Incorporating Music Therapy research with Cerebral Palsy into Physical Therapy/Music Therapy co-treats.
Over the past few weeks, I’ve had the amazing opportunity to work with and get to know this awesome guy with cerebral palsy at the clinic. I look forward to these sessions with him, because they are co-treats—physical therapy and music therapy working together to help him reach his goal of walking independently. When it came time for me to start treating in this setting, I was a bit apprehensive, because I didn’t know what to look for or how to plan to incorporate physical therapy into a session. So, that meant it was time for me to do some research in the good ol’ Journal of Music Therapy (and also go back and read some of my Anatomy text book J).
This proved to be very helpful in acclimating myself to the type of therapy being done in the co-treat, and to some helpful tips that I could use in planning effective interventions. The first article I found was “Music and Rhythmic Stimuli in the Rehabilitation of Gait Disorders.” This article helped me understand the types of interventions being done to facilitate walking from a neurological standpoint. The researchers find in their experiment that significant improvements were made in the participants’ walking with an even and steady gait when they walked to rhythmic stimuli. By matching the tempo of the music with their steps, their brains were able to internalize and entrain the beat of the music to each step, facilitating an even gait. The participants were even able to keep their improved steady gait when the music was taken away by hearing the beat in their head (Staum, 1983). This is exactly what we are working on with our client in the co-treat. I strum the guitar at a steady walking tempo while singing (we always use the same song to ensure that the beat is “stuck in his head”) and the PT facilitates him and steadies him while he is walking. This is an awesome thing to be a part of! I can tell when our client is really hearing the music in his head—he gets such a focused and grounded look and his steps fall with steadiness and ease. I can also see whenever he loses focus, which brings me to the next helpful article I found to incorporate into the co-treat.
Whenever this awesome guy loses focus, his head will drop or his posture will droop. I decided to incorporate the use of music as reinforcement for this behavior—this idea is found in “The Effect of Automated Interrupted Music on Head Posturing of Cerebral Palsied Individuals.” It is simple—whenever undesirable posture is observed, the music is stopped, then the music resumes whenever posture is corrected (Wolfe, 1980). I’ve found that this works really nicely! By stopping the music, our client can immediately correct his posture, and refocus himself on the walking to the beat of the music.
These interventions have made a huge difference in walking independently for this amazing dude!! It is so amazing how rhythm works to synchronize our movements with our brains. He is gaining so much confidence and walking with so much “swagger” J J
Staum, M.J. (1983). Music and Rhythmic Stimuli in the Rehabilitation of Gait
Disorders. Journal of Music Therapy, 20(2), 69-87. doi: 10.1093/jmt/20.2.69.
Wolfe, D.E. (1980). The Effect of Automated Interrupted Music on Head Posturing of
Cerebral Palsied Individuals. Journal of Music Therapy, 17(4), 184-206.
-Posted by Perry Wright (Music Therapy Intern) on 7/13/15