Pro Music Therapy

Enhancing Motor Rehabilitation Through Complementarity: Impact of Music and Physical Therapy Co-Treatment

Recently, I provided an in-service for the physical, occupational, and speech therapists that I work with at the children’s hospital, titled, “Complementarity with Medical Music Therapy.” I explained that music therapists utilize evidence-based music interventions to reach a patient’s specific goals. The specific properties of music such as rhythm, tempo, dynamics, melody, and harmony can be implemented to train motor skills. Music-based interventions also inherently include cognitive and emotional elements because, as we all know, music is engaging. It helps us to focus, motivates us, and moves us to move!

After the presentation, a physical therapist consulted me for one of her patients, a 16-year-old boy. I met her in the rehab gym, and she explained that she wanted the patient to practice reaching and standing. I gave the patient a mallet (i.e., stick with soft-ball top), and invited him to hit the push bell. Initially, he did not hit the bell with enough strength, I physically guided his arm to use more force, and then he did it independently. As a result, he received the pleasing auditory feedback from the bells. I facilitated the above procedure to evaluate his reaching ability and to encourage him with the accomplishment of achieving the pleasant sound.

For the reaching exercise, I placed the bells on a table to his left. The physical therapist verbally requested the color, and, then the patient, assisted by the physical therapist, reached for the correct bell. The patient was encouraged to play the bell, and I behaviorally reinforced his effort by playing a short patient preferred song. This method of reinforcement sustained his attention throughout the intervention, and encouraged him to continue following the physical therapist’s directions because he expected to receive the music after completing the prompted task. The following exercise was standing.

Standing can be a challenging task for a young person with motor difficulties. Using a music-based intervention, however, can make the exercise tolerable. To increase the patient’s endurance while standing, I invited the patient, who was being held by the physical therapist, to play the bongo drums for an entire song while I sang and played a patient-preferred song on guitar. As I played, I adjusted the rhythm and tempo throughout the intervention to sustain his attention. The rehab tech held the drums, so that the patient’s only priority was to play and continue standing. While the patient typically requires constant redirection to remain focused, using music proved to be very engaging. After the patient sat down, he said, “That was so beautiful, I’m going to cry.” Not only was music effective for completing the exercise, but it was also a rewarding experience for this adolescent patient.