The effect of rhythmic auditory stimulation (RAS) on physical therapy outcomes for patients in gait training following stroke: a feasibility study.

Adults aged 55 to 80 years participated voluntarily in a wait-list control study during in-patient physical therapy following first stroke. All participants (N = 15) received conventional physical therapy gait training throughout 30 treatment sessions. Rhythmic auditory stimulation (RAS)-enhanced gait training was nested within conventional treatments in three conditions: (1) RAS throughout 30 treatments (N = 5); (2) RAS in the last 20 treatments (N = 5); and (3) RAS in the last 10 treatments (N = 5). Cadence and balance outcome measurements were taken at baseline, and following 10, 20, and 30 treatment sessions. Improvements across time were statistically significant in all conditions for one-limb stance, cadence, velocity, stride length, and posture head tilt with no statistically significant improvements for the Timed Up and Go Test and the Functional Reach Test. Statistically significant gains were made in the one-limb stance and cadence with earlier implementations of RAS. Results of the study demonstrate the feasibility of RAS to enhance gait training that warrants further investigation of the protocol to demonstrate the effects of RAS in stroke rehabilitation.

The effect of rhythmic auditory stimulation (RAS) on gait characteristics of cadence, velocity, and stride length in persons with late stage dementia.

Persons (N = 28) diagnosed with dementia in late stage who had locomotion Functional Independence Measure (FIM) ratings of l, total assistance required, and 2, maximal assistance required, participated as subjects. All participants were enrolled in a restorative ambulation program which was implemented in this study under 3 conditions: Rhythmic auditory stimulation in which metronomic beats were imbedded in music, rhythmic auditory stimulation which consisted of metronomic beats without music, and no auditory stimulus. Gait characteristics of cadence, velocity, and stride length were compared across the 3 conditions. No statistically significant differences were found, however, observation showed that assistive burden seemed less when both forms of rhythmic auditory stimulation were used. Further research is recommended to study the effects of RAS on care burden and continued ambulation throughout the disease trajectory.

Assessment of active music participation as an indication of subsequent music making engagement for persons with midstage dementia.

Persons with midstage dementia and in special care (N = 45) were assessed in groups by a music therapy practitioner to determine the level of engagement in a 15-minute protocol that included a five-minute segment for each of three music activity types--rhythm playing, exercising with music, and singing. Activity staff with little to no formal music training who were employed by the facility were taught to use the protocol to conduct eight subsequent activity sessions for small groups from which activity engagement data were collected for each subject. Results indicated the protocol was accessible and successful for indigenous activity staff, initial assessments were strong predictors of subsequent engagement, and participation levels were stable over time and across each of the three activities.

The effects of a movement with music program on measures of balance and gait speed in healthy older adults.

A group of 16 healthy older adults participated in a movement with music program to enhance physical flexibility, balance, and gait speed. The program, designed by a Laban Movement Analyst, consisted of 14 movement sequences set to music composed to reflect the dynamics, rhythm, timing, and phrasing of the movements. After 5 weeks, individuals showed statistically significant increases in measures of one-foot stance balance, gait speed, and functional reach. From the 5th to the 14th week, improvements continued in all measures but were not statistically significant.

The effects of music therapy on engagement in family caregiver and care receiver couples with dementia.

The purpose of this study was to examine the effects of caregiver-implemented music applications on engagement with their care receivers. Eight couples participated individually in a series of sessions, where a music therapist trained and cued the caregivers to implement a music application of choice. Changes in engagement frequency over a series of five sessions was highly statistically significant. The authors conclude that music therapy applications are effective in increasing mutual engagement in caregiving and care receiving couples with dementia, and that caregivers can effectively facilitate the engagement using music. Furthermore, once the engagement is established, it carries over into visitation without music.

Influence of aromatherapy on medication administration to residential-care residents with dementia and behavioral challenges.

Thirteen older persons (seven men and six women) in residential care participated as subjects in this study. All participants had histories of confusion due to dementia and were identified by staff as being consistently resistant to medication administration as indicated by vocal outbursts, moving away, or physical combativeness. Subjects were exposed to four aroma interventions during medication administration: 1) lavender vera (lavendula officinalis); 2) sweet orange (citrus aurantium); 3) tea tree (malaleuca alternifolia); and 4) no aroma (control). All medication administrations were videotaped for later data collection. Observers were trained to record frequency and duration of resistive behaviors during medication administration in allfour interventions for each subject. Reliability between two observers was extremely high. Results showed no statistically significant differences across all aroma conditions for either resistive behavior or duration of administration. Also, there were no statistically significant differences based on gender. This study indicates that aromatherapy does not reduce combative, resistive behaviors in individuals with dementia. Research with a larger sample in future studies may yield other results.