Chapter 16 - The impact of music interventions on motor rehabilitation following stroke in elderly

Abstract

Motor skills tend to deteriorate with age, due to muscular wasting, degradation of sensory organs, for example, vision impairment, and changes in the biomechanics of fibrous tissues, joints, and tendons with resulting stiffness. Physiological age-related apoptosis and neurodegeneration of sensory–motor systems induce numerous degradations of neurobiological processes at all levels of the central and peripheral nervous system. This also leads to cognitive decline, including reduced executive function and memory capacity, that additionally impacts motor behavior. However, activities supporting lifelong neuroplasticity, such as making music, may counteract these processes and allow for reacquisition of motor and cognitive skills in elderly following brain tissue damage after stroke. In this chapter, we first outline how musical activity promotes behavioral benefits based on central nervous adaptations related to brain plasticity. We then focus on supposed neurobiological mechanisms underlying these beneficial effects and review the potential of music-supported therapy in restoration of motor skills in seniors suffering from deterioration of motor function following stroke. Keyboard playing may improve fine motor functions along with neurophysiological changes in audiomotor networks. Rhythmic cueing has a positive effect in gait disorders, improving stride length, speed, and overall mobility. Melodic intonation therapy can improve recovery from nonfluent aphasia via activation of right hemispheric networks. Finally, the rewarding effects of music making and listening provoking neurochemical effects, in combination with music-induced brain plasticity, may strongly facilitate neurorehabilitation.