Music therapy in stroke rehabilitation
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Pope John Paul II State School of Higher Education in Biała Podlaska, Institute of Public Health, Poland; Departament of Rehabilitation and Orthopaedics, Medical University of Lublin, Poland
Joanna Strzemecka   

Departament of Rehabilitation and Orthopaedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
J Pre Clin Clin Res. 2013;7(1):23–26
Music therapy is currently used in the rehabilitation of many diseases. It is worth mentioning the possibility of using it in the rehabilitation of stroke-related. Music is a multimodal stimulus that activates many brain structures related to sensory processing, attention, and memory, and can stimulate complex cognition and multisensory integration. Stroke represents one of the most costly and long-term disabling conditions in adulthood worldwide and there is a need to determine the effectiveness of rehabilitation programs. The brain has a large capacity for automatic simultaneous processing and integration of sensory information. Musical training has extensive effects on the brain. One aspect that may be relevant for stroke rehabilitation is that musicians have enhanced subcortical auditory and audiovisual processing of speech and music. Listening to pleasant music activates an interconnected network of subcortical and cortical brain regions. Previous studies have shown rapid functional improvements associated with plastic brain changes due to musical performance, which involved the auditory and integrative a Music Supported Therapy and Melodic Intonation Therapy were proposed to induce plastic changes in the brain in terms of functional connectivity and neural reorganization in the sensorimotor cortex uditory-sensorimotor cortices instead of restricted motor cortical areas.
Sleight P. Cardiovascular effects of music by entraining cardiovascular autonomic rhythms music therapy update: tailored to each person, or does one size fit all? Neth Heart J. 2013; 21: 99–100.
Zatorre RJ, Chen JL, Penhune VA. When the brain plays music: auditory-motor interactions in music perception and production. Nat Rev Neurosci. 2007; 8: 547–558.
Koelsch S. A neuroscientific perspective on music therapy. Ann N Y Acad Sci. 2009; 1169: 406–416.
Thaut MH, Gardner JC, Holmberg D, Horwitz J, Kent L, Andrews G, Donelan B, McIntosh GR. Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation. Ann N Y Acad Sci. 2009; 131: 866–876.
Johansson BB. Multisensory stimulation in stroke rehabilitation. Front Hum Neurosci. 2012; 6: 60.
Pekna M, Pekny M, Nilsson M. Modulation of neural plasticity as a basis for stroke rehabilitation. Stroke. 2012; 43(10): 2819–28.
Bunketorp Käll L, Lundgren-Nilsson Ĺ, Blomstrand C, Pekna M, Pekny M, Nilsson M. The effects of a rhythm and music-based therapy program and therapeutic riding in late recovery phase following stroke: a study protocol for a three-armed randomized controlled trial; BMC Neurol. 2012; 12: 141.
Särkämö T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM, Erkkilä J, Laine M, Peretz J, Hietanen M. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain. 2008; 131: 866–876.
Musacchia G, Arum L, Nicol T, Garstecki D, Kraus N. Audiovisual deficits in older adults with hearing loss: biological evidence. Ear Hear. 2009; 30: 505–514.
Musacchia G, Sams M, Skoe E, Kraus NM. Musicians have enhanced subcortical auditory and audiovisual processing of speech and music. Proc Natl Acad Sci USA. 2007; 104: 15894–15898.
Wong PC, Skoe E, Russo NM, Dees T, Kraus N. Musical experience shapes human brainstem encoding of linguistic pitch patterns. Nat Neurosci. 2007; 10: 420–422.
Parbery-Clark A, Skoe E, Kraus N. Musical experience limits the degradative effects of background noise on neural processing of sound. J Neurosci. 2009; 29: 14100–14107.
Shahin AJ. Neurophysiological influence of musical training on speech perception. Front Psychol. 2011; 2: 126.
Strait DL, Kraus N. Can you hear me now? musical training shapes functional brain networks for selective auditory attention and hearing speech in noise. Front Psychol. 2011; 2(113): 1–10.
Nudo RJ, Plautz EJ, Frost SB. Role of adaptive plasticity in recovery of function after damage to motor cortex. Muscle Nerve 2001; 24: 1000–1019.
Pascual-Leone A. Reorganization of cortical motor outputs in the acquisition of new motor skills. Electroencephalogr Clin Neurophysiol/ Electromyogr Motor Control. 1995; 97: 25–26.
Münte TF, Altenmüller E, Jäncke L. The musician’s brain as a model of neuroplasticity. Nat Rev Neurosci. 2002; 3: 473–478.
Imfeld A, Oechslin MS, Meyer M, Loenneker T, Jancke L. White matter plasticity in the corticospinal tract of musicians: A diffusion tensor imaging study. Neuroimage 2009; 46: 600–607.
Chen JL, Penhune VB, Zatorre RJ. The Role of Auditory and Premotor Cortex in Sensorimotor Transformations. Ann N Y Acad Sci. 2009; 1169: 15–34.
Koelsch S. Towards a neural basis of music-evoked emotions. Trends in Cognitive Sciences 2010; 14: 131–137.
Amengual JL, Rojo N, Veciana de Las Heras M, Marco-Pallarés J, Grau-Sánchez J, Schneider S, Vaquero L, Juncadella M, Montero J, Mohammadi B, Rubio F, Rueda N, Duarte E, Grau C, Altenmüller E, Münte TF, Rodríguez-Fornells A. Sensorimotor Plasticity after Music- Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation. PLoS One. 2013; 17; 8(4): e61883. doi: 10.1371/ journal.pone.0061883.
Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Natl Acad Sci USA 2001; 98: 11818–23.
Brown S, Martinez MJ, Parsons LM. Passive music listening spontaneously engages limbic and paralimbic systems. Neuroreport 2004; 15: 2033–7.
Menon V, Levitin DJ. The rewards of music listening: response and physiological connectivity of the mesolimbic system. Neuroimage. 2005; 28: 175–84.
Koelsch S, Fritz T, V Cramon DY, Müller K, Friederici AD. Investigating emotion with music: An fMRI study. Hum Brain Mapp. 2006; 27: 239–50.
Ashby FG, Isen AM, Turken AU. A neuropsychological theory of positive affect and its influence on cognition. Psychol Rev. 1999; 106: 529–50.
Panksepp J, Bernatzky G. Emotional sounds and the brain: the neuroaffective foundations of musical appreciation. Behav Processes. 2002; 60: 133–55.
Sutoo D, Akiyama K. Music improves dopaminergic neurotransmission: demonstration based on the effect of music on blood pressure regulation. Brain Res. 2004; 1016: 255–62.
Schück S, Bentué-Ferrer D, Kleinermans D, Reymann JM, Polard E, Gandon JM, Allain H.Psychomotor and cognitive effects of piribedil, a dopamine agonist, in young healthy volunteers. Fundam Clin Pharmacol. 2002; 16: 57–65.
What is music therapy? american music therapy association web site. (access: 20.04.2013).
Clair AA, Pasiali V, LaGasse B. In: Introduction to approaches in music therapy. 2. Darrow AA, editor. Silver Spring, MD: The American Music Therapy Association; 2008. Neurologic music therapy; pp. 153–172.
Thaut MH. In: Rhythm, music, and the brain: Scientific foundations and clinical applications. Thaut MH, editor. New York: Routledge; Taylor and Francis Group; 2005. Music in therapy and medicine: from social science to neuroscience; pp. 113–136.
Thaut MH. In: A scientific model of music in therapy and medicine. Thaut MH, editor. San Antonio, TX: IMR Press; 2000. The scientific model (R-SMM): The need for a scientific model; pp. 1–24.
Thaut MH. In: Training manual for neurologic music therapy. Thaut MH, editor. Fort Collins, CO: Colorado State University; 1999. Techniques of neurologic music therapy in neurologic rehabilitation.
Rodriguez-Fornells A, Rojo N, Amengual JL, Ripolles P, Altenmuller E, Munte TF. The involvement of audio-motor coupling in the musicsupported therapy applied to stroke patients. Ann N Y Acad Sci. 2012; 1252: 282–293.
Rojo N, Amengual J, Juncadella M, Rubio F, Camara E, Marco-Pallares J, Schneider S, Veciana M, Montero J, Mohammadi B. et al. Musicsupported therapy induces plasticity in the sensorimotor cortex in chronic stroke: a single-case study using multimodal imaging (fMRITMS) Brain injury: [BI] 2011; 25(7–8): 787–793.
Altenmuller E, Marco-Pallares J, Munte TF, Schneider S. Neural reorganization underlies improvement in stroke-induced motor dysfunction by music-supported therapy. Ann N Y Acad Sci. 2009; 1169: 395–405.
Schlaug G, Marchina S, Norton A. Evidence for plasticity in whitematter tracts of patients with chronic Broca’s aphasia undergoing intense intonation-based speech therapy. Ann N Y Acad Sci. 2009; 1169: 385–394.
Schneider S, Schonle PW, Altenmuller E, Munte TF. Using musical instruments to improve motor skill recovery following a stroke. J Neurol. 2007; 254(10): 1339–1346.
Schneider S, Munte T, Rodriguez-Fornells A, Sailer M, Altenmuller E. Music-supported training is more efficient than functional motor training for recovery of fine motor skills in stroke patients. Music Percept. 2010; 27: 271–280.
Kim DS, Park YG, Choi JH, Im SH, Jung KJ, Cha YA, Jung CO, Yoon YH. Effects of music therapy on mood in stroke patients. Yonsei Med J. 2011; 52(6): 977–981.
Jeong S, Kim MT. Effects of a theory-driven music and movement program for stroke survivors in a community setting. Applied nursing research: ANR. 2007; 20(3): 125–131.
Thaut MH, Leins AK, Rice RR, Argstatter H, Kenyon GP, McIntosh GC, Bolay HV, Fetter M. Rhythmic auditory stimulation improves gait more than NDT/Bobath training in near-ambulatory patients early poststroke: a single-blind, randomized trial. Neurorehabil Neural Repair. 2007; 21(5): 455–459.
Hayden R, Clair AA, Johnson G, Otto D. The effect of rhythmic auditory stimulation (RAS) on physical therapy outcomes for patients in gait training following stroke: a feasibility study. Int J Neurosci. 2009; 119(12): 2183–2195.
Malcolm MP, Massie C, Thaut M. Rhythmic auditory-motor entrainment improves hemiparetic arm kinematics during reaching movements: a pilot study. Top Stroke Rehabil. 2009; 16(1): 69–79.
Whitall J, McCombe Waller S, Silver KH, Macko RF. Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke. 2000; 31(10): 2390–2395.
Villeneuve M, Lamontagne A.Playing piano can improve upper extremity function after stroke: case studies. Stroke Res Treat. 2013; 2013: 159105.
Zipse L, Norton A, Marchina S, Schlaug G.When right is all that is left: plasticity of right-hemisphere tracts in a young aphasic patient. Ann N Y Acad Sci. 2012; 1252: 237–45.
Stahl B, Kotz SA, Henseler I, Turner R, Geyer S.Rhythm in disguise: why singing may not hold the key to recovery from aphasia. Brain. 2011; 134(Pt 10): 3083–93.