Alicia Ann Clair

The effects of music therapy on engagement in family caregiver and care receiver couples with dementia.

The purpose of this study was to examine the effects of caregiver-implemented music applications on engagement with their care receivers. Eight couples participated individually in a series of sessions, where a music therapist trained and cued the caregivers to implement a music application of choice. Changes in engagement frequency over a series of five sessions was highly statistically significant. The authors conclude that music therapy applications are effective in increasing mutual engagement in caregiving and care receiving couples with dementia, and that caregivers can effectively facilitate the engagement using music. Furthermore, once the engagement is established, it carries over into visitation without music.

THE EFFECT OF RHYTHMIC AUDITORY STIMULATION (RAS) ON PHYSICAL THERAPY OUTCOMES FOR PATIENTS IN GAIT TRAINING FOLLOWING STROKE: A FEASIBILITY STUDY

Adults aged 55 to 80 years participated voluntarily in a wait-list control study during in-patient physical therapy following first stroke. All participants (N = 15) received conventional physical therapy gait training throughout 30 treatment sessions. Rhythmic auditory stimulation (RAS)-enhanced gait training was nested within conventional treatments in three conditions: (1) RAS throughout 30 treatments (N = 5); (2) RAS in the last 20 treatments (N = 5); and (3) RAS in the last 10 treatments (N = 5). Cadence and balance outcome measurements were taken at baseline, and following 10, 20, and 30 treatment sessions. Improvements across time were statistically significant in all conditions for one-limb stance, cadence, velocity, stride length, and posture head tilt with no statistically significant improvements for the Timed Up and Go Test and the Functional Reach Test. Statistically significant gains were made in the one-limb stance and cadence with earlier implementations of RAS. Results of the study demonstrate the feasibility of RAS to enhance gait training that warrants further investigation of the protocol to demonstrate the effects of RAS in stroke rehabilitation.

Keeping the beat: Use of rhythmic music during exercise activities for the elderly with dementia

Involving people with dementia in group exercise activities often presents a challenge. The effects of a recorded instrumental musical accompaniment was evaluated on participation in a series of 14 exercise activities with a group of nursing home residents with dementia. All exercise sessions, specifically designed by physical therapists for older adults, were lead by an activity aide and consisted of a series of seated exercises. Direct observations of resident behavior were conducted over a 25-week period in a reversal experimental design. Results showed increased levels of participation during the experimental condition observations where rhythmic music accompanied the exercise activities. The music intervention was most successful on those generally most willing to participate in social activities.

Influence of aromatherapy on medication administration to residential-care residents with dementia and behavioral challenges

Thirteen older persons (seven men and six women) in residential care participated as subjects in this study. All participants had histories of confusion due to dementia and were identified by staff as being consistently resistant to medication administration as indicated by vocal outbursts, moving away, or physical combativeness. Subjects were exposed to four aroma interventions during medication administration: 1) lavender vera (lavendula officinalis); 2) sweet orange (citrus aurantium); 3) tea tree (malaleuca alternifolia); and 4) no aroma (control). All medication administrations were videotaped for later data collection. Observers were trained to record frequency and duration of resistive behaviors during medication administration in all four interventions for each subject. Reliability between two observers was extremely high. Results showed no statistically significant differences across all aroma conditions for either resistive behavior or duration of administration. Also, there were no statistically significant differences based on gender. This study indicates that aromatherapy does not reduce combative, resistive behaviors in individuals with dementia. Research with a larger sample in future studies may yield other results.

Assessment of active music participation as an indication of subsequent music making engagement for persons with midstage dementia

Persons with midstage dementia and in special care (N = 45) were assessed in groups by a music therapy practitioner to determine the level of engagement in a 15-minute protocol that included a five-minute segment for each of three music activity types—rhythm playing, exercising with music, and singing. Activity staff with little to no formal music training who were employed by the facility were taught to use the protocol to conduct eight subsequent activity sessions for small groups from which activity engagement data were collected for each subject. Results indicated the protocol was accessible and successful for indigenous activity staff, initial assessments were strong predictors of subsequent engagement, and participation levels were stable over time and across each of the three activities.

Brief In-Service Training in Music Therapy for Activity Aides: Increasing Engagement of Persons with Dementia in Rhythm Activities

Abstract This study analyzed the effects of a brief in-service training workshop designed to teach activity aides how to use music therapy techniques. Sixteen persons with dementia, living in a nursing home special care unit, served as the research participants. Results showed that training conducted with activity aides significantly increased resident engagement with rhythm instruments in both one-on-one interactions and in group activity situations. Similar increases were observed in residents with a range of cognitive impairments. These results suggest that this intervention offers a potentially promising approach that indigenous staff can use to engage residents with dementia in purposeful activities.

A Feasibility Study of the Effects of Music and Movement on Physical Function, Quality of Life, Depression, and Anxiety in Patients With Parkinson Disease

The purpose of this study was to determine the possible effects of an exercise program facilitated by auditory music cues on the motor function, balance, trunk flexibility, upper limb range of motion, self-perceived daily functioning, and self-perceived quality of life in persons with Parkinson diseases (PDs). Pretest and posttest measures for 7 participants resulted in significant improvements in mean Unified Parkinson’s Disease Rating scale (UPDRS) activities of daily living scores, the ‘‘Timed Up and Go’’ test, and trunk rotations to the right and left. It was concluded that the exercise program that includes musical cues for physical movements is feasible as an intervention to improve movement and quality of life in persons with PD. Although the study provides preliminary evidence for the feasibility of the music-facilitated exercise program, further research with a larger cohort is necessary to determine the long-term program outcomes.

Activity based Alzheimer care: A National Trining Program

Requests from Alzheimer Association chapters, the general public and subsequent focus groups from around the country articulated a strong need for a standardized, education and training curriculum for activity providers in programs for those who have dementia. The current practices for training and service delivery were defined, target audiences for training were determined, and content areas for growth and development were identified. A curriculum was developed and pilot tested with 285 activity providers in five locations across the country. An assessment for knowledge of content was administered before and after the curriculum was delivered at each site to determine curriculum effectiveness in content delivery. With a possible score of 30-points, a statistical comparison between the pilot pre-test (Mean = 22.888) and post-test (Mean = 25.044) revealed a significant difference at .000 level of confidence. Scores were higher after participation than before participation in the curriculum. Participants indicated that the curriculum met learning objectives either completely or reasonably well. The curriculum will be further refined and available for wide use in the near future.

Neural Processing of Emotional Musical and Nonmusical Stimuli in Depression

Background Anterior cingulate cortex (ACC) and striatum are part of the emotional neural circuitry implicated in major depressive disorder (MDD). Music is often used for emotion regulation, and pleasurable music listening activates the dopaminergic system in the brain, including the ACC. The present study uses functional MRI (fMRI) and an emotional nonmusical and musical stimuli paradigm to examine how neural processing of emotionally provocative auditory stimuli is altered within the ACC and striatum in depression. Method Nineteen MDD and 20 never-depressed (ND) control participants listened to standardized positive and negative emotional musical and nonmusical stimuli during fMRI scanning and gave subjective ratings of valence and arousal following scanning. Results ND participants exhibited greater activation to positive versus negative stimuli in ventral ACC. When compared with ND participants, MDD participants showed a different pattern of activation in ACC. In the rostral part of the ACC, ND participants showed greater activation for positive information, while MDD participants showed greater activation to negative information. In dorsal ACC, the pattern of activation distinguished between the types of stimuli, with ND participants showing greater activation to music compared to nonmusical stimuli, while MDD participants showed greater activation to nonmusical stimuli, with the greatest response to negative nonmusical stimuli. No group differences were found in striatum. Conclusions These results suggest that people with depression may process emotional auditory stimuli differently based on both the type of stimulation and the emotional content of that stimulation. This raises the possibility that music may be useful in retraining ACC function, potentially leading to more effective and targeted treatments.

The Effects of a Laban-Based Movement Program with Music on Measures of Balance and Gait in Older Adults

Abstract A group of 36 healthy older adults (Males = 10, Females = 26), who ranged in age from 63 to 86 years, participated in a movement program designed to enhance balance and gait characteristics. The program, designed by a Laban movement analyst, consisted of 14 movement sequences set to music especially composed to reflect the dynamics, rhythm, timing, and phrasing of the movements. After five weeks, individuals showed statistically significant increases in measures of balance and gait characteristics. For those persons (N = 7) who extended their involvement, improvements continued but were not statistically significant.