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Branson J1, Ulanowski E2, Danzl M2, Brothers A2, James A2, Schwartz L2, Starr K2
1Music Therapy Services of Kentuckiana, Indiana, United States, 2Bellarmine University, Physical Thearpy, Louisville, United States
Background: Music therapy (MT) improves patient mood, pain perception, attention, movement patterns, and overall quality of life. MT is not explored in research as a co-treatment and adjunct to physical therapy in individuals with Huntington´s disease (HD), a hereditary neurodegenerative disorder that results in loss of mental, physical, and emotional control.
Purpose: To describe a novel physical therapy and MT approach to working with individuals with late stage HD and to explore the role of MT on functional movements.
Methods: Ten participants with HD (mean age 49 years) living in a long-term care facility were evaluated by a Neurologic Certified Specialist Physical Therapist (PT) including observation of basic functional movements. Evaluations informed the selection of movements to subsequently trial with music as determined by the PT and a Board Certified Music Therapist (MT-BC). The treatment session included performance of functional movements under three separate conditions: physical therapy alone, physical and MT with a drum, and physical and MT with a guitar. In-person and video-recorded participant observations with field notes were collected. Observational movement analyses were also conducted based on the video review. Post intervention, a semi-structured interview was conducted with the PT and MT-BC about their perceptions of the experience, the role of MT on movement in HD, and the collaborative or co-treatment opportunities for a PT and MT-BC in HD rehabilitation. The observations and interview were coded for meaning.
Results: Findings suggest the MT-BC/PT co-treatment was beneficial with the use of a simple auditory cue such as a drum provided by the MT-BC during the functional tasks directed by the PT. The drum allowed the MT-BC to quickly evolve the rhythm to match the needs and variability of the pattern based on the chorea and movements. The cues provided allowed participants to demonstrate improved (timing) control over the hyperkinetic movements. The simple pulse provided by the drum appears to be more effective than the pitched cues provided by the guitar, with participants demonstrating improved attention to the drum cue.
Conclusion(s): MT-BC/PT co-treatment allows for interdisciplinary collaboration that can benefit patients with a complex disease such as HD. Further study is needed to identify the effects of the general music cue versus a more cognitively mediated approach of instructing participants to focus on the music cue during movement.
Implications: This is the first report to describe a PT/MT-BC approach to addressing functional movement patterns in individuals with late stage HD. The role of music therapy on movement in HD and the collaboration opportunities between a PT and MT-BC warrant further consideration and examination. There may be limits to the traditional auditory cues that a PT tends to use (e.g., metronome). It is time to consider and examine the use of skilled and tailored auditory cues from a MT-BC during a PT-guided movement.
Keywords: Huntington's disease, Music Therapy, Physical Therapy
Funding acknowledgements: Bellarmine University Graduate Research Funding Grant
Purpose: To describe a novel physical therapy and MT approach to working with individuals with late stage HD and to explore the role of MT on functional movements.
Methods: Ten participants with HD (mean age 49 years) living in a long-term care facility were evaluated by a Neurologic Certified Specialist Physical Therapist (PT) including observation of basic functional movements. Evaluations informed the selection of movements to subsequently trial with music as determined by the PT and a Board Certified Music Therapist (MT-BC). The treatment session included performance of functional movements under three separate conditions: physical therapy alone, physical and MT with a drum, and physical and MT with a guitar. In-person and video-recorded participant observations with field notes were collected. Observational movement analyses were also conducted based on the video review. Post intervention, a semi-structured interview was conducted with the PT and MT-BC about their perceptions of the experience, the role of MT on movement in HD, and the collaborative or co-treatment opportunities for a PT and MT-BC in HD rehabilitation. The observations and interview were coded for meaning.
Results: Findings suggest the MT-BC/PT co-treatment was beneficial with the use of a simple auditory cue such as a drum provided by the MT-BC during the functional tasks directed by the PT. The drum allowed the MT-BC to quickly evolve the rhythm to match the needs and variability of the pattern based on the chorea and movements. The cues provided allowed participants to demonstrate improved (timing) control over the hyperkinetic movements. The simple pulse provided by the drum appears to be more effective than the pitched cues provided by the guitar, with participants demonstrating improved attention to the drum cue.
Conclusion(s): MT-BC/PT co-treatment allows for interdisciplinary collaboration that can benefit patients with a complex disease such as HD. Further study is needed to identify the effects of the general music cue versus a more cognitively mediated approach of instructing participants to focus on the music cue during movement.
Implications: This is the first report to describe a PT/MT-BC approach to addressing functional movement patterns in individuals with late stage HD. The role of music therapy on movement in HD and the collaboration opportunities between a PT and MT-BC warrant further consideration and examination. There may be limits to the traditional auditory cues that a PT tends to use (e.g., metronome). It is time to consider and examine the use of skilled and tailored auditory cues from a MT-BC during a PT-guided movement.
Keywords: Huntington's disease, Music Therapy, Physical Therapy
Funding acknowledgements: Bellarmine University Graduate Research Funding Grant
Topic: Neurology; Service delivery/emerging roles; Human movement analysis
Ethics approval required: Yes
Institution: Bellarmine University
Ethics committee: Bellarmine University
Ethics number: 663
All authors, affiliations and abstracts have been published as submitted.
