Music therapy and cognitive rehabilitation: Screening of music cognition in adult patients with right hemisphere stroke.

Abstract

Camila F. Pfeiffer and Liliana R. SabeNeurologic Rehabilitation Center FLENI Escobar, Buenos Aires, ArgentinaCamila F. Pfeiffer and Liliana R. Sabe, Music Therapy Department and Department for Cognitive Neurology, Neuropsychology and Neuropsychiatry, Neurologic Rehabilitation Center FLENI, Escobar City, Argentina.Correspondence concerning this article should be addressed to Camila F. Pfeiffer, Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia - Music Therapy, Ruta 9, KM53, Escobar, Argentina. E-mail: cpfeiffer@fleni.org.arCognitive disorders are common consequence of stroke. Impairments of orientation, attention, concentration, velocity of information processing, memory, spatial perception, executive functions, and psychosocial behavior have important functional consequences for stroke survivors. As such, a negative impact on learning processes and rehabilitation outcomes is common, independent of the effect of physical impairment (Barker-Collo, Feigin, Lawes, Parag, & Senior, 2010; Hackett, Yapa, Parag, & Anderson, 2005; Patel, Coshall, Rudd, & Wolfe, 2003; Tatemichi et al., 1994). Thus, everyday functioning can be severely limited and compromise personal safety and independency (Lees, Fearon, Harrison, Broomfield, & Quinn, 2012). Cognitive disorders can negatively affect the usefulness and generalization of rehabilitation strategies, which are necessary to achieve the best possible level of independence and enable reintegration into society and work life-the main goal of rehabilitation.In rehabilitation settings, music therapy has been used to address the functional recovery of patients who suffer from neurologic conditions. Music therapy is an evidence-based practice carried out by a qualified music therapist, commonly functioning as part of a multidisciplinary team. It can be offered in individual, group, and interdisciplinary settings. Music therapists commonly work with patients with hemiparesia, aphasia, neglect, amnesia and attention disorders, breathing and voice disorders, consciousness disorders, balance, gait and fine motor skill disorders, and affective or behavioral disorders, among others. In the past, many music therapists have specialized in neurologic music therapy (NMT), a systematic and researched-based treatment method developed to improve cognitive, communication, and sensorimotor disorders through music. Neurologic music therapists are trained to assess patients' individual needs and to select or design goal-directed interventions to stimulate and recover brain functions involved in movement, cognition, speech, sensory perceptions, emotions, and social behavior. NMT techniques are grounded on a neurobiologic understanding of how music affects the human nervous system and are designed to address specific symptoms caused by neurologic diseases.For example, singing, vocal, and breathing exercises are applied to treat respiration, voice, and speech impairments such as decreased loudness, short phonation time, or a monotonous voice, commonly caused by Parkinson disease, stroke, traumatic brain injuries (TBIs), spinal cord injuries, congenital disorders such as a cleft palate or abnormalities of the vocal apparatus (Baker, Wigram, & Gold, 2005; Haneishi, 2001; Tamplin & Grocke, 2008). Melodic intonation therapy has been proven to be effective in aiding recovery of language production of patients with nonfluent aphasia (Norton, Zipse, Marchina, & Schlaug, 2009; Tomaino, 2012). Rhythm takes a predominant role in motor rehabilitation due to its impact on the auditory-motor system. In speech fluency disorders such as stuttering or dysarthria, pulsed signals or rhythmic patterns can acoustically cue speech production and enhance speech rate control. Here, recovering temporal characteristics of speech such as fluency, articulatory rate, and intelligibility is the main therapeutic goal (Mainka & Mallien, 2014; Van Nuffelen, De Bodt, Vanderwegen, Van de Heyning, & Wuyts, 2010). …