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Objective Patients with Parkinson's disease (PD) frequently experience depression associated with voice problems. Singing involves the use of similar muscles and the neural networks associated with vocal function and emotional response. The purpose of this study is to enhance vocal quality and depressive symptoms of patients with PD using individual singing program. Methods The Individual Therapeutic Singing Program for PD (ITSP-PD) was conducted by a certified music therapist. In total, nine PD patients with a subjective voice problem or depression participated in 6 sessions over 2 weeks. We measured the Maximum Phonation Time (MPT) via the Praat test, the Voice Handicap Index (VHI), the Voice-Related Quality of Life (V-RQOL) and the Geriatric Depression Scale (GDS). Results In total, 8 out of 9 patients completed all the sessions; 6 out of 8 patients participated in the follow-up test after 6 months. A statistically significant change in MPT (p = 0.011) was observed between the pre- and post-tests. The VHI (p = 0.035) and the GDS (p = 0.018) were significantly lower in the post-test. In the pre-, post-, and follow-up tests, the MPT (p = 0.030), V-RQOL (p = 0.008), and GDS (p = 0.009) were significantly changed. Conclusion The ITSP-PD based on neurological singing therapy for PD showed therapeutic possibility for vocal function and depression in patients with PD. Our findings suggest the need for a randomized study to examine the continuing positive effects of the ITSP-PD over a longer period of time. more...

This study measured surface electromyography of the biceps brachii and triceps brachii during repeated drum playing with and without a drumstick to better understand activation of the upper arm muscles and inform the use of instrument playing for motor rehabilitation. A total of 40 healthy college students participated in this study. All participants were asked to strike a drum with their hand and with a drumstick at three different levels of stroke: soft, medium, and strong. The stroke order was randomly assigned to participants. A sound level meter was used to record the intensity of the drum playing. Surface electromyography signals were recorded at every hit during drum playing both with and without the drumstick in each of the three stroke conditions. The results demonstrated that the highest muscle activation was observed in both biceps brachii and triceps brachii with strong drum playing with and without the drumstick. A two-way repeated measures analysis of variance showed that there was a significant main effect for stroke intensity in muscle activation and produced sound level. While higher activation of the triceps brachii was observed for drum playing without a drumstick, no significant differences were found between the biceps brachii and sound level. This study demonstrated via surface electromyography data that greater muscle activation of the biceps brachii and triceps brachii does not occur with the use of drumsticks in drum playing. With the drum sound controlled, drum playing by hand can be an effective therapeutic intervention for the upper arm muscles. more...

Background While a number of studies have tested the therapeutic effectiveness of playing musical instruments, such as the electronic keyboard using Musical Instrument Digital Interface (MIDI), it is still unclear whether outcomes of electronic keyboard playing are related to hand function tests. Objective The purpose of this study was to investigate the correlation between MIDI-keyboard playing and hand function tests, including grip strength, Box and Block test (BBT), and Jensen-Taylor Hand Function Test (JTHF). Methods A total of 66 stroke patients were recruited from medical centers and were classified into acute (n = 21), subacute (n = 28), and chronic (n = 17) recovery stages. The participants' mean age was 60.5 years. The MIDI-keyboard playing protocol based on sequential key pressing was implemented. All hand function tests were performed by certified occupational therapists. Results MIDI scores from participants at all three recovery stages were significantly correlated with BBT and grip strength. Overall, MIDI-keyboard playing scores demonstrated moderate to high correlations with hand function tests except for participants at the chronic stage and the JTHF, which showed no correlation. Conclusions These findings suggest that MIDI-keyboard playing has great potential as an assessment tool of hand function, especially hand dexterity in acute and subacute stroke patients. Further studies are needed to refine the specific keyboard playing tasks that increase responsiveness to traditional hand function tests. more...

The purpose of this study is to examine the effects of Therapeutic Instrument Music Performance (TIMP) for fine motor exercises in adults with cerebral palsy (CP). Individuals with CP (n = 5) received a total of twelve, 30-min TIMP sessions, two days per week for six to nine weeks. Pre- and post-Music Instrument Digital Interface (MIDI) data were used as a measure of hand function. Pre-velocity was significantly different from the normative data obtained from typical adults (n = 20); however, post-velocity did not yield significance, specifically in the second and fifth fingers, indicating improvement in hand function for the adults with cerebral palsy. The finding implies that TIMP using keyboard playing may effectively improve manual dexterity and velocity of finger movement. Based on these results, future program development of instrumental playing for adults with CP is called for to enhance both their independent living skills and quality of life. more...

Although instrument playing-based training has been repeatedly reported to improve functional hand movements including grasping, the attempts to present quantitative information on physiological mechanism of grasping have been relatively insufficient to determine the type and the intensity of the exercises involved. This study aimed to examine the muscle activation during hand percussion playing depending on the grasping type and the playing tempo. A total of twelve healthy older adults with a mean age of 71.5 years participated in this study. Surface electrodes were placed on three grasping-related muscles: Flexor digitorum superficialis, extensor digitorum, and flexor pollicis brevis. Participants were instructed to play with the egg shaker, paddle drum mallet and clave involving different types of grasp at three different tempi (i.e., 80, 100, and 120 bpm) and sEMG data were collected during each playing. Significantly greater muscle activation was generated with the small sphere type of egg shaker, compared to the handle type of paddle drum mallet and the small cylinder type of clave. Playing at faster tempo also elicited significantly greater muscle activation than at slower tempo. With regard to the rise time of muscle activation, while tempo significantly affected the rise time, the time to peak muscle did not significantly change depending on the grasping type. This study confirmed that grasping pattern and the tempo of movement significantly influence the muscular activation of grasping involved in instrument playing. Based on these results, clinical implication for instrument selection and structured instrument playing would be suggested. more...

Background As a sequential, programmed movement of fingers, keyboard playing is a promising technique for inducing execution and a high level of coordination during finger movements. Also, keyboard playing can be physically and emotionally rewarding for adolescents in rehabilitation settings and thereby motivate continued involvement in treatment. Objective The purpose of this study is to evaluate the effects of keyboard playing using Musical Instrument Digital Interface (MIDI) on finger movement for adolescents with brain damage. Methods Eight adolescents with brain damage, ages 9 to 18 years (M = 13 years, SD = 2.78), in physical rehabilitation settings participated in this study. Measurements included MIDI keyboard playing for pressing force of the fingers and hand function tests (Grip and Pinch Power Test, Box and Block Test of Manual Dexterity [BBT], and the Jebsen Taylor Hand Function Test). Results Results showed increased velocity of all fingers on the MIDI-based test, and statistical significance was found in the velocity of F2 (index finger), F3 (middle finger), and F5 (little finger) between pre- and post-training tests. Correlation analysis between the pressing force of the finger and hand function tests showed a strong positive correlation between the measure of grip power and the pressing force of F2 and F5 on the Grip and Pinch Strength Test. All fingers showed strong correlation between MIDI results and BBT. For the Jebsen Taylor Hand Function Test, only the moving light objects task at post-training yielded strong correlation with MIDI results of all fingers. Conclusions The results support using keyboard playing for hand rehabilitation, especially in the pressing force of individual finger sequential movements. Further investigation is needed to define the feasibility of the MIDI program for valid hand rehabilitation for people with brain damage. more...

The development of music therapy in Korea has been rapid as any other nation in Asia. Music therapy curriculum was first established in 1997 at the graduate level, and the educational and clinical trainings have become strong. Among many reasons, the main one is that the trained music therapist from U.S., Europe, and Australia have returned, contributed their expertise and incorporated insightful ideas to the music therapy program. Music therapy is an attractive field, with lots of spot light and vision. However, music therapists should work out some of the intra-discipline issues on the professional and educational/training, in order to facilitate further development of music therapy. Among many issues, I would like to articulate a few. more...