My interest in learning more about the effectiveness of music therapy in the treatment of patients with an acquired brain injury comes from my passion of helping others who lived a “normal” lifestyle like myself and all of a sudden, due to an unfortunate event in their life- now live without the ability to care for themselves, reliving the trauma of the event that has changed their world forever. As a Psychology graduate from McMaster University, with a background in classical piano and voice, I was challenged with the question- there is occupational therapy for individuals who have suffered physical injuries such as broken arms/legs due to accidents, but what is out there for individuals who endure trembling, repetition and frequent outbursts who relive the painful memories of traumatic events that has resulted in an acquired brain injury? After just taking an intro course to music therapy taught by Professor Rachael Finnerty at McMaster and getting to know her work in the field, I understood that music therapy has been effective for individuals with an acquired brain injury. Neurologic Music therapy is evidence based and can be used for treatment for individuals suffering with an ABI. I discovered that music therapy for individuals with an acquired brain injury has not been popularized (not been recognized by the health care system as an effective tool) and since then have been on a quest to find out what work remains to be done to get music therapy to be recognize as an effective way of treating individuals who have an ABI.
A Cochrane Systematic Review was published on July 7th, 2010 including all journals that referenced music therapy and acquired brain injury as opposed to just music listening/playing an instrument for therapy of individuals with an ABI. However, an update of this review was published in 2017. The countries represented in this systematic review are USA, Australia, South Korea, and Germany. In the first review, the studies include patients who are 16 years of age or older with an acquired brain injury that resulted in complications such as stroke, speech impediments, joint pain and hemiplegia. Interestingly, they compared standard care, standard care alone, other therapies vs. music therapy in treatment of the individuals with an ABI. 7 studies were included in total in the systematic review however I found 4/7 to be referencing music therapy-that of I was able to identify a certified music therapist providing music therapy to the patient. In the second review, the revision protocol was to add music interventions implemented by non-music therapists (Bradt et al., 2017) including the cognitive outcomes of the music interventions (Bradt et al., 2017). I found a study that took place by a board-certified music therapist that yielded positive communication outcomes for patients with Aphasia following an acquired brain injury however- it included a high risk of bias (Bradt et.al, 2017 ). The frequency of sessions ranged from 1 to 10 times a week (Bradt et al., 2017). This is an encouraging finding as it shows an area of research that can be delved into in order to help individuals who have an ABI besides just physiological motor concerns. Also board-certified music therapist Min-Jeong Bae was able to find a significant effect of improved interpersonal relationship compared with the control group (Bradt et al., 2017) in the study. I found this outcome to be very pleasing because of the high risk of depression that follows individuals that sustain an acquired brain injury as stated in the review “poststroke depression and apathy are estimated to be as high as 33%, impeding functional recovery effective treatment of depression” (Bradt et al., p.6).
Neurologic music therapy, specifically Rhythmic Auditory Stimulation has a statistically significant positive outcome towards the goal of synchronizing step patterns and entraining higher stride frequencies for stroke patients in a particular study by Michael Thaut. Rhythmic cueing showed to have significant improvements in spatial temporal control in another study by Thaut. The other music therapy interventions used that did not stem from Neurologic Music Therapy still conducted by a music therapist, had no significant improvement in health goals. Even still, the positive results of RAS and rhythmic cueing showing a clinically significant difference in the goal of synchronizing step patterns only pointed to the conclusion that more randomized control trials needed to be done in order to make any general statements.
The next step would include identifying the necessary resources that must be in place to carry out more randomized control trials for individuals with an ABI to continue to prove music therapy’s validity within the healthcare practice today. Neurologic Music Therapy is an effective tool used in the treatment of individuals with an ABI concerning gait, however there is promising evidence of treating individuals with an ABI concerning their mental health, the overall quality of their life as presented in research board certified music therapists Jeung and Conklyn.
Bradt, J., Magee, W.L., Dileo, C., Wheeler, B., McGilloway, E. (2010). Music therapy for acquired brain injury. Cochrane Database of Systematic Review, Issue 7. doi:10.1002/14651858.CD006787.pub2.
Bradt, J., Clark, I., Magee, W.L. (2017). Music interventions for acquired brain injury. Cochrane Database of Systematic Review. doi: 10.1002/14651858.CD006787.pub3.
Contributed by: Deandra Nduka