What is Neurological Music Therapy (NMT)?
NMT is a model of music therapy, guided by research, to address functional changes for people with neurological disorders.
It involves a collection of techniques that use the perception, production and performance of music to stimulate, shape, and change movement dynamics, speech and language skills, and cognitive skills.
Who can benefit from NMT?
NMT can help improve the quality of life for those living with:
an Acquired Brain Injury (ABI) such as a haemorrhagic stroke
a Traumatic Brain Injury (TBI)
the elderly (especially those prone to falling)
and those living with a neurological condition that affects function or speech.
The purpose of NMT is to help the brain relearn, and the way in which it does this is by creating new neural pathways and bypassing the damaged area of the brain. Through these new pathways, the brain uncovers a new way to enable someone to perform a task such as speak or move.
NMT techniques to aid speech development
The musical properties of melody and rhythm immediately help the brain find new neural pathways to bypass the damaged areas of the brain.
Exercises may include sound warm ups. The client sings different sounds up and down the scale and using different rhythms. Then using a keyboard, the therapist can play different chords - each chord representing a word. When the chord changes, the client then changes the word. This allows the client to work on specific vocabulary, using well-known tunes from songs. This is especially effective in haemorrhagic stroke victims.
Oral Motor and Respiratory Exercises (OMREX) is a technique designed to enhance articulatory control, respiratory strength and the function of speech apparatus often with wind instruments. It uses a mixture of familiar music and improvisation, allowing the client to work on breath control and increase the duration of play, both of which play a vital role in speech development.
NMT techniques to aid walking ability
Rhythmic Auditory Stimulation (RAS) is a scientific walking technique that uses rhythm and musical cues as a facilitating stimulus for training optimum gait. Essentially, when someone links neurologically to a beat and tempo, it aids walking practice.
RAS uses strong, predictable rhythmic patterns to guide the sensori-motor movements required for walking. Predictable rhythmic structure allows the sensori-motor system to move ‘in sync’ with the beat.
Stroke patients have reported improved stride length and symmetry with RAS. Similarly, there is a reduction in falls in the elderly when using RAS as it increases muscle strength, gait and walking speed. It is all in the music.
Music with high beats per minute (BPM) promotes movement, good cadence and walking speed. Walking speed correlates with functional ability and balance confidence. BPM strongly correlates to step cadence, and therefore walking speed. Improved walking speed equates to improved balance.
Patterned Sensory Enhancement (PSE) exercises are often implemented for pre-prosthetic lower limb amputees. They isolate specific hip movements and promote development of greater hip control ensuring the stump remains straight, in a neutral position and preventing any compensatory actions. This helps prevent the client walking in an unnatural manner with their prosthetic.
NMT for core strength development
Therapeutic Instrumental Musical Performance (TIMP) exercises focus on reaching toward an instrument to:
challenge core strength
improve sitting balance skills
and extend range of movement.
The importance of NMT
These are just a handful of specific NMT techniques that enable Neurologic Music Therapists to support those living with neurological conditions, work towards achieving their functional goals.
NMT can be implemented as a stand-alone treatment but typically forms an integral part of a multidisciplinary team. In doing this, every aspect of the patient/clients rehab is enhanced.
NMT techniques help support:
speech and language therapy
and occupational therapy goals.
Implemented as a team effort, NMT serves to improve all rehab outcomes.
By Daniel Thomas, managing director at Chroma Therapies