Hemiparesis and Restoration of Motor Function in Chronic Stroke – What’s Music Therapy Got to Do With It?

March 1st is International Music Therapy Day! What a great day for a blog post!

A few months ago, I posted about music therapy in stroke rehabilitation in general. Since there are so many ways music therapy can help people recover from a stroke, I thought it might be useful to dive in to each topic in-depth, individually. Today’s focus is on the rehabilitation of Upper Extremity Hemiparesis.

What is Hemiparesis and Why Does it Matter?

Hemiparesis is weakness or inability to move (paralysis) on one side of the body, resulting from an injury to the opposite side (hemisphere) of the brain. In layman’s terms, “upper extremity” basically refers to arms.

A leading cause of functional disability in people with chronic stroke is upper extremity hemiparesis. Around 80% of stroke survivors experience acute hemiparesis, and half of these continue to experience hemiparesis long-term.

Why is music effective in retraining the brain to use an effected limb?

The brain that engages in music is changed by engaging in music,” (Thaut, 2014). Music drives neuroplasticity, improves adherence to and engagement in treatment, and utilizes cortical reorganization to create a new pathway for lost functions.

Musical tasks provide “anticipation and timing structure for movement from the external rhythmic cue and from integrating the external cue (feedforward) with the patient produced sound patterns (feedback),” (Thaut, 2014).

What does music therapy in stroke rehabilitation look like?

Imagine your physical therapy exercises to improve flexion, extension, range of motion, etc. Now imagine having the sensory feedback that playing musical instruments provides and the rhythmic cueing that is so essential in a good work-out session.

To your brain, this multisensory feedback enriches the motor experience; anytime you are having fun and enjoying something, the event is more significant neurologically. New neural pathways are built more quickly, and with less effort. This is how all humans naturally learn and re-learn. You are getting “more bang for your buck,” basically!

Translating functional arm rehabilitation movements into musical activities occurs in a neurologic music therapy technique known as Therapeutic Instrumental Musical Performance, or TIMP. To quote one research participant, TIMP was “hugely different from being asked for no apparent reason to hit the table.” (I have to admit, I had a little chuckle at that quote!

Utilizing musical cueing via dynamic, temporal, and rhythmic changes is known as Patterned Sensory Enhancement, or PSE. Just as music cues a dancer’s moves, music may also cue gross and fine movements for functional gain.

Music therapists are trained in choosing and adapting musical instruments and mallets to stimulate functional gains; we will find *something* to suit your gripping needs and capabilities, or an instrument that is the right height, or provides the right amount of feedback.

How Do I Get Started with Music Therapy for Stroke Rehabilitation?

When you’re ready to try music therapy, give us a call to schedule your assessment session. After your assessment, your board-certified music therapist will determine a treatment plan to meet your rehabilitation goals.

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