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Huang X, Dong K, Gan C, Xu Z, Lei D, Dong X, Liu H, Chen X. Effect of Rhythmically Cued Exercise Interventions on Functions in Patients With Parkinson Disease: A Meta-Analysis. Phys Ther 2024; 104:pzad158. [PMID: 37962936 DOI: 10.1093/ptj/pzad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/06/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with Parkinson disease. METHODS PubMed, Cochrane Database, Web of Science, Embase, and CINAHL were searched June 15, 2023. Original studies investigating the efficacy of rhythmically cued exercise interventions on the functions of patients with Parkinson disease were included. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. The protocol was registered in PROSPERO (CRD42022371203). RESULTS A total of 38 original studies involving 1486 participants were included. Rhythmically cued exercise interventions demonstrated superior effects on motor function compared to exercise therapy without rhythm (standardized mean difference [SMD] = -0.31). However, no significant improvements were observed in cognition and mental state. Overall, significant improvements were observed in motor examination (SMD = -0.61), Timed "Up & Go" Test (mean difference [MD] = -0.91), activities of daily living (SMD = -0.49), balance (SMD = 0.59), walking velocity (MD = 0.06), step length (MD = 2.65), and stride length (MD = 0.04) following rhythmically cued exercise interventions. No significant improvements were observed in freezing of gait and cadence. Assessment of publication bias showed no significant evidence of publication bias. Meta-regression analyses revealed a significant association between treatment duration and improvement in motor function. Furthermore, adverse events and dropout rates did not significantly differ between the 2 groups. CONCLUSION Rhythmically cued exercise interventions are effective in improving motor function in the early to middle stages of Parkinson disease. More than 10 weeks of intervention yielded better results. However, these interventions do not have a significant impact on cognition and mental states. Importantly, rhythmically cued exercise interventions are safe and well tolerated. Large-scale trials are needed for further confirmation. IMPACT This study contributes to the development of safe and reliable home rehabilitation programs, aiming to enhance the quality of life for patients with Parkinson disease.
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Affiliation(s)
- Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ke Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chu Gan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiqin Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xinghua Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Burrai F, Apuzzo L, Zanotti R. Effectiveness of Rhythmic Auditory Stimulation on Gait in Parkinson Disease: A Systematic Review and Meta-analysis. Holist Nurs Pract 2024; 38:109-119. [PMID: 34121062 DOI: 10.1097/hnp.0000000000000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parkinson disease is a neurodegenerative disease present in approximately 2% of the population older than 65 years. Rhythmic auditory stimulation in the early 1990s aimed to improve individual mobility in terms of gait speed, stride length, and cadence. Our systematic review and meta-analysis aimed to summarize and evaluate the evidence of the effects of rhythmic auditory stimulation on gait speed, stride length, and cadence in patients with Parkinson disease. A systematic review and meta-analysis of randomized controlled trials was conducted to determine the efficacy of rhythmic auditory stimulation in patients with Parkinson disease. Five studies were included in the review (209 patients). Rhythmic auditory stimulation resulted, on average, a gait speed improvement of 0.53 standard deviation (SD) units (95% CI, 0.23 to 0.83; P = .0005), a stride length improvement of 0.51 SD units (95% CI, 0.18 to 0.84; P = .003) greater than that in the control group. All trials contained a risk of bias due to a lack of blinding. The quality of evidence was low. No adverse events were identified. Rhythmic auditory stimulation may have a beneficial effect on gait speed and stride length in patients with Parkinson disease. Future studies should consider a power analysis to recruit an adequate number of subjects and minimize the risk of sample bias. Further research should provide the additional results required for an acceptable estimate of the effects of rhythmic auditory stimulation on gait in patients with Parkinson disease.
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Affiliation(s)
- Francesco Burrai
- SC Educational, Research and Organization, ATS Sardegna, Sassari, Italy (Dr Burrai); Carlo Chenis Hospice, Local Health Authority, ASL Roma 4, Civitavecchia, Italy (Mr Apuzzo); and Department of Medicine, University of Padova, Padova, Italy (Dr Zanotti)
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Toma I, Dinu A, Abu-Awwad A, Sandesc MA, Abu-Awwad SA, Nitu R, Popean M. Patterned Sensory Enhancement, a Music Rehabilitation Therapy for Elderly Patients with Neuromotor Deficit during the COVID-19 Pandemic: A Pilot Study. Diseases 2023; 12:11. [PMID: 38248362 PMCID: PMC10814683 DOI: 10.3390/diseases12010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
(1) Background: The Patterned Sensory Enhancement (PSE) technique refers to a music-based rehabilitation therapy strategy used in neurological pathologies. (2) Methods: This study aims at developing a music-drill protocol for recovery in elderly patients with neuromuscular degenerative pathologies. Each music drill is based on a number of specific music-composition parameters. The conclusions represent suggestions for further enhancing the PSE technique through collaborations between the rehabilitation team and the musicians involved due to the importance of the music stimuli used as a therapy. (3) Results: The music-composition parameters used in this study relate to the existence of music homogeneity factors such as the key signature and rhythm; the importance of the major scale and the tonal system in general; the obvious music suggestions of movement, repetition or absence of movement; the importance of rhythm; the introduction of musical instruments in order to harmonize the music material as much as possible; the connection between PSE music along with patients' musical taste and the musical recording as a therapy during patient outcare; (4) Conclusions: The therapy efficiency was observed by measurements taken before and after the therapeutic intervention by means of a Takei dynamometer. The present study asserts that for a patient undergoing the PSE technique, the researcher should compose personalized music material adapted to each patient's peculiarities.
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Affiliation(s)
- Iulia Toma
- Faculty of Music and Theatre, West University of Timisoara, 300223 Timisoara, Romania; (I.T.); (M.P.)
- Department XVI—Medical Recovery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Anca Dinu
- Department XVI—Medical Recovery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Research Center for Assessment of Human Motion and Functionality and Disability, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (A.A.-A.); (M.-A.S.); (S.-A.A.-A.); (R.N.)
| | - Ahmed Abu-Awwad
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (A.A.-A.); (M.-A.S.); (S.-A.A.-A.); (R.N.)
- Department XV—Discipline of Orthopedics-Traumatology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center Professor Doctor Teodor Șora, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Mihai-Alexandru Sandesc
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (A.A.-A.); (M.-A.S.); (S.-A.A.-A.); (R.N.)
- Department XV—Discipline of Orthopedics-Traumatology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center Professor Doctor Teodor Șora, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Simona-Alina Abu-Awwad
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (A.A.-A.); (M.-A.S.); (S.-A.A.-A.); (R.N.)
- Department XII—Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Razvan Nitu
- “Pius Brinzeu” Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania; (A.A.-A.); (M.-A.S.); (S.-A.A.-A.); (R.N.)
- Department XII—Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Mihai Popean
- Faculty of Music and Theatre, West University of Timisoara, 300223 Timisoara, Romania; (I.T.); (M.P.)
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Tamiasso RSS, Silva VAD, Turrini RNT. Membranophone percussion instruments in music therapy with adult patients in the health context: a scope review. Rev Esc Enferm USP 2023; 57:e20220263. [PMID: 37486369 PMCID: PMC10364967 DOI: 10.1590/1980-220x-reeusp-2022-0263en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/14/2023] [Indexed: 07/25/2023] Open
Abstract
OBJECTIVE To map scientific knowledge about the use of percussion instruments in music therapy in individuals over 18 years of age in the health context. METHOD Scope review with search strategy implemented in September 2021, in 13 databases, using indexed descriptors and keywords. Studies on the use of membranophones for care of people over 18 years of age were included. Studies with the participation of pregnant women, psychiatric patients (schizophrenia, psychosis, addiction), or people with hearing impairment, and journal editorials were excluded. The selection process was carried out by two independent researchers. RESULTS Thirteen studies were included and the results showed that the membranophones have a positive impact on the physical, psychological, and social health of people in different care environments, and allow them to repeat rhythmic patterns and play music. Active music therapy was the strategy predominantly used in interventions, and the most used membranophone was the djembe. CONCLUSION The results suggest that music therapy with membranophones proved to be a viable intervention with beneficial results in improving physical, psychological, and social health of people over 18 years of age.
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Affiliation(s)
- Renata Souza Souto Tamiasso
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil
| | - Vladimir Araujo da Silva
- Universidade Federal de Santa Catarina - Campus de Curitibanos, Coordenadoria Especial de Biociências e Saúde Única, Curitibanos, SC, Brazil
| | - Ruth Natalia Teresa Turrini
- Escola de Enfermagem - Programa de Pós-graduação Enfermagem na Saúde do Adulto, Universidade de São Paulo, São Paulo, SP, Brazil
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Lee H, Ko B. Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1046. [PMID: 36673802 PMCID: PMC9859027 DOI: 10.3390/ijerph20021046] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
This systematic review and meta-analysis examined previous studies on music-based interventions for individuals with Parkinson’s disease (PD). The effectiveness of the interventions on various motor and non-motor outcomes was evaluated. This review was conducted by searching PubMed, CINAHL, PsycINFO, and Cochrane Library CENTRAL prior to June 2022 for randomized controlled trial (RCT) and controlled clinical trial (CCT) studies published in English. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was used for heterogeneity. The initial search identified 745 studies, and 13 studies involving 417 participants with PD which met the inclusion criteria included in this review. The results of the meta-analysis revealed that music-based interventions can significantly improve walking velocity (MD = 0.12, 95% CI = 0.07~0.16, p < 0.00001), stride length (MD = 0.04, 95% CI = 0.02~0.07, p = 0.002), and mobility (MD = −1.05, 95% CI = −1.53~−0.57, p < 0.0001). However, the results did not support significant effects for music-based interventions on cadence (MD = 3.21, 95% CI = −4.15~10.57, p = 0.39), cognitive flexibility (MD = 20.91, 95% CI = −10.62~52.44, p = 0.19), inhibition (SMD = 0.07, 95% CI = −0.40~0.55, p = 0.76), and quality of life (SMD = −0.68, 95% CI= −1.68~0.32, p = 0.18). The findings suggest that music-based interventions are effective for the improvement of some motor symptoms, but evidence for non-motor symptoms is limited. Further high-quality studies with a larger sample size are required to obtain the robust effects of music-based interventions on various outcomes among patients with PD.
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Affiliation(s)
- Hyunjung Lee
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Bumsuk Ko
- Department of Music, Graduate School, Hansei University, Gunpo 15852, Republic of Korea
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Rusowicz J, Szczepańska-Gieracha J, Kiper P. Neurologic Music Therapy in Geriatric Rehabilitation: A Systematic Review. Healthcare (Basel) 2022; 10:2187. [PMID: 36360527 PMCID: PMC9690210 DOI: 10.3390/healthcare10112187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 09/08/2024] Open
Abstract
(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson's disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients.
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Affiliation(s)
- Jagoda Rusowicz
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
| | | | - Paweł Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
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Butala A, Li K, Swaminathan A, Dunlop S, Salnikova Y, Ficek B, Portnoff B, Harper M, Vernon B, Turk B, Mari Z, Pantelyat A. Parkinsonics: A Randomized, Blinded, Cross-Over Trial of Group Singing for Motor and Nonmotor Symptoms in Idiopathic Parkinson Disease. PARKINSON'S DISEASE 2022; 2022:4233203. [PMID: 36247106 PMCID: PMC9553721 DOI: 10.1155/2022/4233203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/14/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
Abstract
Introduction Parkinson's disease (PD) frequently causes communication difficulties due to various voice impairments and there are few treatment options for vocal/communication complaints. We assessed the effects of weekly group singing on PD patients' objective vocal and motoric function, cognition, mood, self-efficacy, and quality of life. Methods Thirty-two participants were randomly assigned to either a singing group or a facilitated discussion group weekly over 12 weeks. After 12 weeks, participants crossed over for an additional 12 weeks. Evaluations were performed at baseline and every six weeks for 30 weeks. Objective voice measures included volume/loudness (decibels), held vowel duration, jitter, shimmer, and harmonic-to-noise ratio. Additional outcome measures included patient-centered quality of life, voice-related quality of life, MDS-UPDRS, Montreal Cognitive Assessment, and questionnaires assessing depression, self-efficacy, and overall well-being. Results Twenty-six participants (16 M/10F; Hoehn & Yahr stage 2.3 (range 2-3); and age 68.6 (55-89)) completed the study. Across participants in both groups (intention-to-treat analyses), there was significant improvement from baseline in average loudness on the Cookie Theft picture description at 24 weeks (end of interventions), corresponding with improved minimal reading volumes at 24 weeks and 30 weeks (end of study). Similarly, there were improvements in minimal loudness on Rainbow passage reading at 24 and 30 weeks. There were improvements observed in the Emotional Well-Being (mean delta -12.7 points, p = 0.037) and Body Discomfort (mean delta -18.6 points, p = 0.001) domains of the PDQ-39 from baseline to week 24 in the overall cohort and greater improvement in the Communication domain for Group S than Group D after 12 weeks of singing (delta -12.9 points, p = 0.016). Baseline differences between the participant groups (age, gender, Hoehn & Yahr stage, and several voice loudness measures) and observed improvements during the weekly discussion group period limited our ability to attribute all of the above results specifically to singing (per-protocol analyses). No significant changes in other assessed outcome measures were found. Conclusions Weekly group singing may improve some aspects of conversational voice volume and quality of life in PD. Some improvements were sustained at least six weeks after interventions ended. Further investigations of the mechanism of benefit and randomized controlled studies (without crossover) to assess the longitudinal effects of singing in PD are necessary.
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Affiliation(s)
- Ankur Butala
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Kevin Li
- Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore MD, USA
| | - Aathman Swaminathan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Susan Dunlop
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Yekaterina Salnikova
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Brandon Portnoff
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Michael Harper
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Bailey Vernon
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Bela Turk
- Moser Center for Leukodystrophies, Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore MD, USA
| | - Zoltan Mari
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
| | - Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD 21218, USA
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Ye X, Li L, He R, Jia Y, Poon W. Rhythmic auditory stimulation promotes gait recovery in Parkinson's patients: A systematic review and meta-analysis. Front Neurol 2022; 13:940419. [PMID: 35968291 PMCID: PMC9366143 DOI: 10.3389/fneur.2022.940419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveUsing rhythmic auditory stimulation (RAS) to improve gait disturbance in Parkinson's disease (PD) is an available treatment option, yet a consensus on its effectiveness remains controversial. We summarized the effects of RAS on gait, functional activity and quality of life in PD patients through a systematic review and meta-analysis.MethodsPubMed, Embase, Web of Science, Medline, and Cochrane Library databases were initially searched to identify relevant literature up to August 2021. Next, the methodological quality of eligible comparative studies was assessed by the Physiotherapy Evidence Database Scale. The treatment effects to clinical outcome in relation to gait, motor activities, and quality of life were analyzed.ResultsA total of 18 studies consisted of 774 subjects were included in this meta-analysis. Comparing with the control group, RAS had significantly increased stride length (p < 0.001), accelerated gait speed (p < 0.001), reduced the occurrence of freezing events during walking (P = 0.009), achieved an improvement in Unified Parkinson's Disease Rating Scale (UPDRS) II (P = 0.030), UPDRS-III (P < 0.001) and Parkinson's Disease Quality of Life Questionnaire (PDQL) (p = 0.009) scores over an interval of 1–26 months.ConclusionIn this meta-analysis of 18 randomized controlled trials, we have demonstrated that RAS improves the general motor functions (UPDRS-III), particularly in gait, mobility and quality of life, in patients with Parkinson's disease.
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Affiliation(s)
- Xiaofan Ye
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Ling Li
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Rong He
- Physiotherapy Department, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yizhen Jia
- Core Laboratory, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Waisang Poon
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
- *Correspondence: Waisang Poon
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Bastepe-Gray S, Wainwright L, Lanham DC, Gomez G, Kim JS, Forshee Z, Kaas B, McCoy A, McGregor C, Moukheiber E, Rajan S, Suarez-Cedeno G, Wang J, Brennan S, Coughlin S, Kang K, Pantelyat A. GuitarPD: A Randomized Pilot Study on the Impact of Nontraditional Guitar Instruction on Functional Movement and Well-Being in Parkinson's Disease. PARKINSON'S DISEASE 2022; 2022:1061045. [PMID: 35795456 PMCID: PMC9252755 DOI: 10.1155/2022/1061045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022]
Abstract
Playing musical instruments may have positive effects on motor, emotional, and cognitive deficits in patients with Parkinson's disease (PD). This pilot study examined the feasibility of a six-week nontraditional guitar instruction program for individuals with PD. Twenty-six participants with idiopathic PD (Age: 67.22 ± 8.07; 17 males) were randomly assigned to two groups (intervention first or 6 weeks of usual care control exposure) with stepwise exposure to the guitar intervention condition with cross-over at six weeks. Outcomes were assessed at baseline, 6, 12, and 18 weeks. Twenty-four participants completed the study. Combined analysis of the groups showed significant BDI-II improvement immediately after intervention completion (3.04 points, 95% CI [-5.2, -0.9], p = 0.04). PDQ-39 total quality of life scores improved from baseline to immediately postintervention 5.19 points (95% CI [-9.4, -1.0]) at trend significance (corrected p = 0.07). For Group 1 (exposed to the intervention first), MDS-UPDRS total scores improved by a mean of 8.04 points (95% CI [-12.4, -3.7], p = 0.004) and remained improved at 12 weeks by 10.37 points (95% CI [-14.7, -6.0], p < 0.001). This group also had significant improvements in mood and depression at weeks 6 and 12, remaining significant at week 18 (BDI-II: 3.75, 95% CI [-5.8, -1.7], p = 0.004; NeuroQoL-depression: 10.6, 95% CI [-4.9. -1.4], p = 0.004), and in anxiety at week 6 and week 18 (NeuroQoL; 4.42, 95% CI [-6.8, -2.1], p = 0.004; 3.58, 95% CI [-5.9, -1.2], p = 0.02, respectively). We found clinically and statistically significant improvements in mood/anxiety after 6 weeks of group guitar classes in individuals with PD. Group guitar classes can be a feasible intervention in PD and may improve mood, anxiety, and quality of life.
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Affiliation(s)
- Serap Bastepe-Gray
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Peabody Conservatory, Johns Hopkins University Peabody Institute, Baltimore, MD, USA
| | - Lavinia Wainwright
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Diane C. Lanham
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gabriela Gomez
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jieung S Kim
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zane Forshee
- Peabody Conservatory, Johns Hopkins University Peabody Institute, Baltimore, MD, USA
| | - Bonnie Kaas
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arita McCoy
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Colin McGregor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Emile Moukheiber
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Suraj Rajan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerson Suarez-Cedeno
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins University School of Public Health Biostatistics Center, Baltimore, MD, USA
| | - Sean Brennan
- Peabody Conservatory, Johns Hopkins University Peabody Institute, Baltimore, MD, USA
| | - Shane Coughlin
- Peabody Conservatory, Johns Hopkins University Peabody Institute, Baltimore, MD, USA
| | - Kyurim Kang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wang L, Peng JL, Ou-Yang JB, Gan L, Zeng S, Wang HY, Zuo GC, Qiu L. Effects of Rhythmic Auditory Stimulation on Gait and Motor Function in Parkinson's Disease: A Systematic Review and Meta-Analysis of Clinical Randomized Controlled Studies. Front Neurol 2022; 13:818559. [PMID: 35493833 PMCID: PMC9053573 DOI: 10.3389/fneur.2022.818559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study aimed to summarize the effectiveness of rhythmic auditory stimulation (RAS) for the treatment of gait and motor function in Parkinson's disease (PD) through a systematic review and meta-analysis. Methods All studies were retrieved from eight databases. The effects of RAS on PD were determined using the following indicators: gait parameters including step length, stride width, step cadence, velocity, stride length; motor function including 6 min walk test (6MWT) and timed up-and-go test (TUGT); the Unified Parkinson's Disease Rating Scale (UPDRS); and the Berg Balance Scale (BBS). The risk map of bias of the quality of the studies and the meta-analysis results of the indicators was prepared with RevMan 5.2 software. Results Twenty-one studies were included in the systematic review, and 14 studies were included in the meta-analysis. In the meta-analysis, the results of gait parameters, namely, velocity, step length, and stride length, were statistically significant (P < 0.05), whereas the results of cadence and stride width were not statistically significant (P ≧ 0.05). The results of 6MWT and TUGT for motor function as well as UPDRS-II, UPDRS-III, and BBS were statistically significant (P < 0.05). Conclusions RAS could improve gait parameters, walking function, balance function, and daily living activities of individuals with PD. The application of RAS in conventional rehabilitation approaches can enhance motor performance in PD. Future studies should use a large sample size and a rigorous design to obtain strong conclusions about the advantages of RAS for the treatment of gait and motor function in PD.
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Affiliation(s)
- Lei Wang
- Department of Rehabilitation Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- *Correspondence: Lei Wang
| | - Jin-lin Peng
- Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-bin Ou-Yang
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Li Gan
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuai Zeng
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Hong-Yan Wang
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guan-Chao Zuo
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ling Qiu
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
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11
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Apreleva Kolomeytseva AT, Brylev L, Eshghi M, Bottaeva Z, Zhang J, Fachner JC, Street AJ. Home-Based Music Therapy to Support Bulbar and Respiratory Functions of Persons with Early and Mid-Stage Amyotrophic Lateral Sclerosis-Protocol and Results from a Feasibility Study. Brain Sci 2022; 12:494. [PMID: 35448025 PMCID: PMC9027911 DOI: 10.3390/brainsci12040494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 01/27/2023] Open
Abstract
Respiratory failure, malnutrition, aspiration pneumonia, and dehydration are the precursors to mortality in ALS. Loss of natural communication is considered one of the worst aspects of ALS. This first study to test the feasibility of a music therapy protocol for bulbar and respiratory rehabilitation in ALS employs a mixed-methods case study series design with repeated measures. Newly diagnosed patients meeting the inclusion criteria were invited to participate, until the desired sample size (n = 8) was achieved. The protocol was delivered to participants in their homes twice weekly for six weeks. Individualised exercise sets for independent practice were provided. Feasibility data (recruitment, retention, adherence, tolerability, self-motivation and personal impressions) were collected. Bulbar and respiratory changes were objectively measured. Results. A high recruitment rate (100%), a high retention rate (87.5%) and high mean adherence to treatment (95.4%) provide evidence for the feasibility of the study protocol. The treatment was well tolerated. Mean adherence to the suggested independent exercise routine was 53%. The outcome measurements to evaluate the therapy-induced change in bulbar and respiratory functions were defined. Findings suggest that the protocol is safe to use in early- and mid-stage ALS and that music therapy was beneficial for the participants' bulbar and respiratory functions. Mean trends suggesting that these functions were sustained or improved during the treatment period were observed for most outcome parameters: Maximal Inspiratory Pressure, Maximal Expiratory Pressure, Peak Expiratory Flow, the Center for Neurologic Study-Bulbar Function Scale speech and swallowing subscales, Maximum Phonation Time, Maximum Repetition Rate-Alternating, Maximum Repetition Rate-Sequential, Jitter, Shimmer, NHR, Speaking rate, Speech-pause ratio, Pause frequency, hypernasality level, Time-to-Laryngeal Vestibule Closure, Maximum Pharyngeal Constriction Area, Peak Position of the Hyoid Bone, Total Pharyngeal Residue C24area. Conclusion. The suggested design and protocol are feasible for a larger study, with some modifications, including aerodynamic measure of nasalance, abbreviated voice sampling and psychological screening.
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Affiliation(s)
| | - Lev Brylev
- Bujanov Moscow City Clinical Hospital, 115419 Moscow, Russia;
- Institute of Higher Nervous Activity and Neurophysiology, 115419 Moscow, Russia
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia
| | - Marziye Eshghi
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA 02129-4557, USA;
| | - Zhanna Bottaeva
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, 119180 Moscow, Russia;
| | - Jufen Zhang
- Faculty of Health, Education, Medicine & Social Care, School of Medicine, Anglia Ruskin University, Cambridge CM1 1SQ, UK;
| | - Jörg C. Fachner
- Music, Health and the Brain, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CM1 1SQ, UK;
| | - Alexander J. Street
- Music, Health and the Brain, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CM1 1SQ, UK;
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12
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Brown EL, Gannotti ME, Veneri DA. Including Arts in Rehabilitation Enhances Outcomes in the Psychomotor, Cognitive, and Affective Domains: A Scoping Review. Phys Ther 2022; 102:6515752. [PMID: 35084031 DOI: 10.1093/ptj/pzac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/25/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to analyze the published literature regarding the use of art in the context of rehabilitation for consideration in physical therapy. METHODS The CINAHL, PsycArticles, APA PsycInfo, Art Index, Music Index, Cochrane Reviews, and PubMed electronic databases were accessed. Inclusion and exclusion criteria were established and utilized to determine study eligibility. Study details were extracted from each article by researchers using a systematic format. Summation of journal type, participants, dosing and type of intervention, setting and interventionist, outcome domains, and study results were included. RESULTS Out of 1452 studies, 76 were included for extraction. Of these studies, most had outcome measures aligned with the psychomotor and affective domains of learning (n = 66). Very few studies had outcome measures with psychomotor and cognitive domains (n = 2) or psychomotor, affective, and cognitive outcome measures (n = 8). Regarding the arts used, music, dance, or both were used in 77 instances. Fewer studies reported using creative arts therapy, singing, theater, writing, and rhythm (n = 17). Of the 76 studies analyzed, 74 reported a within-group treatment effect. CONCLUSION The arts effectively enhance physical therapist practice; therefore, it is recommended that physical therapists continue to seek collaboration with art professionals and explore the use of arts in practice. IMPACT Findings demonstrate that combining the arts with physical therapist practice amplifies not only psychomotor but affective and cognitive outcomes as well. The arts have applicability across broad populations (eg, chronic pain, neurologic dysfunction, respiratory conditions). This study supports that physical therapist education and practice should embrace the arts as a collaborative modality to promote enhanced psychomotor, affective, and cognitive outcomes.
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Affiliation(s)
- Emma L Brown
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Mary E Gannotti
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Diana A Veneri
- Department of Physical Therapy, Sacred Heart University, Fairfield, Connecticut, USA
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13
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Trindade MFD, Viana RA. Effects of auditory or visual stimuli on gait in Parkinsonic patients: a systematic review. Porto Biomed J 2021; 6:e140. [PMID: 34368491 PMCID: PMC8341369 DOI: 10.1097/j.pbj.0000000000000140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/17/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND External stimuli can improve gait performance in Parkinsons Disease (PD): auditory stimuli can increase velocity and visual stimuli may act at step length. OBJECTIVE To systematize the scientific evidence about the effects of auditory or visual stimuli on gait in patients with PD. METHODS From January 2016 to December 2018, a systematic literature research was conducted in the PubMed/Medline and Web of Science databases. Study designs considered were randomized controlled trials (RCTs) and observational studies, which evaluated the effects of auditory or visual stimuli on gait in PD. The methodological quality was assessed by the Critical Appraisal Skills Program. RESULTS Five articles were included with 232 participants and a methodological rank of mean of 10.3 on the cohort studies (n = 3), 8 on the case control studies (n = 1), and 6 on the RCTs (n = 1). Although 3 evaluated the effects of auditory stimuli on gait in PD, 2 analyzed those of visual stimuli. Based on these, it was verified a significant improvement of diverse gait parameters. CONCLUSION The application of auditory or visual stimuli have beneficial effects on gait parameters. Further investigation is required.
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Affiliation(s)
| | - Rui A Viana
- Faculty of Health Sciences, Fernando Pessoa University
- Physical Medicine and Rehabilitation Department, Centro Hospitalar São João EPE, Porto, Portugal
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14
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Tramontano M, De Angelis S, Mastrogiacomo S, Princi AA, Ciancarelli I, Frizziero A, Iosa M, Paolucci S, Morone G. Music-based techniques and related devices in neurorehabilitation: a scoping review. Expert Rev Med Devices 2021; 18:733-749. [PMID: 34162284 DOI: 10.1080/17434440.2021.1947793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction:The music as a powerful, and versatile stimulus for the brain, is at the date sometimes used in neurorehabilitation and proposed as a promising complementary strategy provided in combination with other therapy in individuals with neurological disorders. Different techniques and devices have been developed in the field of the music-based neurorehabilitation.Areas covered:This scoping review analyzes the current scientific literature concerning the different techniques and devices used in the music-supported neurorehabilitation, also focusing on the devices used in music-based therapies in patients with neurological disorders: 46 studies met the inclusion criteria and were included.Expert opinion:Included studies, highlight the potentiality and the versatility of the music-based therapy in the rehabilitation of neurological disorders. The variety of existing techniques allow to applied the music-based therapy in different situations and conditions. Moreover, the wide range of used devices that ranging from the simple musical instruments to the more advanced technologies, allows to develop customized exercises based on the needs of the patient. This review may be considered as a starting point to better design future RCTs that would investigate the effectiveness of music therapy on neurological disorders.
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Affiliation(s)
| | | | | | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Iosa
- Fondazione Santa Lucia IRCCS, Rome, Italy.,Department of Psychology, University of Rome La Sapienza, Rome, Italy
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15
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Chatterjee D, Hegde S, Thaut M. Neural plasticity: The substratum of music-based interventions in neurorehabilitation. NeuroRehabilitation 2021; 48:155-166. [PMID: 33579881 DOI: 10.3233/nre-208011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
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.
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Affiliation(s)
- Diya Chatterjee
- Senior Research Fellow, Music Cognition Laboratory, Department of Clinical Psychology, NIMHANS, India
| | - Shantala Hegde
- Associate Professor and Wellcome DBT India Alliance Intermediate Fellow, Clinical Neuropsychology and Cognitive Neurosciences Center and Music Cognition Laboratory, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Michael Thaut
- Music and Health Science Research Collaboratory and Faculty of Medicine, Institute of Medical Sciences, University of Toronto, Toronto, Canada
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16
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How Technology Applied to Music-Therapy and Sound-Based Activities Addresses Motor and Social Skills in Autistic Children. MULTIMODAL TECHNOLOGIES AND INTERACTION 2021. [DOI: 10.3390/mti5030011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Autism affects how people perceive and make sense of the world around them. Autism is a spectrum condition which impacts people in different ways. Also referred to as Autism Spectrum Disorder (ASD), it is characterized by challenges in the domains of social, cognitive and motor functioning, which differ in severity. Previous research suggests that music can have cognitive, psychosocial, behavioural, and motor benefits in this population. We systematically review the use of technology in Music-therapy and related sound-based activities to improve the motor and social skills of children. In May 2020 we conducted a systematic search on Music-therapy and musical activities for autistic children in research databases including Science Direct, APA PsycNet, Cochrane, IEE and Web of Science, to collect relevant studies. We initially collected 5179 papers of which only 27 studies were identified as suitable for the scope of this review. In the paper, we analyse and describe key characteristics of each project. We then highlight the commonalities, strengths and limitations of existing work, and identify implications for future interaction design.
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17
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Zhou Z, Zhou R, Wei W, Luan R, Li K. Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson's disease: A systematic review and meta-analysis. Clin Rehabil 2021; 35:937-951. [PMID: 33517767 DOI: 10.1177/0269215521990526] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson's disease. DATA SOURCES A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. REVIEW METHODS Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger's regression test. "Trim and fill" analysis was performed to adjust any potential publication bias. RESULTS Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson's Disease Rating Scale motor subscale, MD = -5.44, P = 0.002; Timed Up and Go Test, MD = -1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = -2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = -0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. CONCLUSION The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson's disease.
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Affiliation(s)
- Zonglei Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ruzhen Zhou
- Department of Anorectal Surgery, Changhai Hospital of Shanghai, Shanghai, China
| | - Wen Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rongsheng Luan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Kunpeng Li
- Department of Neurorehabilitation, Shanghai Second Rehabilitation Hospital, Shanghai, China
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18
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Park KS, Hass CJ, Patel B, Janelle CM. Musical pleasure beneficially alters stride and arm swing amplitude during rhythmically-cued walking in people with Parkinson's disease. Hum Mov Sci 2020; 74:102718. [DOI: 10.1016/j.humov.2020.102718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022]
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19
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García-Casares N, Martín-Colom JE, García-Arnés JA. Music Therapy in Parkinson's Disease. J Am Med Dir Assoc 2019; 19:1054-1062. [PMID: 30471799 DOI: 10.1016/j.jamda.2018.09.025] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/05/2018] [Accepted: 09/22/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Parkinson's disease (PD) is a chronic progressive neurologic disorder involving degeneration of the dopaminergic system. Its clinical manifestations include motor and nonmotor symptoms. Several nonpharmacologic therapies, such as music therapy (MT), have recently been developed in order to improve the clinical manifestations of this disease. The aim of this narrative literature review is to analyze the scientific evidence for the therapeutic effects of music in PD. DESIGN We undertook a search in the databases of PubMed, PsycINFO, Scopus, MEDLINE, and Science Direct. SETTINGAND PARTICIPANTS Inclusion criteria were articles including persons with PD rehabilitated with an MT intervention. MEASURES Keywords used were music therapy, Parkinson's disease, auditory cueing, non-motor symptoms, motor symptoms, and quality of life. RESULTS We detected a total of 27 articles, all of which analyzed the therapeutic effects of MT in PD. Of these, 20 studies analyzed the effects in motor symptoms (16 showed beneficial effects and 4, nonbeneficial effects); 9 studies analyzed the effects in nonmotor symptoms, 7 of which demonstrated beneficial effects; and 8 studies analyzed the effects on quality of life, with 6 reporting benefits. None of the articles analyzing nonmotor symptoms and quality of life showed negative effects. CONCLUSIONS/IMPLICATIONS Most of the studies analyzed demonstrated that MT has beneficial effects for the nonpharmacologic treatment of motor and nonmotor symptoms and quality of life of persons with PD. The use of music as a therapeutic tool combined with conventional therapies should be taken into account.
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Affiliation(s)
- Natalia García-Casares
- Department of Medicine, Faculty of Medicine, University of Malaga, Malaga, Spain; Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Malaga, Spain.
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20
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Devlin K, Alshaikh JT, Pantelyat A. Music Therapy and Music-Based Interventions for Movement Disorders. Curr Neurol Neurosci Rep 2019; 19:83. [PMID: 31720865 DOI: 10.1007/s11910-019-1005-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW There is emerging evidence that music therapy and other methods using music and rhythm may meaningfully improve a broad range of symptoms in neurological and non-neurological disorders. This review highlights the findings of recent studies utilizing music and rhythm-based interventions for gait impairment, other motor symptoms, and non-motor symptoms in Parkinson disease (PD) and other movement disorders. Limitations of current studies as well as future research directions are discussed. RECENT FINDINGS Multiple studies have demonstrated short-term benefits of rhythmic auditory stimulation on gait parameters including gait freezing in PD, with recent studies indicating that it may reduce falls. Demonstration of benefits for gait in both dopaminergic "on" and "off" states suggests that this intervention can be a valuable addition to the current armamentarium of PD therapies. There is also emerging evidence of motor and non-motor benefits from group dancing, singing, and instrumental music performance in PD. Preliminary evidence for music therapy and music-based interventions in movement disorders other than PD (such as Huntington disease, Tourette syndrome, and progressive supranuclear palsy) is limited but promising. Music therapy and other music and rhythm-based interventions may offer a range of symptomatic benefits to patients with PD and other movement disorders. Studies investigating the potential mechanisms of music's effects and well-controlled multicenter trials of these interventions are urgently needed.
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Affiliation(s)
- Kerry Devlin
- Peabody Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Jumana T Alshaikh
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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21
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Effect of different music genres on gait patterns in Parkinson’s disease. Neurol Sci 2019; 41:575-582. [PMID: 31713758 DOI: 10.1007/s10072-019-04127-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
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22
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Schwartz AE, van Walsem MR, Brean A, Frich JC. Therapeutic Use of Music, Dance, and Rhythmic Auditory Cueing for Patients with Huntington's Disease: A Systematic Review. J Huntingtons Dis 2019; 8:393-420. [PMID: 31450508 PMCID: PMC6839482 DOI: 10.3233/jhd-190370] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Studies have assessed the therapeutic effect of music, dance, and rhythmic auditory cueing for patients with Huntington’s disease (HD). However, the synthesis of evidence in support of their positive impact on symptoms is lacking. Objective: We conducted a systematic literature review to evaluate the potential benefits of music, dance, and rhythm on the cognitive, psychiatric and motor function in patients with HD. Methods: Two- and three-keyword searches and a manual search identified medical literature published from 1999 through 2019. We considered literature that assessed outcomes of art-based rehabilitation programs or individual modalities for persons with early, middle, or advanced HD. Structured analysis was conducted using data entry tables with categories for patient health status, art methods, and outcomes. Results: Seven articles and six abstracts met eligibility criteria, of which nine evaluated art-based rehabilitation programs. Studies mainly assessed cognitive, psychiatric, and motor functions through music, dance, or rhythm modalities. Although results were conflicting, in summary improvements to motor function were dependent on disease severity and more responsive to art therapy programs than rhythm-motor synchronization. Benefits to global cognition that resulted from rhythmic training correlated with microstructural changes. Qualitative data verified a positive impact on language production, chorea, behavior, and quality of life. Conclusions: Our review has shown a potential benefit of music, dance, and rhythm for patients with HD, which is particularly important for a disease that has no cure. Art forms seemed to affect cognitive, psychiatric, motor, psychosocial, and neuroanatomical domains. However, evidence is preliminary, warranting further investigation to establish the foundation for this field.
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Affiliation(s)
- Anna E Schwartz
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marleen R van Walsem
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway
| | - Are Brean
- Department of Music Education and Music Therapy, Norwegian Academy of Music, Oslo, Norway
| | - Jan C Frich
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,South-Eastern Norway Regional Health Authority, Norway
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23
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Calabrò RS, Naro A, Filoni S, Pullia M, Billeri L, Tomasello P, Portaro S, Di Lorenzo G, Tomaino C, Bramanti P. Walking to your right music: a randomized controlled trial on the novel use of treadmill plus music in Parkinson's disease. J Neuroeng Rehabil 2019; 16:68. [PMID: 31174570 PMCID: PMC6555981 DOI: 10.1186/s12984-019-0533-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/08/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Rhythmic Auditory Stimulation (RAS) can compensate for the loss of automatic and rhythmic movements in patients with idiopathic Parkinson's disease (PD). However, the neurophysiological mechanisms underlying the effects of RAS are still poorly understood. We aimed at identifying which mechanisms sustain gait improvement in a cohort of patients with PD who practiced RAS gait training. METHODS We enrolled 50 patients with PD who were randomly assigned to two different modalities of treadmill gait training using GaitTrainer3 with and without RAS (non_RAS) during an 8-week training program. We measured clinical, kinematic, and electrophysiological effects of both the gait trainings. RESULTS We found a greater improvement in Functional Gait Assessment (p < 0.001), Tinetti Falls Efficacy Scale (p < 0.001), Unified Parkinson Disease Rating Scale (p = 0.001), and overall gait quality index (p < 0.001) following RAS than non_RAS training. In addition, the RAS gait training induced a stronger EEG power increase within the sensorimotor rhythms related to specific periods of the gait cycle, and a greater improvement of fronto-centroparietal/temporal electrode connectivity than the non_RAS gait training. CONCLUSIONS The findings of our study suggest that the usefulness of cueing strategies during gait training consists of a reshape of sensorimotor rhythms and fronto-centroparietal/temporal connectivity. Restoring the internal timing mechanisms that generate and control motor rhythmicity, thus improving gait performance, likely depends on a contribution of the cerebellum. Finally, identifying these mechanisms is crucial to create patient-tailored, RAS-based rehabilitative approaches in PD. TRIAL REGISTRATION NCT03434496 . Registered 15 February 2018, retrospectively registered.
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Affiliation(s)
- Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy.
| | - Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Serena Filoni
- Fondazione Centri di Riabilitazione Padre Pio Onlus, San Giovanni Rotondo, FG, Italy
| | - Massimo Pullia
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Luana Billeri
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Provvidenza Tomasello
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Simona Portaro
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Giuseppe Di Lorenzo
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
| | - Concetta Tomaino
- Institute for Music and Neurologic Function, Mount Vernon, NY, USA
| | - Placido Bramanti
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, Contrada Casazza, S.S. 113, 98124, Messina, Italy
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Miroshnichenko GG, Meigal AY, Saenko IV, Gerasimova-Meigal LI, Chernikova LA, Subbotina NS, Rissanen SM, Karjalainen PA. Parameters of Surface Electromyogram Suggest That Dry Immersion Relieves Motor Symptoms in Patients With Parkinsonism. Front Neurosci 2018; 12:667. [PMID: 30319343 PMCID: PMC6168649 DOI: 10.3389/fnins.2018.00667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 09/05/2018] [Indexed: 11/13/2022] Open
Abstract
Dry immersion (DI) is acknowledged as a reliable space flight analog condition. At DI, subject is immersed in water being wrapped in a waterproof film to imitate microgravity (μG). Microgravity is known to decrease muscle tone due to deprivation of the sensory stimuli that activate the reflexes that keep up the muscle tone. In contrary, parkinsonian patients are characterized by elevated muscle tone, or rigidity, along with rest tremor and akinesia. We hypothesized that DI can diminish the elevated muscle tone and/or the tremor in parkinsonian patients. Fourteen patients with Parkinson's disease (PD, 10 males, 4 females, 47-73 years) and 5 patients with vascular parkinsonism (VP, 1 male, 4 females, 65-72 years) participated in the study. To evaluate the effect of DI on muscles' functioning, we compared parameters of surface electromyogram (sEMG) measured before and after a single 45-min long immersion session. The sEMG recordings were made from the biceps brachii muscle, bilaterally. Each recording was repeated with the following loading conditions: with arms hanging freely down, and with 0, 1, and 2 kg loading on each hand with elbows flexed to 90°. The sEMG parameters comprised of amplitude, median frequency, time of decay of mutual information, sample entropy, correlation dimension, recurrence rate, and determinism of sEMG. These parameters have earlier been proved to be sensitive to PD severity. We used the Wilcoxon test to decide which parameters were statistically significantly different before and after the dry immersion. Accepting the p < 0.05 significance level, amplitude, time of decay of mutual information, recurrence rate, and determinism tended to decrease, while median frequency and sample entropy of sEMG tended to increase after the DI. The most statistically significant change was for the determinism of sEMG from the left biceps with 1 kg loading, which decreased for 84% of the patients. The results suggest that DI can promptly relieve motor symptoms of parkinsonism. We conclude that DI has strong potential as a rehabilitation method for parkinsonian patients.
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Affiliation(s)
- German G Miroshnichenko
- Biosignal Analysis and Medical Imaging Group, Department of Applied Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio, Finland
| | - Alexander Yu Meigal
- Laboratory for Novel Methods in Physiology, Institute of High-Tech Biomedical Solutions, Petrozavodsk State University, Petrozavodsk, Russia
| | - Irina V Saenko
- Laboratory of Gravitational Physiology of Sensorimotor System, Department of Sensorimotor Physiology and Countermeasure, Institute of BioMedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Liudmila I Gerasimova-Meigal
- Department of Human and Animal Physiology, Physiopathology, Histology, Petrozavodsk State University, Petrozavodsk, Russia
| | - Liudmila A Chernikova
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, Russian Academy of Medical Sciences, Moscow, Russia
| | - Natalia S Subbotina
- Department of Neurology, Psychiatry, and Microbiology, Petrozavodsk State University, Petrozavodsk, Russia
| | - Saara M Rissanen
- Biosignal Analysis and Medical Imaging Group, Department of Applied Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio, Finland
| | - Pasi A Karjalainen
- Biosignal Analysis and Medical Imaging Group, Department of Applied Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio, Finland
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Ghai S, Ghai I. Effects of Rhythmic Auditory Cueing in Gait Rehabilitation for Multiple Sclerosis: A Mini Systematic Review and Meta-Analysis. Front Neurol 2018; 9:386. [PMID: 29942278 PMCID: PMC6004404 DOI: 10.3389/fneur.2018.00386] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/11/2018] [Indexed: 12/15/2022] Open
Abstract
Rhythmic auditory cueing has been shown to enhance gait performance in several movement disorders. The "entrainment effect" generated by the stimulations can enhance auditory motor coupling and instigate plasticity. However, a consensus as to its influence over gait training among patients with multiple sclerosis is still warranted. A systematic review and meta-analysis was carried out to analyze the effects of rhythmic auditory cueing in studies gait performance in patients with multiple sclerosis. This systematic identification of published literature was performed according to PRISMA guidelines, from inception until Dec 2017, on online databases: Web of science, PEDro, EBSCO, MEDLINE, Cochrane, EMBASE, and PROQUEST. Studies were critically appraised using PEDro scale. Of 602 records, five studies (PEDro score: 5.7 ± 1.3) involving 188 participants (144 females/40 males) met our inclusion criteria. The meta-analysis revealed enhancements in spatiotemporal parameters of gait i.e., velocity (Hedge's g: 0.67), stride length (0.70), and cadence (1.0), and reduction in timed 25 feet walking test (-0.17). Underlying neurophysiological mechanisms, and clinical implications are discussed. This present review bridges the gaps in literature by suggesting application of rhythmic auditory cueing in conventional rehabilitation approaches to enhance gait performance in the multiple sclerosis community.
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Affiliation(s)
- Shashank Ghai
- Institute of Sports Science, Leibniz University Hanover, Hanover, Germany
| | - Ishan Ghai
- Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
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Ghai S, Ghai I, Schmitz G, Effenberg AO. Effect of rhythmic auditory cueing on parkinsonian gait: A systematic review and meta-analysis. Sci Rep 2018; 8:506. [PMID: 29323122 PMCID: PMC5764963 DOI: 10.1038/s41598-017-16232-5] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/06/2017] [Indexed: 01/11/2023] Open
Abstract
The use of rhythmic auditory cueing to enhance gait performance in parkinsonian patients' is an emerging area of interest. Different theories and underlying neurophysiological mechanisms have been suggested for ascertaining the enhancement in motor performance. However, a consensus as to its effects based on characteristics of effective stimuli, and training dosage is still not reached. A systematic review and meta-analysis was carried out to analyze the effects of different auditory feedbacks on gait and postural performance in patients affected by Parkinson's disease. Systematic identification of published literature was performed adhering to PRISMA guidelines, from inception until May 2017, on online databases; Web of science, PEDro, EBSCO, MEDLINE, Cochrane, EMBASE and PROQUEST. Of 4204 records, 50 studies, involving 1892 participants met our inclusion criteria. The analysis revealed an overall positive effect on gait velocity, stride length, and a negative effect on cadence with application of auditory cueing. Neurophysiological mechanisms, training dosage, effects of higher information processing constraints, and use of cueing as an adjunct with medications are thoroughly discussed. This present review bridges the gaps in literature by suggesting application of rhythmic auditory cueing in conventional rehabilitation approaches to enhance motor performance and quality of life in the parkinsonian community.
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Affiliation(s)
- Shashank Ghai
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany.
| | - Ishan Ghai
- School of Life Sciences, Jacobs University Bremen, Bremen, Germany
| | - Gerd Schmitz
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany
| | - Alfred O Effenberg
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany
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