Written By: Lisa Milliken, MA, CCC-SLP, FNAP, CDP, RAC-CT
“Parkinson’s Disease is a terrible disease”, stated Mr. Raj as we sat at his dining room table during a home health visit. But then his wife reminded him that he is actually very fortunate to still be blessed with so many abilities and pointed out all the things for which they have to be grateful. At this point, I had been working with him for three weeks and he was progressing very well with compensatory strategies as well as with increased function as a result of physical, occupational, and speech therapy. One clinical strategy that he especially loved was to utilize all his learned techniques while singing the songs from his homeland of India, which extended his breath support, intelligibility, and coordinated movements for walking and dressing. He was quite surprised at all his successful functions which he had thought were lost forever.
Using Music with all Disciplines of Therapy
Though we employ multiple evidence-based techniques, strategies, and exercises for skilled interventions, I find it is also critical to ask my patients about their prior occupations, interests, cultures, and preferences so I can incorporate these factors into the plan of care. And with those people living with Parkinson’s Disease, we often include their favorite music as an intervention to add function. For speech therapy, this incorporates diaphragmatic support, increased prosody, pacing, increased intelligibility, and volume. For physical and occupational therapy, music can have a significant impact on gait, coordination, and movement.
Incorporating music into our physical, occupational, or speech therapy treatments often makes a significant difference in their clinical outcomes. For instance, Mr. Bob was almost completely unintelligible to his family and was experiencing frequent falls in his home. But he learned to incorporate his favorite music of singing and listening to church hymns, which helped him with pacing his speech, walking, and ADLs, for increased function for his goals by all disciplines. Imagine the shock of his family when, even though they could not understand a single phrase he was trying to say, he was able to sing a beautifully loud and clear version of “It is well with my soul”!
Music with Dual Task Training
Singing or listening to music while walking with the PT, or while completing a dressing task with the OT can lead to remarkable results as well, as it incorporates Dual Task Training. Evidence and clinical case studies have proven the effectiveness of combining cognitive and motor tasks to significantly improve both cognitive and motor functions, more so than when such tasks are targeted alone. Dance is another modality to incorporate music with motor and cognitive functions in dual task training.
I’ve found the power of music and dual task training utilized by all disciplines to help many of my patients succeed in their functional goals! To learn more about these options, check out my online course, Seeking Improved Therapy Outcomes with Music.
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Barnish, M.S., Barran, S.M. (2020) A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson’s disease. BMC Neurol 20, 371. https://doi.org/10.1186/s12883-020-01938-3
Fodor, D. M., Breda, X.-M., Valean, D., Marta, M. M., & Perju-Dumbrava, L. (2021). Music as Add-On Therapy in the Rehabilitation Program of Parkinson’s Disease Patients—A Romanian Pilot Study. Brain Sciences, 11(5), 569. MDPI AG. Retrieved from http://dx.doi.org/10.3390/brainsci11050569
Machado Sotomayor, M. J., Arufe-Giráldez, V., Ruíz-Rico, G., & Navarro-Patón, R. (2021). Music Therapy and Parkinson’s Disease: A Systematic Review from 2015-2020. International journal of environmental research and public health, 18(21), 11618. https://doi.org/10.3390/ijerph182111618
Stegemöller EL, Jordan TR, O’Connor MC, et al. (2017) Elucidating program experiences of persons with Parkinson’s disease engaged in therapeutic singing. J Music Ther.
Tamplin, J., Morris, M. E., Marigliani, C., Baker, F. A., & Vogel, A. P. (2019). ParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson’s Disease. Neurorehabilitation and neural repair, 33(6), 453–463. https://doi.org/10.1177/1545968319847948
Yanpei Zheng, Zhaoli Meng, Xiao Zhi, Zhanghua Liang (2021) Dual-task training to improve cognitive impairment and walking function in Parkinson’s disease patients: A brief review. Sports Medicine and Health Science, 4 (4) 202-206. https://doi.org/10.1016/j.smhs.2021.10.003.
Morris Ilene Berger, Vasudevan Erin, Schedel Margaret, Weymouth Daniel, Loomis Jay, Pinkhasov Tzvia, Muratori Lisa M.
Morris, I. B., Vasudevan, E., Schedel, M., Weymouth, D., Loomis, J., Pinkhasov, T., & Muratori, L. M. (2019). Music to One’s Ears: Familiarity and Music Engagement in People With Parkinson’s Disease. Frontiers in neuroscience, 13, 661. https://doi.org/10.3389/fnins.2019.00661