One of the movements that can be worked on in the music therapy session is the sit-to-stand. This movement not only involves a large amount of muscular control, but also involves balance, making it difficult for persons who have motor impairments. This week we will look at a study of Patterned Sensory Enhancement (PSE) for the loaded sit-to-stand movement in children with Cerebral Palsy (CP). 

Peng et al (2010) studied 23 children (ages 5 – 12) with spastic diplegia who had the ability to stand independently. The children were suited with a weighted vest at their maximum load (heaviest possible for movement), which is used to strengthen muscles in the sit-to-stand movement. They used music composed by  music therapist and split the movement into two phases: 1) trunk movement to seat-off and 2) seat-off to sand. Data were recorded using infrared kinematics analysis. The conditions (music vs. no music) were randomized for the participants.

Results indicated that participants had significantly increased knee extensor power, smoother movement, and faster movement. These effects carried-over to the continuation phase, where participants completed the movement a few more times without music.

This study looks at the effect of musical cueing on a complex movement with a child population. This is pretty exciting because we have a lack of research with children and few studies on PSE to date.  This is a very well-written and clearly explained study. The researchers describe their protocol/music in such great detail that this study could easily be replicated based on the written description. They used an objective quantification of movement patterns (kinematics) and randomized the condition. Although the study size isn’t huge, 23 children is a nice size for an initial study on this topic.

Clinical implications:  This study really looks at music cueing for a movement – using the basic elements of music to better engage in a complex motor movement. This study not only shows evidence that music can improve this movement, but in my opinion, is a reminder to step back and look at how you are using music in therapy. Does the music accurately cue the movement alone, or are you having to give a lot of verbal directions throughout? Are there ways to better cue the client for a functional outcome? By reminding ourselves to examine how we use music, we can make sure that we are using this amazing tool to its fullest extent.

Reference:

Peng, Y-C, et al. (2010). Immediate effects of therapeutic music on loaded sit-to-stand movement in children with spastic diplegia. Gait Posture, doi:10.1016/j.gaitpost.2010.11.020