The scope and potential of music therapy in stroke rehabilitation

There is a growing interest in the use of music therapy in neurological rehabilitation. Of all the major neurological illnesses, stroke rehabilitation has been observed to have some of the strongest potential for music therapy's beneficial effect. The current burden of stroke has raised the need to embrace novel, cost-effective, rehabilitation designs that will enhance the existing physical, occupation, and speech therapies. Music therapy addresses a broad spectrum of motor, speech, and cognitive deficits, as well as behavioral and emotional issues. Several music therapy designs have focused on gait, cognitive, and speech rehabilitation, but most of the existing randomized controlled trials based on these interventions have a high risk of bias and are statistically insignificant. More randomized controlled trials with greater number of participants are required to strengthen the current data. Fostering an open and informed dialogue between patients, healthcare providers, and music therapists may help increase quality of life, dispel fallacies, and guide patients to specific musical interventions.

Neural plasticity: The substratum of music-based interventions in neurorehabilitation

BACKGROUND

The plastic nature of the human brain lends itself to experience and training-based structural changes leading to functional recovery. Music, with its multimodal activation of the brain, serves as a useful model for neurorehabilitation through neuroplastic changes in dysfunctional or impaired networks. Neurologic Music Therapy (NMT) contributes to the field of neurorehabilitation using this rationale.

OBJECTIVE

The purpose of this article is to present a discourse on the concept of neuroplasticity and music-based neuroplasticity through the techniques of NMT in the domain of neurological rehabilitation.

METHODS

The article draws on observations and findings made by researchers in the areas of neuroplasticity, music-based neuroplastic changes, NMT in neurological disorders and the implication of further research in this field.

RESULTS

A commentary on previous research reveal that interventions based on the NMT paradigm have been successfully used to train neural networks using music-based tasks and paradigms which have been explained to have cross-modal effects on sensorimotor, language and cognitive and affective functions.

CONCLUSIONS

Multimodal gains using music-based interventions highlight the brain plasticity inducing function of music. Individual differences do play a predictive role in neurological gains associated with such interventions. This area deserves further exploration and application-based studies.

Interrelation of non-drug correction of menopausal disorders and functioning of the pituitary-thyroid system in women with metabolic syndrome

In perimenopausal women, the frequency of thyroid diseases and metabolic syndrome (MS) increases. In this work, the effect of non-drug correction programs for menopausal disorders on the structural and functional state of the thyroid gland in patients with MS was evaluated. For that, five groups of women (330 people total) aged 45–50 years with climacteric syndrome (CS) against the background of MS were examined. For the index group and the experimental groups the following was used: basic treatment, exercise therapy, drinking balneotherapy, additional oral intake of multivitamins and minerals, as well as physical therapy — vibrotherapy, chromotherapy, music therapy, aromatherapy, aeroionotherapy in various combinations. In the control group, only basic treatment was used. The levels of thyroid-stimulating hormone (TSH) and free thyroxine (free T4) in serum were determined, a sonographic study of the thyroid gland was performed. According to the study results, the use of correction programs using physical therapy methods improved the functioning parameters of the pituitary-thyroid system in the surveyed patients. In women with moderate-severity CS, the best results were obtained while simultaneously using all the mentioned above physiotherapy methods: during the transition period the TSH decreased by 6.5%, during the postmenopausal period — by 5.6%, the level of free T4 increased by 6.5% and 6,6% respectively (р < 0.05, applied to both parameters). It can be concluded that non-drug programs, including physical therapy, have a protective effect on the thyroid gland function. In case of moderate-severity climacteric syndrome, the program with simultaneous use of vibrotherapy, chromotherapy, music therapy, aromatherapy, aeroionotherapy has priority.

Motor imagery training induces changes in brain neural networks in stroke patients

Motor imagery is the mental representation of an action without overt movement or muscle activation. However, the effects of motor imagery on stroke-induced hand dysfunction and brain neural networks are still unknown. We conducted a randomized controlled trial in the China Rehabilitation Research Center. Twenty stroke patients, including 13 males and 7 females, 32–51 years old, were recruited and randomly assigned to the traditional rehabilitation treatment group (PP group, n = 10) or the motor imagery training combined with traditional rehabilitation treatment group (MP group, n = 10). All patients received rehabilitation training once a day, 45 minutes per session, five times per week, for 4 consecutive weeks. In the MP group, motor imagery training was performed for 45 minutes after traditional rehabilitation training, daily. Action Research Arm Test and the Fugl-Meyer Assessment of the upper extremity were used to evaluate hand functions before and after treatment. Transcranial magnetic stimulation was used to analyze motor evoked potentials in the affected extremity. Diffusion tensor imaging was used to assess changes in brain neural networks. Compared with the PP group, the MP group showed better recovery of hand function, higher amplitude of the motor evoked potential in the abductor pollicis brevis, greater fractional anisotropy of the right dorsal pathway, and an increase in the fractional anisotropy of the bilateral dorsal pathway. Our findings indicate that 4 weeks of motor imagery training combined with traditional rehabilitation treatment improves hand function in stroke patients by enhancing the dorsal pathway. This trial has been registered with the Chinese Clinical Trial Registry (registration number: ChiCTR-OCH-12002238).