Thursday, 28 March, 2024
HomeEditor's PickNeurologic music therapy benefits stroke victims — small, 2-year study

Neurologic music therapy benefits stroke victims — small, 2-year study

Neurologic music therapy helps stroke patients through mood regulation, improved concentration, and neural re-organisation. Physical benefits include better arm function and gait, found a small, two-year UK observational study.

Dr Alex Street, of Anglia Ruskin University (ARU) has carried out a study – the first large-scale investigation into the feasibility of delivering these stroke rehabilitation exercises – on a 26-bed stroke and rehabilitation unit at Addenbrookes Hospital in Cambridge. In total, 177 patients took part in 675 Neurologic Music Therapy (NMT) sessions over a two-year period. The researchers investigated its success among patients, their relatives, and health professionals.

Lots of repetition, or “massed practice”, is central to neuro-rehabilitation. In addition to playing physical instruments (keyboard, drums and hand-held percussion), iPads featuring touchscreen instruments were used in the trial to help patients with hand rehabilitation, through improving finger dexterity, and cognitive training.

NMT sessions were run alongside existing stroke rehabilitation treatment, including physiotherapy, occupational therapy, speech therapy, and clinical psychology.

Of the 139 patients, relatives and hospital staff who completed questionnaires, the average response was that NMT was "helpful" or "very helpful." And of the 52 patients who completed mood scale questionnaires, there was a reduction in "sad" and an increase in "happy" responses immediately following a session.

Speech and language therapists observed a positive impact on patient arousal and engagement, and reported that it may help patients overcome low mood and fatigue – both common following stroke – and therefore be beneficial for their rehabilitation.

Following the success of the trial, the Cambridge Institute for Music Therapy Research at Anglia Ruskin University (ARU) and Addenbrookes Hospital are developing a proposal to establish a permanent NMT post on the stroke ward, funded by the National Health Service (NHS).

Street said: "Our study found that Neurologic Music Therapy was received enthusiastically by patients, their relatives, and staff. The fact 675 sessions were carried out in two years is in itself an indication of the success of the treatment. It shows that staff are referring patients because they understand the mechanisms of the exercises and can see how it can benefit their patients. It also shows that patients are willing to do the exercises, with each one participating in an average of five sessions.

"Staff felt that using music and instruments allowed patients to achieve a high amount of repetition to help achieve their goals. They felt that the exercises appear less clinical, because the patients are playing music with the music therapist, and they are receiving immediate feedback from the exercises, through the sounds they create. Further research is necessary to establish potential effects of music therapy on recovery rate and length of hospital stay."

Abstract
Background: There is increasing evidence for music-based interventions in neurorehabilitation, improving mood and functional outcomes. In response, there is growing interest from health-care providers in setting up Neurologic Music Therapy (NMT) services. This paper presents some preliminary data on the feasibility and acceptability of NMT in the acute stroke, multidisciplinary team setting, about which little is known.
Objectives: To assess the feasibility and acceptability of a two-day per-week NMT service over 24 months.

Methods: Data were collected on the number of referrals received, sessions attended, sessions declined and reasons why. Staff completed questionnaires, and collected them from patients and their relatives, rating interventions: 1. Not helpful, 2. Quite helpful, 3. Helpful, 4. Very helpful. Patients completed the Visual Analogue Mood Scale (VAMS) pre-/post- a single session.
Results: Of 201 patients referred, 177 received treatment and 675 sessions were delivered. Twenty-four patients were discharged before sessions were scheduled and 28 sessions were declined, predominantly due to fatigue. Mean scores (SD) from questionnaire data were: patients (n = 99) 3.34 (0.825), relatives (n = 13) 3.83 (0.372), staff (n = 27) 3.85 (0.388). Mean, post-session VAMS data (n = 52) showed a non-significant reduction in ‘Sad’ (7.5, p = .007, CI = 2.1, 12.9) and an increase in ‘Happy’ (+ 6.2, p = .013, CI = −11.0, −1.4).

Conclusions: Data suggest the service was feasible and helpful, particularly for patient mood, possibly improving engagement in rehabilitation. Research to determine generalizability in different stroke environments and treatment effects within them is warranted.

Authors
Alexander Street, Jufen Zhang, Susan Pethers, Lydia Wiffen, Katie Bond, Helen Palmer

[link url="https://aru.ac.uk/news/study-finds-music-therapy-helps-stroke-patients"]Anglia Ruskin University material[/link]

[link url="https://www.tandfonline.com/doi/full/10.1080/10749357.2020.1729585"]Topics in Stroke Rehabilitation abstract[/link]

MedicalBrief — our free weekly e-newsletter

We'd appreciate as much information as possible, however only an email address is required.