Kazoos are good for youse

All of the following links have to do with improving voice for PD folks, and also the use of kazoos.

I used to write for this student newspaper:

Music therapy helps tackle Parkinson’s (The Miami Hurricane July 5, 2019)

This is a fairly long honors project paper reviewing voice therapy techniques:

Voice Therapy Techniques in Combination with the Group Therapy Setting for Individuals withParkinson’s Disease

Not necessarily for PD, but the study used spectrographic analysis to measure the improvement in voice in addition to qualitative results.

Finger Kazoo: spectrographic acoustic modifications and vocal self-assessment

I might have already mentioned this in a previous entry, but kazoos were used:

Individual Therapeutic Singing Program for Vocal Quality and Depression in Parkinson’s Disease

Vocal warmups for the individual: Vocal warmups

Vocal warmups for the group: Anatomy of a choral warmup

 

I got rhythm, I got music…

Put together a slide presentation trying to synthesize some of the research on Parkinson’s Disease (PD) and the possibility of music, singing, playing musical instruments, and dance as means to counteract the progressive effects of dopaminergic neurons lost in the course of PD. Due to the length of the presentation and the limits of my computer resources, the narration seems to have gotten a little out of sync towards the end. But it is what it is, as they say: (note: added a PDF file of the presentation on 6-9-19 to make it easier to download and view)

Rhythm, Music, Singing, Dancing and the Brain

2019-06-05-Rhythm Music Singing and the brain  (PDF file)

and an even smaller file with all the blue and yellow intact (6-15-2019):

Rhythm Music Singing Dancing and the Brain

Dance, aerobic exercise and musical training

Today we have a couple of links to articles on the effects of dance and music:

Effects of Dance/Movement Training vs. Aerobic Exercise Training

Abstract only, but the results appear to be in favor of Dance Movement Therapy (DMT) as positive. Aerobic Exercise Therapy (AET) improved cardiovascular health, though, so both aerobic and dance movement therapies should be used for health.

Executive and non-executive composite scores showed a significant increase post-training (F(1,37)=4.35, p=.04; F(1,37)=7.01, p=.01). Cardiovascular fitness improvements were specific to the AET group (F(2,38)=16.40, p<.001) while mobility improvements were not group-dependent (10m walk: F(1,38)=11.67, p=.002; Timed up and go: F(1,38)=22.07, p<.001).
Results suggest that DMT may have a positive impact on cognition and physical functioning in older adults however further research is needed. This study could serve as a model for designing future RCTs with dance-related interventions.

Next, a short article on the effects of musical training on brain plasticity.

The-Effects-of-Musical-Training-on-Brain-Plasticity-and-Cognitive-Processes

The link between musical training and its effects on brain plasticity have been studied since the early 20thcentury neuroanatomy research of Ramon y Cajal. In recent decades, studies have observed the contributions of musical training in enhancing auditory, motor, and language processing areas of the brain. The ability of musical training to impact behavior and critical thinking skills may also open the door for new methods of combating age-and illness-related cognitive decline(emphasis added)

In conclusion, whether or not one has a neurodegenerative disease or not, it is good advice to do aerobic exercise for the heart, dance for the mobility, and learn or continue to play a musical instrument to keep the brain plastic and elastic and fantastic.

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Searching for the secret chord…

These came out of a search, so might have been previously covered in a post:

This review covers music performed in groups and is not directly related to Parkinson’s: Collaboration and improvisation

Music performance is inherently social. Most music is performed in groups, and even soloists are subject to influence from a (real or imagined) audience. It is also inherently creative. Performers are called upon to interpret notated music, improvise new musical material, adapt to unexpected playing conditions, and accommodate technical errors. The focus of this paper is how creativity is distributed across members of a music ensemble as they perform these tasks

This article does cover Parkinson’s – singing as a way to help with vocal issues and depression. Positive results, but not a randomized control type experiment, so conclusions are tentative:

Individualized singing program

Here’s an interesting experiment in which participants are asked to improvise music which reflects varied feeling states. Not sure how the results can be applied, except that creating music or dance/movement to express emotions is probably of benefit to the brains of people with Parkinson’s, regardless of the strength of the research.
Effects of music making

This study has gotten some wide distribution – on how musicians (people who play an instrument) react more quickly than people who do not. This article digest is from Science Daily (January 2017)

Play an instrument?

“fine” as they say on the sheet music.

Dance and exercise – a study and a publications review

Not much new here – more evidence that dance exercises and physical exercise in general, is beneficial for people with PD.

Shall We Dance – master’s thesis  by Brittni Lynn McAlister, University of North Colorado

 In the words of one participant, the dance classes have been “. . . completely life-changing.”

Systematic review of exercises for Parkinson’s

This review revealed that people with Parkinson’s disease viewed physical activity as an enjoyable and positive experience, which aided with control of their symptoms and enhanced their wellbeing and quality of life.

 

Almost let these references get away

Some recent articles about music and dance – thought I had already published this – it appears not. Either that, or I’m more cognitively impaired than I thought I was. If this keeps up, I’ll have normal intelligence:

Dopamine, Oxytocin, Serotonin, and Endorphins 

Acronym is DOSE, and it’s a short article talking about how dance is good for you because it releases several different hormones and neurotransmitters – and not just because it makes you feel good – but because it does….😎

Language of music and psychophysical foundations  

from the abstract: “Application of music in rehabilitation medicine requires an understanding of the mechanisms of music perception. This article discusses differences in character of the basic melodic elements and addresses some of the specifics of tonal space. Colloquially, music is called the language of emotion. Bearing in mind that high-level cognitive functioning in humans is inseparable from affective consciousness, investigating the mechanisms of emotional processing belongs to an important area of cognitive sciences. Studying music perception can help to advance methods of music therapy and to elucidate major aspects of human consciousness.(emphasis added)(Article is on ReseaechGate; membership(.

Drumming program to improve social interactions

Although the article is about subjects with autism spectrum disorder (ASD), I think that the results are likely to be replicable with or generalizable to Parkinson’s Disease folks.

results suggest that the children with ASD significantly improved in the domains of enjoyment and fun, and showed a positive trend for developing improved social relationships with peers and camp counselor partners.

 

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Music on the brain

Rhythmic Auditory Stimulation (RAS) and Argentinean Tango

Results: Results showed significant improvements in the Tinetti scale total (mean±SD of post-pre change: 5.3±2.8, p<0.01), gait (2.5±1.2 p<0.01), and balance scores (2.8±2.0 p<0.01). TUG also improved by 3.6±0.8 seg (p<0.01). Statistically non-significant changes were recorded in mobility, bodily discomfort, stigma, social support and cognition PDQ-39 domains, with Cohen’s d sizes of 0.5-0.6 and NNTs of 5-7.

Conclusion: RAS could be combined with Argentinean Tango. Positive effects on gait and balance were observed, together with a trend towards improvement in some quality of life domains. A randomized, blinded, controlled trial in a larger number of patients followed-up during a longer period is underway.

And this:Brief review of music and cognition

Given that the participants were not musicians, it can be inferred that the results of the research can be applied in other non-musical contexts, what we call “generalization” in cognitive rehabilitation, which means, non-musical gains can be transferred to daily activities. In this perspective Billhiartz et. al. (2000) argue that there is a link between musical instruction and development in non-musical skills.

… we agree that music is an important element in human life that can be used in many contexts. The musical activity is multisensorial, simultaneously integrating several systems, mainly the sensorimotor, cognitive, and affective, within a specific context, which consecrates in the sphere of embodied musical cognition.

An interview with Tom Moore

This is just a darn interesting interview with a musician and musicologist. You can’t make this stuff up.

 

Autism and Parkinson’s, and data-driven subtyping of PD

Found this reference to a study involving autistic children.
Since Parkinson’s is a movement disorder, it stands to reason that music would be beneficial to both groups as a therapy (and it is).
“Highlights
● A growing body of evidence suggests that motor impairments are frequently present in children with autism.
● Music therapy along with physical activity might benefit children with autism.
● We observed a significant difference between the experimental and control group after applying music therapy along with play therapy.
Plain Language Summary: Children with autism show motor impairments. Music therapy along with physical activity is a significant treatment in improving motor coordination. In this study, 30 children with autism were participated in 15 music therapy sessions. Music therapy are presented in two methods: (a) inactive one; listening to music and (b) active one; playing and rhythmic movements. Based on the results, motor coordination was achieved in the posttest.”
 
Directly related to Parkinson’s is this research paper on data-driven subtyping of PD:
“466 patients with idiopathic PD were investigated and three subtypes were identified. Subtype I (Mild Baseline, Moderate Motor Progression) is comprised of 43.1% of the participants, with average age 58.79 ± 9.53 years, and was characterized by moderate functional decay in motor ability but stable cognitive ability. Subtype II (Moderate Baseline, Mild Progression) is comprised of 22.9% of the participants, with average age 61.93 ± 6.56 years, and was characterized by mild functional decay in both motor and non-motor symptoms. Subtype III (Severe Baseline, Rapid Progression) is comprised 33.9% of the patients, with average age 65.32 ± 8.86 years, and was characterized by rapid progression of both motor and non-motor symptoms. These subtypes suggest that when comprehensive clinical and biomarker data are incorporated into a deep learning algorithm, the disease progression rates do not necessarily associate with baseline severities, and the progression rate of non-motor symptoms is not necessarily correlated with the progression rate of motor symptoms.”
 
In other words, everybody’s Parkinson’s journey is unique.

A couple of studies on gait improvement in PD, and a thesis on music therapy

What looked promising turned out to be fairly lackluster as far as results – although it appears that putting in time on a treadmill might be better for Parkinson’s patients than some other forms of exercise, when it comes to gait and balance. And challenging courses of treatment were recommended for people with PD.

Exercise and Parkinson’s – comparison

Background and Purpose: Impaired gait, balance, and motor function are common in Parkinson disease (PD) and may lead to falls and injuries. Different forms of exercise improve motor function in persons with PD, but determining which form of exercise is most effective requires a direct comparison of various approaches. In this prospective, controlled trial, we evaluated the impact of tango, treadmill walking, and stretching on gait, balance, motor function, and quality of life. We hypothesized tango and treadmill would improve forward walking and motor symptom severity, and tango would also improve backward walking, balance, and quality of life.
Results: In this study, treadmill walking improved forward and backward walking.

Healing Sounds: an anthropology of Music Therapy

explore embodiment, relationship – building and aesthetic creation as three areas n which music can allow the harnessing of affect towards health goals. I note music’s powerful affect on the human body and movement, and the ways in which these affects are mobilized towards specific clinical goals. I explore the various human –  to – human and human – to sound relationships that are mobilized, created or strengthened through music therapy interventions, and how they relate to health and to the affect of “becoming”. Finally, I note the strong evidence for musical and esthetic creation as a part of self – care, both by music therapists and by their clients, and argue for a broader understanding of how creativity impacts health, by allowing people to affect their environments

Exercise and Gait

Methods: Forty-seven PwPD (mean age: 73 years; 19 females, Hoehn and Yahr stages 2-3) who had participated in 10 weeks of highly challenging gait and balance training were included. Baseline demographics, disease-related factors, physical and cognitive ability, and perceived health were used for the prediction of percent change in balance performance (the Mini-BESTest) and comfortable gait speed between the pre- and postassessments, using multiple linear regression analyses.
Results: Thirty-five percent of the variance of change in balance performance was explained by General Health Perceptions (β = −0.36), the Timed Up and Go test (β = −0.33), and the single-task performance of a cognitive task (β = −0.24). Forty-nine percent of change in gait speed was explained by gait speed while performing a dual task (β = −0.46), dual-task interference while walking (β = 0.43), time to complete the Timed Up and Go test (β = −0.29), and percent error on a cognitive task (β = −0.25).
Discussion and Conclusions: The results may suggest that the PwPD with overall lower perceived health, functional mobility, and cognitive functions are the ones most likely to benefit from highly challenging and attention-demanding gait and balance training.

Advice to People with PD: Sing while you walk

Internal cueing improves gait more than external cueing in healthy adults and people with Parkinson disease 

Results indicate that internal cueing was associated with improvements in gait velocity, cadence, and stride length in the backward direction, and reduced variability in both forward and backward walking. In comparison, external cueing was associated with minimal improvement in gait characteristics and a decline in gait stability. People with gait impairment due to aging or neurological decline may benefit more from internal cueing techniques such as singing as compared to external cueing techniques.

The feasibility of singing to improve gait in Parkinson disease.

Abstract

Brain regions important for controlling movement are also responsible for rhythmic processing. In Parkinson disease (PD), defective internal timing within the brain has been linked to impaired beat discrimination, and may contribute to a loss of ability to maintain a steady gait rhythm. Less rhythmic gait is inherently less efficient, and this may lead to gait impairment including reduced speed, cadence, and stride length, as well as increased variability. While external rhythmic auditory stimulation (e.g. a metronome beat) is well-established as an effective tool to stabilize gait in PD, little is known about whether self-generated cues such as singing have the same beneficial effect on gait in PD. Thus, we compared gait patterns of 23 people with mild to moderate PD under five cued conditions: uncued, music only, singing only, singing with music, and a verbal dual-task condition. In our single-session study, singing while walking did not significantly alter velocity, cadence, or stride length, indicating that it was not excessively demanding for people with PD. In addition, walking was less variable when singing than during other cued conditions. This was further supported by the comparison between singing trials and a verbal dual-task condition. In contrast to singing, the verbal dual-task negatively affected gait performance. These findings suggest that singing holds promise as an effective cueing technique that may be as good as or better than traditional cueing techniques for improving gait among people with PD.