MUSIC THERAPY FOR ACQUIRED BRAIN INJURY

Bradt J, Magee WL, Dileo C, Wheeler BL, McGilloway E. Music therapy for acquired brain injury. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD006787. DOI: 10.1002/14651858.CD006787.pub2.

The team of authors are an international group who, between them, have 46 years’ experience working with adults with acquired brain injuries as Music Therapists (JB, WM, CD & BW) or medical officers (EM). In their work, the authors have observed the dramatic clinical benefits of music with people with neurological problems. This review examined music therapy with adult populations with acquired brain damage of a non-degenerative nature, and its effects on gait, upper extremity function, communication, mood and emotions, social skills, pain, behavioral outcomes, activities of daily living, and adverse events.

Seven randomized controlled trials with a total of 184 participants were included. We examined trials that compared music therapy and standard care with standard care alone or combined with other therapies. We included only trials which had involved trained or trainee Music Therapists, delivering interventions including active music-making using instruments and/or voice; music listening; song-writing; rhythmic auditory stimulation; or any combination of these.

 

 

The trials were conducted in four different countries: USA, South Korea, Germany, and Australia. Three studies measured the effects of rhythmic auditory stimulation (RAS) on gait (including velocity, cadence, or stride length) or hemiparetic arm movements in stroke patients. RAS uses an external metronome beat embedded in music to entrain movements into stable time relationships. The other four trials used differing interventions, including music listening to live or pre-recorded music; music-based voice training methods; or active music-making using touch-sensitive electronic devices. We graded the trials for bias control by assessing the methods of randomization, allocation concealment, blinding and intention-to-treat analysis.

 

The results suggest that rhythmic auditory stimulation may be beneficial for improving gait parameters in stroke patients. These results were based on two studies with a low risk of bias score. We could not pool the results of the other included trials, although the individual results suggest there may be promising effects for music-based methods on upper extremity functioning, communication and behavioural outcomes.

We would like to conclude with several clinical research recommendations to strengthen this evidence:

• More randomized controlled trials involving interventions delivered by Music Therapists are needed with populations with acquired brain injuries
• Future studies should consider examining the following outcomes which are frequently reported in clinical trials: agitation, cognitive orientation, mood and emotions, social skills and interactions, and activities of daily living
• Future studies need to include power analyses so that sufficiently large samples are used
• Trials need to improve measures taken for controlling bias and report these

 

For fulltext review, click here.