Neurologic music therapy in multidisciplinary acute stroke rehabilitation: Could it be feasible and helpful?

ABSTRACT

Background: There is increasing evidence for music-based interventions in neurorehabilitation, improving mood and functional outcomes. In response, there is growing interest from health-care providers in setting up Neurologic Music Therapy (NMT) services. This paper presents some preliminary data on the feasibility and acceptability of NMT in the acute stroke, multidisciplinary team setting, about which little is known.

Objectives: To assess the feasibility and acceptability of a two-day per-week NMT service over 24 months.

Methods: Data were collected on the number of referrals received, sessions attended, sessions declined and reasons why. Staff completed questionnaires, and collected them from patients and their relatives, rating interventions: 1. Not helpful, 2. Quite helpful, 3. Helpful, 4. Very helpful. Patients completed the Visual Analogue Mood Scale (VAMS) pre-/post- a single session.

Results: Of 201 patients referred, 177 received treatment and 675 sessions were delivered. Twenty-four patients were discharged before sessions were scheduled and 28 sessions were declined, predominantly due to fatigue. Mean scores (SD) from questionnaire data were: patients (n = 99) 3.34 (0.825), relatives (n = 13) 3.83 (0.372), staff (n = 27) 3.85 (0.388). Mean, post-session VAMS data (n = 52) showed a non-significant reduction in ‘Sad’ (7.5, p = .007, CI = 2.1, 12.9) and an increase in ‘Happy’ (+ 6.2, p = .013, CI = −11.0, −1.4).

Conclusions: Data suggest the service was feasible and helpful, particularly for patient mood, possibly improving engagement in rehabilitation. Research to determine generalizability in different stroke environments and treatment effects within them is warranted.

KEYWORDS:

• Acute stroke
• neurorehabilitation
• Neurologic Music Therapy
• feasibility
• acceptability
• mood

Acknowledgments

The lead author would like to acknowledge the auditing team, music therapists from the Royal Hospital for Neurodisability, London, Dawn Loombe, and the CUH speech therapy team for their advice on designing the questionnaires and information booklets for patients; Professor Wendy Magee for her advice on data collection and the use of mood scales; Katie Cummins for initiating the project and funding actions, Helen Palmer, Deborah Stanton, Julie Rycarte, and Caroline Parr for giving momentum to the setting up of the project and support for its duration; all staff, patients and relatives for their feedback and enthusiasm. Felicity Alwell and Professor Helen Odell-Miller from the Cambridge Institute for Music Therapy Research for their support throughout.

Author contributions

Service delivery and data analysis: Alex Street; helping with procedures in the acute inpatient setting: Helen Palmer; data collection and writing: Alex Street, Helen Palmer, Susan Pethers, Katie Bond and Lydia Wiffen; data analysis: Jufen Zhang

Disclosure statement

The authors declare no potential conflict of interest.

Additional information

Funding

The project was funded by the Addenbrooke’s Charitable Trust, including the purchase of all instruments and equipment.