‘Moving on up, moving on out…nothing can stop me’

Elizabeth Winterburn and James Lea are part of an innovative collaboration in rehabilitation, using neurologic music therapy 

Elizabeth and James
Elizabeth Winterburn, neuro physiotherapist at Holywell Rehab Unit and James Lea, neurologic music therapist, at Chiltern Music Therapy

In 2019, Holywell Neurological Rehabilitation Unit, Watford, trialled an innovative three-month neurologic music therapy (NMT) pilot project.

Following the positive impact on patient outcomes, the unit secured 12 months of charitable trust funding for a weekly NMT day service for 2021-2022 with an emphasis on joint working and providing support for functional and psychosocial goals.

An example of how this research-based treatment modality supported function was seen with a 76 year old woman who had suffered a Right Middle Cerebral Artery Infarct, resulting in left hemiplegia and sensory changes affecting coordination of movements – that is, assistance of one was required to move from lying to sitting. 

From NMT’s three standardised clinical techniques, specific to the sensorimotor domain, Patterned Sensory Enhancement (PSE) was identified for her treatment plan. 

PSE uses the rhythmic, melodic, harmonic and dynamic-acoustical elements of music to provide temporal, spatial, and force cues for movements which reflect functional exercises for activities of daily living (ADLs).

PSE is broader in application than Rhythmic Auditory Stimulation (RAS) because it is applied to movements that are not rhythmical by nature, for example arm and hand movements, and functional movement sequences such as dressing or sit-to-stand transfers (Thaut et al. 1991). 

Following the introduction of the clinical protocols specific to PSE, the patient was able to move with supervision on the first attempt.

She was then able to utilise this within function and consequently was able to carry it over, without a metronome, after repeating it in therapy sessions outside of NMT.

‘Neurologic music therapy helped to rehab patients more effectively.

‘It helped my patients to aid communication, to improve mood and to engage in therapy which ultimately improved their independence and quality of life.’

NMT features 20 standardised clinical techniques for speech and language training, cognitive training and sensorimotor training. Each technique has a target population, clinical protocol and research base. 

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