Recruitment And Informed Consent
Participants will be recruited from the Movement Disorders Center at University of Colorado Anschutz Medical Campus, from the community via advertisements, fliers, and through support group outreach. After a preliminary telephone screening, evaluation and consent will be obtained at a face-to-face interview between the subject and a member of the research team. Study details will be explained to the subject in a quiet room, without disturbance. Each subject will be asked to review the consent document, approved by the Colorado Multiple Institutional Review Board, and the University of Colorado Committee for the Protection of Human Subjects, which will include HIPAA authorization. Although this trial has minimal risk, subject harms fall under responsibility of the subject and their insurance, as indicated in the consent form.
Mental Outlook Makes A Difference
According to Atwood you can always learn to live better with Parkinsons, since how you live with your illness comes from your mental outlook. You can do something about your mental outlook. Dont think that you are a burden.2
When a chronic illness happens, it affects the whole family, and each family member has to cope with the illness in some way. Dont devalue yourself it is a biological happening and not something to be ashamed of. Parkinsons, like ageing, is something that happens to you, not something you do.
Future Reasrach On The Role Of Music Therapy For Parkinson’s
Future studies of the role of music therapy and singing on PD should provide additional clarity. The GRAMMY Foundation has awarded a grant to Professor Stegemöller to study the overall effects of singing and to verify if there is measurable improvement in PD symptoms.7
To find a music therapist near you check out MusicTherapy.org.
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Imperfect Treatments For A Complex Disease
As a neurodegenerative disease, PD involves the progressive loss of dopamine-producing neurons. This loss leads to irregular activity and connections in the surviving brain cells, impacting movement coordination. It may also account for non-motor symptoms in PD related to emotion and mood.
Traditionally, physicians prescribe medications that target the dopamine system to compensate for the patients lost dopamine production surgical interventions, such as deep brain stimulation, can also help and are believed to mitigate some of the aberrant brain activity caused by the disease.
Unfortunately, these medications and surgeries become increasingly ineffective with extended treatment in most patients. To address PD and all its complexities, healthcare providers are exploring different treatment strategies to complement more traditional interventions.
Music Therapies For Parkinsons Disease
Music therapy, which utilizes rhythm, movement, voice and creativity to try to improve Parkinsons disease symptoms, are very popular for people with PD. Music-based therapies may work in a variety of ways to improve Parkinsons related challenges. The types of therapies that utilize the qualities of music are numerous and varied and it is hard to capture the full breadth of what is available.
A few types of music therapy:
All of these activities may have additional benefits including:
- Providing avenues for socialization Working with others to perform a dance or a song offers the opportunity for socialization and collaboration.
- Enhancing mood and/or cognitive function Some studies support the ability of music-based therapies to improve mood and cognition.
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Research Objectives And Comparators
The central goal for this study is to investigate the underlying networks used during TIMP and test the rehabilitative power of TIMP techniques for fine motor control in PD. Specifically, the study aims to demonstrate whether the use of musical instruments to specifically promote fine motor function allows differential mobilization of neuronal networks when they are combined with external rhythmic cueing. To allow for an accurate clinical comparator, a standardized OT research protocol will be tested as well.
Music Sets Emotions In Motion
Music is more than just a beat: it can also stir up powerful feelings, which can help PD patients.
Listening to and producing music is associated with increased activity in brain areas involved with reward and emotion and increased release of dopamine. By naturally increasing the brains dopamine levels, music may partially counteract the loss of dopamine neurons from the progression of PD. As an added benefit, music is intrinsically motivating, which means music therapy is more effective and easier to keep up with compared to other training regimens, like conventional physical therapy.
Recent studies conducted by neurologist Alexander Pantelyat of Johns Hopkins University found that regular choir, guitar, or drum sessions helped patients with Parkinsons disease improve their movement and coordination as well as their mood.
The group music sessions also provide a social benefit, establishing a community for PD patients who may otherwise find themselves isolated and lonely. Allowing PD patients to experience camaraderie and develop social bonds likely benefits their mood and quality of life.
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The Many Disharmonies Of Parkinsons Disease
As the second-most common neurodegenerative disease following Alzheimers, Parkinsons disease affects more than 10 million people worldwide and is projected to impact 1.2 million Americans by 2030.
PD is marked by a host of movement-related problems, including tremors, rigidity of muscles, sluggish movement, and postural instability. As the disease progresses, patients may develop a slow, shuffling gait and experience difficulty maintaining their balance. With less mobility and autonomy, patients find their quality of life can suffer considerably.
Though PD is most often associated with motor impairment, symptoms related to deficits in mood, behavior, and cognition also surface throughout the course of the disease, further complicating treatment and diminishing the quality of life for patients. Approximately 30 percent of PD patients have anxiety, while an average of 35 percent report clinically significant depressive symptoms. These mood disorders often develop years before the onset of PDs motor symptoms, suggesting that they may be part of the disease process instead of a response to coping with PD.
Harp Music And Parkinsons
The harp differs from many other instruments and the human voice by its vibrational pattern. A harp usually has 26 to 47 strings, and when listening to a harp on which a string is being plucked, you will immediately experience a quality of sound that is more than just a single note.
Dr Ron Price, who suffers from Parkinsons disease, started to play the harp for several hours daily. The harp has kept him relatively free of symptoms, but when he does not play music for several days, the symptoms return. His speech becomes garbled, his face slackens and his motor functions decrease. It is clear to medical researchers that harp playing greatly improves the motor skills of those suffering from Parkinsons disease. He started the Healing Harps group . Today this group has 120 active members.
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How Music Accompanies My Parkinsons Journey
by Daphne Bryan, music teacher, MA and Phd in Music Psychology and Person with Parkinsons Disease.
I have played piano since the age of seven and taught music all my life, so it is not surprising that my mobility problems initially became evident to me while playing the piano. I had been asked to demonstrate a new piano, which the local church was considering buying, but while playing I found that I could not move the fingers of my right-hand as quickly as those of my left. For the next eighteen months doctors and physios gave me various diagnoses from trapped nerve to dystonia. When I finally consulted a neurologist, the diagnosis of Parkinsons was a complete shock.
Over the next few weeks, I deteriorated quickly as I mentally tried on the mantle of Parkinsons. I was frightened and in shock and I was grieving for the life I thought I would no longer be able to lead. I confess that I stopped playing the piano. I did not want to witness my ability becoming more and more restricted and I mourned for my loss.
In March this year, a few days before self-isolation, I threw a party. I had reached ten years since my diagnosis and I wanted to give thanks that I was doing so well. There is no doubt that music has helped in many ways. It has helped me walk with a better gait, strengthen my voice and my swallowing, it has calmed me when Ive felt anxious and lifted my spirits when Ive felt down, and playing the piano has given me a means of self-expression. I am truly blessed.
What Is Parkinsons Disease
Parkinsonâs Disease is a neurological disorder. This disorder disrupts the flow of the central nervous system. It is caused when dopamine stops producing or dies within the brain. Dopamine is a neurological chemical that helps control movement in humans. When there becomes a lack of dopamine, it then causes a person to struggle to move. Stiffness in the hands or having difficulty walking are symptoms of Parkinsonâs. Itâs also a lifelong, progressive disease which implies that it grows worse over time.
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Music Therapy To Help With Parkinson’s Disease
First off, I am not a doctor or a scientist. I am a physiotherapist who tries hard to make sure your exercise program has function and maybe even some fun built in. I have always enjoying listening, singing, and even dancing around to music. So, I was excited to hear about combining music therapy in the treatment of Parkinsons disease . Anytime I can combine something like that I want to know more.
Lets take a look at a review article. This article was a systematic review of PD and music therapy from 2015-2020. The research reviewed 58 articles, and it included various types of interventions . The researchers grouped the results into areas of potential impact in the areas of movement, communication, emotion, and cognition.
Some of the articles in the review found that music therapy could help with improving movement components such as gait speed, reducing the number of steps, helps with gait freezing, and as a result reduce falls. As a side note one particular study noted that different types of music had different effects on our bodies. For example, classical music had a different effect on gait speed and trunk inclination compared to heavy metal music.
Clinical Trials For Complementary Therapies In Pd
Just like they do for medications, clinical trials are also done for complementary therapies. Trials that test complementary therapies in PD can be conducted in a variety of ways, some more rigorous than others. Typically, patients are assessed for different outcome measures depending on the treatment. For example, a study of massage investigated the change in pain level as an outcome measure, whereas studies of acupuncture looked at changes in sleep and depression as outcome measures. The different types of treatments have not been compared to each other, so there is little way of knowing if one edges out the others in terms of effectiveness on any given measure.
In general, however, these modalities are low-risk and typically demonstrate improvement in either a motor or a non-motor symptom. Additional research with larger and more rigorous trials is needed, but it is exciting to realize that there are many possible therapeutic avenues to explore. It is also important to note that complementary therapies are typically not covered by insurance, so they may be out of financial reach for many people with PD. Increased research demonstrating the efficacy of these modalities is the first step in convincing insurance providers that these services are worth covering.
Tips and Takeaways
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How Music Therapy May Help Parkinson’s Disease
Singing, specifically shares similar neural and anatomical connections with our speech network. This review article noted that singing had the potential to assist with breath control, vocal deterioration, and swallowing.
Unfortunately, there were even fewer studies that looked at music and cognition. One of the articles found that music improved frontal lobe functions like higher level executive functioning such as planning. The research in this area was even more limited.
My overall take home message was that more research needs to be done. The use of music has many potential benefits in both the physical and mental well-being of patients with neurological disorders such as Parkinson’s disease. Music therapy, including singing, may assist with gait patterns, gait speed, improved breath control and swallowing. It could also improve mood, motivation, social interactions and overall quality of life.
In the meantime as research improves, there is no harm in finding your rhythm. What’s important when incorporating any therapy into your life is making it a regular part of your life, at least once per week, more often if possible. Put some music on your cell phone or tablet that helps you get going and keep going. Music that lifts your mood. Music that makes you sing. As they say dance like no one is watching. And, I will also add sing like no one is listening.
Michelle Tyler, physiotherapist at Pillars of Wellness
Effects Of Music Therapy On The Cognitive Sphere
Spina detected a beneficial effect of music therapy on cognition. There was an improvement at the end of the program in tests that examine frontal lobe function in a pilot study conducted on Parkinsons patients, which suggests that the music-based intervention could improve frontal function by acting as a training ground for these cognitive skills since it stimulates attention and executive functions such as planning, flexible thinking, and execution. Although, according to the authors, this effect tends to disappear after the music therapy program is stopped, so it should be continued for a longer period.
However, another study led by Dalla Bella shows how patients with relatively moderate rhythmic abilities are the most likely to benefit from rhythmic auditory signals. These can be enhanced with the use of technological devices such as cell phones and tablets, among others, which can help to generate, apart from rhythm, the correction of cognitive functions of speech and language. This applies not only to people with PD but to patients such as children and adults with neurodevelopmental disorders.
Healing Is Music To Our Ears
Elizabeth Stegemöller is an assistant professor in kinesiology researching how music facilitates movement in people with neurological disorders. Stegemöller is a board certified music therapist with a Ph.D. in neuroscience. Her research has demonstrated that singing training can significantly improve swallowing and respiratory functions, often major impairments in people with Parkinsons disease. This research has resulted in two outreach programs in Ames, IA: a singing group and a music and movement group.
Each program meets for one hour once a week.
Where We See Improvements
Libby McDermott claims that playing piano has helped alleviate the stiffness in her hands. She says that she has always had trouble writing and typing due to Parkinsonâs. Playing piano helps her hand muscles loosen by pressing the pianoâs keys to a rhythmic beat.
Music therapy also helps clients with Parkinsonâs disease by restoring their balance. People with Parkinsonâs struggle to move side to side or stride with ease. Music therapy causes moving to become easier and more effortless.
Communication is a vital aspect of understanding one another. People that suffer from Parkinsonâs struggle to get their words out. With the help of singing, clientsâ volume and articulation levels rise. It is also proven to help swallowing. Humming helps to relax vocal folds that may be tense or stretched.
Clients are encouraged to sing because it restores and improves issues with memory. Recall, recognition, and attention spans improve by using music-based cues.
Almost half of the adults in the United States struggle with some sort of mental disease. People with Parkinsonâs Disease are no different. Music therapy helps them express themselves. This alleviates anxiety, fatigue, depression, sleeping problems, and more. The increase in self-expression leads to self-discovery in people with Parkinson’s. Self-discovery fights against any unwanted feelings such as anxiety and depression.
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Effects Of Music Therapy On The Social And Communication Sphere
Impaired communication is one of the most common symptoms in PD, significantly affecting the persons quality of life. In a study by Tamplin et al. , they consider that singing shares many of the neural networks and structural mechanisms used during speech and therefore has the potential for therapeutic application to address speech disorders. They therefore set out to explore the effects of an interdisciplinary singing-based therapeutic intervention on voice and communication in people with PD, concluding that ParkinSong is an attractive intervention with the potential to increase volume and respiratory function in patients with this condition.
Hypokinetic dysarthria during the disease was analyzed with regard to communication skills as predominant factors in daily life, with the same immediately influencing decreased competence in communication, thereby increasing frustration and a loss of confidence, regardless of the degree of symptoms. Regarding the feasibility and outcome measures, they concluded that there is initial evidence to warrant further study of the protocol. On the other hand, in a narrative review, the role of music therapy in improving aphasia and other neurological disorders was described, underlying the reasons why this tool could be effective in rehabilitation settings, especially in people affected by stroke , in maintaining vocal skills, and in delaying the vocal deterioration that often accompanies PD .
Bringing Harmony To The Brain: The Neuroscience Of Music And Parkinsons Disease
As anyone who has heard their song can attest, the right music has the power to make you move. Now healthcare providers are trying to harness this power to help patients with a neurological motor disorder, Parkinsons disease .
Over the past three decades, researchers have begun to uncover the neural basis of musics effect on the brain with an eye toward treating diseases like PD. A growing body of research reveals that the influence of music is far-reachingshaping connections in the brain, improving our senses and movement, and enhancing our mood.
The Many Disharmonies of Parkinsons Disease
As the second-most common neurodegenerative disease following Alzheimers, Parkinsons disease affects more than 10 million people worldwide and is projected to afflict almost 1 million Americans by 2020.
At its core, PD is marked by a host of movement-related problems, including tremor, rigidity of muscles, slowness of movement, and postural instability. The disease can affect the patients throat muscles, resulting in softer or slurred speech, as well as the muscles in their limbs. Patients often describe challenges with everyday tasks that require fine motor control, like writing or buttoning their clothing. As the disease progresses, patients may develop a slow, shuffling gait and experience challenges with maintaining their balance. With less mobility and daily autonomy, patients quality of life can take a nosedive.
Imperfect Treatments for a Complex Disease
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