Learning to play a musical instrument could improve cerebral palsy (CP) patients’ hand movement and strengthen their sensorimotor skills, researchers said in the journal Neural Plasticity.
Conventional CP rehabilitation does not engages the entire brain like playing an instrument, but few studies have explored the idea, researchers from Technical University of Munich wrote in the report, “The Case for Musical Instrument Training in Cerebral Palsy for Neurorehabilitation.“
In their review, the researchers argued that, because CP is caused by a non-progressive brain injury, rehabilitation programs that harness the plastic potential of the brain are likely to offer long-term benefits. They called for more experimental studies to explore musical training.
Studies have shown CP patients often have structural brain changes in regions that deal with sensations and movement. Brain scans show children with CP do not react well to touch, and their brains are less active during tests in which they must discriminate between objects based on sensation.
The researchers said musical training has many attributes that make it ideal for movement and sensorimotor rehabilitation. In addition to the need for hand and finger coordination, playing an instrument requires that movements be synchronized with auditory, visual, and sensory information.
That, in turn, involves neural signaling to and from muscles, as well as between different parts of the brain and spinal cord.
Music has been used before in CP rehabilitation programs — to help patients develop a more symmetrical or balanced gait, or to promote relaxation and motivation — but not often for working on hand movements.
In one of the few studies to assessed that, five adults with CP who trained twice a week for six to 12 weeks were able to improve their playing speed on MIDI keyboards to levels close to controls.
Another study let 18 children and adolescents, ages 6 to 16, receive individual piano training for 18 months. The study showed that the variability of their keystroke timing was reduced. Furthermore, connections between the patients’ cerebellum and primary motor cortex — the main region of the brain that deals with movement — improved, compared to those who received conventional therapy.
The researchers behind the review said musical therapy’s benefits likely extend beyond the nerve pathways that deal directly with movement. Because playing an instrument engages the entire central nervous system, they argued that such training would likely impact sensorimotor interactions, leading to coordinated motor responses.
Patients vary greatly in the symptoms they display and the underlying brain damage, so personalized training is likely to have the greatest benefit, the researchers said.
“Individualized training that takes into account the specific impairments and development stage of each patient, as well as the individual training period required for plastic changes to occur, may in this case be advised in order to maximize benefit,” they wrote.
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