Page 34 - NAMAH-Apr-2021

Namah Vol. 29, Issue 1, 24th April 2021

1. Rhythmic Auditory Stimulation (RAS) of exercises and higher compliances with
advocates the use of physiological effects home exercise programmes.
of auditory rhythm on a motor function to
improve and maintain control of movement 3. Therapeutic Instrumental Music Performance
in rehabilitation and development of patients (TIMP) advocates the engagement of Musical
with significant gait deficits due to neurological instrument playing, which requires an
impairment. FMRI studies described the effects interaction between the sensorimotor,
of external acoustic stimuli before and during auditory, and visual systems. Through this
the movements that lead to activation of dorsal technique, appropriate musical instruments
premotor areas which trigger and influence are selected for therapeutic exercise to enhance
the timing of movements, and focuses on functional hand movements, finger dexterity,
oscillatory movements such as gait and arm limb coordination, endurance, and strength.
swings. This technique is not only part of the In this technique, the instruments are not
treatment plan of PD patients but also very played in the traditional way but placed
effective and beneficial for improving gait in different locations as a target to practice
parameters in patients with Stroke, Traumatic movements for feedback and feed-forward
Brain Injury, Cerebral Palsy, Spinal cord interactions between the premotor areas of the
injuries, and Multiple Sclerosis, including cortex and auditory, along with engaging the
gait velocity, cadence, stride length, and gait cerebellum and the basal ganglia. Repetition is
symmetry. extremely important for learning and training
movements, TIMP exercises can give the
2. Patterned Sensory Enhancement (PSE) is opportunity to perform repetitive movements
a technique applied to non-biologically at various speeds and combinations, enhance
rhythmic movements such as arm and hand fine and gross motor skills. On the other
movements, functional movement sequences hand, through the appropriate placement of
like dressing or sit-to-stand transfers. This instruments to facilitate repetition, discrete
musical intervention uses the rhythmic, movements of the fingers, arms, and legs
melodic, harmonic, and dynamic-acoustical can be trained, and eventually, sequential
construct of music to provide temporal, movements of different limbs along with
spatial, and force cues for movement bilateral engagement of both the upper and
which are not very rhythmic by nature but lower extremities can be trained successfully.
which help to organise functional exercise,
movement patterns, and daily life activities. Conclusion
For successful rehabilitation of fine and gross
motor control of the upper extremities, high- Over the last three decades, a series of evidence-
intensity training with frequent repetition is based papers have set the foundation of
very important. PSE is not only helping the research in ‘Music and the brain’. These papers
patient through auditory structures to drive advocate Neurological Music Therapy as an
and enhance the movement, but also provides evidence-based therapy in the treatment of
an additional motivational component to neurological disorders. The hidden secrets
therapy through the incorporation of familiar of music therapy lie behind the science of
songs and music, resulting in more repetitions the use of rhythm and music as a tool in the

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