- Introduction
Strokes are the second cause of death and the third cause of invalidity in the world. Following a stroke, rehabilitation is necessary and can last months or even years. Thus a multidisciplinary rehabilitation program is encouraged : be it physiotherapy, ergotherapy, speech therapy or neuropsychology. However, creation of suitable music programs isn’t a priority. Despite its universal aspect, music therapy has been disregarded for a long time. Therefore, we will dive into its history and skim the research revolving around it.
- History
The link between music and brain function was first discovered in the mid-90s. According to Galinska (2015), music activates various key areas of the brain, so it has the ability to stimulate the brain as a whole. In fact, when we listen to music, it activates not only the auditory areas but also the limbic areas (involved in emotions), memory systems and much more. Therefore, music can be used to boost cognitive, affective, and sensorimotor processes in the brain. These can be generalized and transferred to nonmusical therapeutic applications. Even more, music allows the patient to develop and properly maintain their motivation, essential in rehabilitation exercises, following the stroke.
- Music rehabilitation and strokes
A meta-analysis of 27 articles examined the effects of several musical interventions in rehabilitation following a stroke. For each one, therapeutic efficacy has been established.
- RAS (Rhythmic Auditory Stimulation) : uses a metronome combined with motor exercises. It increases the anticipation and regulation of repetitive movements, necessary for walking and balance. It also improves walking speed, step, stride length and balance.
- Active music therapy : uses various instruments. It improves strength and upper limb function.
- The receptive music therapy : consist in listening to music while handling another task. Even though its effects on psychological and cognitive function (verbal memory and focused attention) are yet to be quantified, results are noteworthy. Listening to music allows us to generate emotional commitment and pleasure in activities. Simply including music in a rehabilitation program, generates positive reactions in patients.
- Melodic Intonation Therapy (MIT) : uses melody by words and sentences to improve speaking. It’s normally used to improve aphasias, but doesn’t show any efficacy.
Likewise, MNT technique (for hemispatial neglect) uses exercises with percussion instruments that are structured in time, tempo, and rhythm. They allow the patient to focus his attention on the neglected visual field. In their research, Hommel et al. (1990) observed beneficial effects of musical stimulation in overcoming visual neglect. In fact, music stimuli were proven to be superior to other sensory and cognitive cues (speech or tactile cues).
Furthermore, listening to rhythm activates the motor and premotor cortices which can improve gait (Hayden et al., 2009). Music therapy also improves executive function and emotional adjustment in traumatic brain injury rehabilitation (Thaut et al., 2009). It has been reported to enhance attention and verbal memory (Sarkamo et al., 2008). Finally, a community-based intervention program combining rhythmic music and a specialized rehabilitation program during 8 weeks resulted in: a broader range of motion and flexibility, more positive moods as well as an increased frequency and quality of interpersonal relationships compared to the control group (Jeong & Kim, 2007).