How music helps rehab patients learn to move again

‘Music is part of the most complex auditory language the brain ever invented.’

Music therapist Jennifer Buchanan works with post-stroke patient Alan Hubbard at the Association for the Rehabilitation of the Brain Injured in Calgary. Josh Nudd CBC

Dr. Brian Goldman, White Coat, Black Art, CBC Radio May 26, 2018

Lynn Lewis has a neurological disorder and uses music to help her regain the use of her arms.

She’s not alone.

Research on patients who’ve suffered some injury to the brain that affects movement — like stroke or Parkinson’s disease — have suggested that using music with the right tempo “can improve their walking ability.”

Michael Thaut, director of the Music and Health Research Collaboratory at the University of Toronto. Supplied photo

Music is part of the most complex auditory language the brain ever invented,” said Professor Michael Thaut, who’s at the forefront of research on how music can alter the brain networks to heal the body.

The former professional musician’s research journey into neurological music therapy started 25 years ago when he studied if music could be used as a tool or language of rehabilitation.

Music’s rhythm has a very profound effect on motor system, said the director of the Music and Health Research Collaboratory at the University of Toronto.

“If you don’t have a sense of rhythm then your movement coordination will always be out of control.”

Can music improve motor function?

He questioned if music’s profound effect on the motor system could be harnessed to improve the motor function of patients who are neurologically compromised,

To find an answer, Thaut conducted experiments on patients who were suffering from limited mobility due to a stroke or Parkinson’s disease.

Those experiments, he said, revealed that using music with the right tempo can improve their walking ability by synchronizing their movements to a rhythmic beat that gives them the timing for their movement.

The results were surprisingly positive, recalled Thaut.

Thaut said they had stroke patients walk. “They had, you know, certain asymmetric walk — very slow, very unsafe.”

But then the music was turned on, and the patients were told to “walk to the beat,” said Thaut.

“All the parameters of movement almost instantaneously changed very dramatically.”

When the brains of these patients were studied, they revealed that the auditory system in the brain is very closely coupled to the motor system, according to Thaut.

“We found that the auditory system can actually make up for some of the deficiencies in a motor system, and it gives additional information that helps the brain program movement and… control the movement better.”

Once a patient relearns how to move using music, and continues to exercise, they no longer need the music to regulate their activity, said Thaut.

“The most important thing to remember with any form of therapy is the brain says, Use me or lose me.”

Jennifer Buchanan provides music therapy to a child at Williams Syndrome Association Conference. Joey Podlubny

Music as a tool for rehabilitation

Calgary’s Foothills Medical Centre is actively using music therapists to put Thaut’s research findings into clinical application. Music is the medicine prescribed to help some of their patients get better.

On a recent spring afternoon, the sounds of music wafted through the corridors of the hospital. The source is patient Lynn Lewis, who suffers from a neurological condition, sitting in her wheelchair singing the Gene Autry classic, Don’t fence me in. Accompanying her is music therapist Jennifer Buchanan on the guitar.

For Lewis, the singing brings back joyful memories of singing and dancing with her mum. It’s what she needs to relax and lift her spirits in the dreary routine of her hospital stay.

But the music is much more than a mood enhancer.

It is providing neurorehabilitation for Lewis, who is experiencing numbness that has limited the mobility in her arms.

Her music treatment includes playing various drums and noise makers to maintain the rhythm set by the music therapist. Keeping up the tempo forces her to use the injured arm.

As Buchanan explains to Lewis, rhythmic exercise “gets your brain starting to be engaged about the function you are about to be doing.”

Music Therapy at Foothills Hospital, Calgary. Department of Clinical Neurosciences. Youtube May 9, 2018

Music and cognitive impairments

In the last 10 years, Thaut has expanded his research interests to explain how music can help patients slow down the progress of cognitive impairments in patients with dementia and Alzheimer’s disease.

While it is well known that musical memories and their associated biographical information is preserved longer than all other types of memory, nobody could explain why that happened, according to Thaut.

In a new study yet to be published, Thaut’s research team at St. Michael’s Hospital took brain scans of cognitively-impaired patients after they listened to music they were familiar with and after they listened to music that was new to them.

The brain scans revealed the long-term music memory activates a large part of the brain, including areas not affected by cognitive impairment. That means there are lots of reserve or backup regions in the brain where that memory can be accessed.

On the other hand, the short-term music memory only shows up in a network with only three or four regions in the brain.

Thaut’s research team took brain scans of cognitively-impaired patients after they listened to music. The brain maps show activation patterns during long-term familiar (red) and short-term familiar listening (blue). Keenan Research Centre for Biomedical Science of St. Michael’s Hospital and Music and Health Science.

“That network will probably not survive. It may be gone 60 minutes after they leave the brain scan. The traces are not that distributed,” said Thaut.

In another part of the study, the patients listen to a playlist made up of their musical memories which they are required to listen for an hour each day for a month.

At the end of the month when their brains are scanned, Thaut said, it shows better connectivity between brain regions. That means “we can maintain longer levels of functioning, but we cannot reverse the progression of the disease at this point.”

Applying this research to treat traumatic brain injury with music is more challenging.

“The impact of the injury is very broadly distributed over the whole brain. So that means people with traumatic brain injury have multiple issues to deal with,” said Thaut.

While music can help with mobility, unlocking the music solution to other areas of the brain affected requires a lot more research.