MUSIC THERAPY AND BACKGROUND MUSIC IN THE PHYSIOTHERAPY OF A PATIENT WITH NORMAL PRESSURE HYDROCEPHALUS

Abstract

Cognitive deterioration and gait balance disturbances are the core symptoms of idiopathic normal pressure patients with normal pressure hydrocephalus – NHP (J. Larson et al, 2021). The manifestations caused by NPH directly foul the patient’s autonomy. Rehabilitation in NPH and supervised physical exercise are important factors to improve patient’s functions (J. Rydja et al, 2021). Music therapy and background music have cognitive, psychosocial, behavioural, and motor benefits for people with neurological disorders. Various forms and genres of music can be engaging, emotional, physical, personal, social, persuasive, and music also promotes synchronization of movement (O. Brancatisano et al., 2020). The process of music therapy intervention was structured and designed according to American Music Therapy Association (2005) in a 3-step process of preparation, implementation, and evaluation. Background music and instrumental and movement music activities were aimed at relaxation and cognitive stimulation in a patient with NPH during physiotherapy. In instrumental activities three music instruments were used, two Orff instruments a tambourine, a rattle, and a plastic string resembling an accordion (made from recycled material) – to improve the range of movements, strength, endurance, and coordination of the upper limb bilaterally and to improve walking motor skills. Furthermore, we selected background music according to the patient’s taste and choice. The music genres in our sessions were electronic music, pop, and relaxing jazz: The music styles were Synth-pop, Ambient, Disco, Eurodance, Dance-pop and Relaxing jazz. A total of 5 music therapy sessions were held within two months. Each session lasted for 60 min. We observed the following changes in the patient: The mechanism of regulation of fine motor movements was affected in his upper arm bilaterally, and communication skills were also improved. The gross motor skills in upper arm improved bilaterally. The walking speed was more pronounced, and his submaximal performance distance was extended. During background music the patient myofascially relaxed – the spasticity began to subside, and music induced psychological and physical well-being on his emotional level.