduced physiological indicators of stress. Elizabeth Stegemöller, an assistant professor of kinesiology, cautions this is preliminary data, but says the improvements among singing participants are similar to benefits of taking medication. She presented the work at the Society for Neuroscience 2018 conference.

“We see the improvement every week when they leave singing group. It’s almost like they have a little pep in their step. We know they’re feeling better and their mood is elevated,” Stegemöller said. “Some of the symptoms that are improving, such as finger tapping and the gait, don’t always readily respond to medication, but with singing they’re improving.”

Why does singing work?

In this video from 2017, Stegemöller leads a singing group for people with Parkinson’s disease:

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What Does It Mean For People With Parkinsons

This work is still in the beginning stages, so there is a lot of work to be done and data to be collected before scientists have a good idea of just what is at work here. Plus, the study groups have been small and the studies themselves few.

That being said, the results have been overwhelmingly positive, and concerning both physical and emotional symptoms of the disease. The other upside is that anyone can sing. Breathing exercises, posture work, and technique require skill and effort, but anyone can learn to do it.

While Stegemöllers singing therapy sessions tailored specifically to Parkinsons patients arent available everywhere, music and singing is.

How The Intervention Might Work

Studies have found that participation in group singing or choirs is associated with various health benefits across a wide range of outcome groups, including enhanced physical functions and mental, social, and spiritual wellbeing . Singing may enhance health and wellbeing through promoting neurochemicals such as dopamine, cortisol, serotonin, and oxytocin, as the structures of songs can induce a range of emotional and physical responses. For example, we may feel relaxed, peaceful, excited, or happy when singing certain songs .

Singing has also been reported to be beneficial for people with neurological conditions, such as PD, stroke, multiple sclerosis, and dementia . It is posited that singing offers an effective adjunct rehabilitation therapy for people with PD.

Quality of life

Several studies have suggested that participating in singing can enhance a persons QoL . Singing studies specifically for people with PD have also reported positive associations with enhanced QoL .

Physical health

Psychological health

Social health

Participating in group singing, such as a choir, can reduce isolation and provide social support. Taking part in group singing is reported to increase neurochemicals , which is associated with bonding and social affiliation . Singing with others can promote positive feelings, such as friendship and empathy, which are positively associated with a sense of wellbeing .

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Mm: What Percentage Of People With Parkinsons Disease Are You Able To Help In Some Way To Be Able To Sing Again

Kurowski: I would say in the high 90s. Its tough to put it into a percentage, but pretty much everybody who has come to work with me on these exercises says that, in particular, their spouses notice a difference. Im really glad to be able to use something that I love, music, to help people to be able to have conversations with the people they care about. I am very passionate about it.

What Is Parkinsons Disease

Could singing relieve the symptoms of Parkinson

Characterized by gradual and progressive muscle rigidity, a mask-like facial expression, shuffling walk, tremors, and clumsiness, the National Institute on Aging explains that Parkinsons disease is an incurable disease that takes place in the central nervous system of the human body. Symptoms usually begin to show when one is at the later years of their middle age or at their earlier years of old age , affecting one to two percent of people over the age of sixty-five and approximately six percent of people over the age of eighty-five. The most striking abnormality of Parkinsons disease is the degeneration of dopamine-using neurons in the brainstem. According to Healthline, the axons of these deteriorating nerve cells make contact with the nerve cells of the striatum, which is one of the areas of the brain that is mainly used as an area to input information in the basal ganglia . Therefore, when these signals are not received due to the deteriorating axons that are unable to communicate and send electrical impulses effectively, there is decreased activity in the basal ganglia loop circuits. This causes the issue of restricted movement.

Image is courtesy of ResearchGate.

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What The Study Looked Like

At Iowa State University, assistant professor of kinesiology Elizabeth Stegemöller and graduate student Andrew Zaman measured the heart rate, blood pressure, and cortisol levels for 17 participants and took note of their reported feelings of sadness, anxiety, happiness, and anger.

After a one-hour session of vocal and breathing exercises then singing, all three levels were reduced and the participants reported feeling less sad and anxious.

To this effect, Stegemöller noted that, “We see the improvement every week when they leave singing group. It’s almost like they have a little pep in their step. We know they’re feeling better and their mood is elevated.

The results werent just limited to strict data and emotional strides. “Some of the symptoms that are improving, Stegemöller said, Such as finger tapping and the gait, don’t always readily respond to medication, but with singing they’re improving.

In 2015, Stegemöller led weekly therapeutic singing groups for Parkinsons patients in Iowa for an 8-week study.

Pitch range & duration and swallowing measures were taken at the beginning of the study for four singing groups and a total of 30 people. The groups met weekly for a similar hour-long session of exercises and singing, working together as a group.

At the end of the two months, there was significant improvement in all areas, and participants also reported a lift in mood and a feeling of community and that they were not alone in this fight.

Why It Is Important To Do This Review

Nonpharmacological treatments for people living with PD play an increasingly important role . As discussed above, evidence suggests that singing can be a beneficial complementary therapy for people with PD . The number of singing groups for people with PD in the community has been fastgrowing in highincome countries, such as the UK, Australia, the USA, and Germany.

A recent review of musicbased interventions in neurological rehabilitation highlighted the benefits of music for people with neurological conditions, including PD . However, the review did not examine the specific effects of singing for people with PD. Another recent review on singing for people with PD reported benefits of singing in people with PD, but this was a narrative review and included nonrandomised studies .

It is therefore timely to conduct a robust systematic review of the efficacy of singing for people with PD, including an examination of the effect of dose of singing on relevant outcomes.

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Data Collection And Analysis

Selection of studies

Two review authors will screen, by title and abstract, the articles identified by the search strategy. We will obtain the fulltext articles of potentially eligible studies, and two review authors will screen these fulltext articles. Any disagreements will be resolved by consulting a third review author . We will list any articles excluded after fulltext assessment, and their reasons for exclusion, in a Characteristics of excluded studies’ table. We will illustrate the study selection process in a PRISMA diagram.

Data extraction and management

Two review authors will independently extract data onto a data collection form, including citation details, trial setting, inclusion and exclusion criteria, study population, intervention details, outcome measures, and results. All review authors involved in data extraction will be provided with detailed instructions. We will resolve any differences in opinion through discussion or, if necessary, through independent arbitration by a third review author . We will attempt to contact study authors for any additional information needed. We will collect as many details as possible on participants including age at time of study, gender, disease duration, presence of speech problem, and PD medication.

Assessment of risk of bias in included studies

Measures of treatment effect

Unit of analysis issues

The primary data for analysis in the included studies will be individual trial participants.

Dealing with missing data

Description Of The Intervention

How singing can help with Parkinson’s

Singing is an accessible and popular form of musical activity. It involves physical functions, such as engaging the vocal apparatus and respiratory system , as well as mental functions through emotional expression . From a neurological point of view, singing is a complex activity that integrates auditory and sensorimotor processes in the brain . When singing, speechrelated mechanisms, such as respiration, phonation, articulation, and resonance, are directly stimulated .

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Speech Dysprosody But No Music Dysprosody In Parkinsons Disease

Singing of Parkinson patients does not differ from the singing of healthy individuals.

Rhythmic recitation of song lyrics is a good indicator of Parkinsonian dysprosody.

Listener perception of dysprosody is a useful diagnostic tool.

Singing might be used to enhance prosodic aspects of Parkinson patients speech.

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